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Metronidazole-Induced Aseptic Meningitis during Helicobacter pylori Eradication Therapy
- Sujoy Khan, MBBS;
- Basil Sharrack, MD, PhD; and
- W.A.C. Sewell, MBBS, PhD
- From Scunthorpe General Hospital, Scunthorpe, United Kingdom; Lincoln County Hospital, Lincoln, United Kingdom; and University of Lincoln, Brayford Pool, Lincoln, United Kingdom.
Background: Drugs can cause symptomatic meningitis with cerebrospinal fluid (CSF) abnormalities, such as neutrophilic pleocytosis, and increased CSF protein that mimic infection. Nonsteroidal anti-inflammatory drugs (NSAIDs) and antimicrobials are the most common causes of drug-induced aseptic meningitis.
Objective: To report a case of a patient who had 3 episodes of aseptic meningitis during eradication therapy for Helicobacter pylori infection.
Case Report: A 42-year-old man was admitted in July 2004, reporting headache, nausea, photophobia, and neck stiffness within 2 hours of taking lansoprazole (30 mg), amoxicillin (1 g), and metronidazole (400 mg) combination therapy. He had been diagnosed with viral meningitis on 2 previous occasions in 1991. He had been receiving regular proton-pump inhibitor therapy and had used metronidazole in 1996 without any ill effects. He had …
