allopurinol and Meningitis--Aseptic

Allopurinol is an FDA -Approved xanthine oxidase inhibitor, which is effective in the treatment of gout, hyperuricemia and uremic kidney stones in patients with an increased level of uric acid excretion. Xanthine oxidase acts by converting hypoxanthine and xanthine into uric acid, and therefore its inhibition results in decreased production of uric acid. The most common side effects of this medication are as follows: maculopapular rashes, hives, itching, headache, dizziness, abnormal hair loss, fever and hypersensitivity reaction. Case Presentation: This report represents a case of drug-induced meningitis of a senile man who ended up in the ICU due to the remarkably reduced state of consciousness.

Topics: Aged; Allopurinol; Gout; Gout Suppressants; Humans; Male; Meningitis, Aseptic; Tomography, X-Ray Computed; Unconsciousness

Topics: Aged; Aged, 80 and over; Allopurinol; Antimetabolites; Female; Humans; Meningitis, Aseptic

Drug-induced aseptic meningitis is a syndrome with symptoms similar to those of infectious meningitis. A 60-year-old man with a history of recurrent renal stones was admitted to the hospital with fever, chills, and mental status changes after taking levofloxacin, allopurinol, and acetazolamide. No infectious source was identified. Once home, he resumed allopurinol, and within 2 hours, he experienced the same symptoms, requiring rehospitalization. He was diagnosed with suspected meningitis from an adverse drug reaction that we believe was due to allopurinol. It is important to remember, when all other causes are ruled out, that a patient's symptoms may be a drug-induced adverse effect. Drug-induced aseptic meningitis should be considered when patients with symptoms similar to those of infectious meningitis appear without infectious etiologies or cerebrospinal fluid pleocytosis, a suspected agent was recently started, and resolution of adverse effects occurs when the agent is withdrawn.

Topics: Allopurinol; Diagnosis, Differential; Enzyme Inhibitors; Humans; Kidney Calculi; Male; Meningitis, Aseptic; Meningitis, Bacterial; Middle Aged; Xanthine Oxidase

Topics: Allopurinol; Enzyme Inhibitors; Humans; Male; Meningitis, Aseptic; Middle Aged; Urinary Calculi; Xanthine Oxidase