A diagnostic dilemma: drug-induced aseptic meningitis in a 45-year-old HIV-positive man

Int J STD AIDS. 2014 Mar;25(4):309-11. doi: 10.1177/0956462413501157. Epub 2013 Sep 2.

Abstract

We describe a case of aseptic meningitis following the administration of moxifloxacin in a 45-year-old man with human immunodeficiency virus (HIV). At presentation he was receiving tuberculosis treatment on a modified regimen following severe hepatotoxicity; this included moxifloxacin, started 8 days previously. Initial cerebrospinal fluid (CSF) analysis was grossly abnormal. Anti-viral and -bacterial treatments were started. All microbiological tests proved negative and his moxifloxacin was withheld resulting in a complete normalisation of CSF. Drug-induced aseptic meningitis is a diagnosis of exclusion and presents a serious diagnostic dilemma. The decision to withhold medication cannot be taken lightly.

Keywords: AIDS; Europe; HIV; antibiotic; aseptic meningitis; drug-induced; hypersensitivity; moxifloxacin; toxicity; viral disease.

MeSH terms

  • Anti-Bacterial Agents / adverse effects*
  • Anti-Bacterial Agents / therapeutic use
  • Aza Compounds / adverse effects*
  • Aza Compounds / therapeutic use
  • Fluoroquinolones
  • HIV Infections / complications*
  • Humans
  • Male
  • Meningitis, Aseptic / cerebrospinal fluid
  • Meningitis, Aseptic / chemically induced*
  • Meningitis, Aseptic / diagnosis
  • Middle Aged
  • Moxifloxacin
  • Quinolines / adverse effects*
  • Quinolines / therapeutic use
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Aza Compounds
  • Fluoroquinolones
  • Quinolines
  • Moxifloxacin