Saya ingin tahu lebih banyak mengenai meningitis ini.
Umur berapa anak siap di suntik imun meningitis ini ?
Apakah ada efek samping dari imunisasi tsb ?
Terima kasih
Imelda Pasni wrote:
Aseptic meningitis after treatment with amoxicillinW Czerwenka, C Gruenwald, D Conen.
Department of Internal Medicine, Canton Hospital, CH-5001 Aarau, SwitzerlandThe development of aseptic meningitis has been associated with various
drugsfor example, non-steroidalanti-inflammatory drugs, ranitidine,
carbamazepine, vaccines against hepatitis B and mumps, immunoglobulins,
co-trimoxazole,and penicillin.1-5 We report a case of aseptic meningitis
after treatment with amoxicillin.A 76 year old woman was admitted to our hospital with fever, headache, and
neck stiffness. Five days before admission shehad had a pretibial wound
treated with amoxicillin-clavulanic acid. Long term treatment with aspirin,
enalapril, and levothyroxine(thyroxine) had not been changed in the
previous month. Two days before admission she had developed fever,
headache, andneck ache.On admission her general condition was poor, but findings on physical
examination were normal except for neck stiffness. Alllaboratory findings
were within the normal range. Cerebrospinal fluid showed pleocytosis with
63 cells (62 monocytes) and aslightly raised protein concentration of 0.47
g/l (0.15-0.45 g/l). No micro-organisms were found. She recovered with
treatment
of symptoms.>From her history we knew of two similar episodes in 1992 and 1995. Twelve
and 6 days respectively after the initiation ofantibiotic treatment with
amoxicillin (with and without clavulanic acid), she had been admitted to
our hospital with the same symptoms of fever, headache, and neck stiffness.
Cerebrospinal fluid had been examined during the first admission and also
showed pleocytosis with 40 cells (38 monocytes) without an increase in
protein concentration. No bacterial micro-organisms or serological signs of
neurotropic viral infections had been found.
On the basis of these three confirmed episodes of meningitis after
recurrent exposure to amoxicillin, with and without clavulanic acid, with
repetitive negative testing for viral, bacterial, and mycobacterial
micro-organisms, we diagnosed aseptic meningitis induced by amoxicillin. To
our knowledge, this is the first well documented publication of such a
severe side effect of a commonly used antibiotic.The exact mechanism for the development of aseptic meningitis induced by
drugs is not known, although hypersensitivity reactions and immunological
mechanisms have been suggested.5References
1. Weksler BB, Lehany AM. Naproxen-induced recurrent aseptic meningitis.
Drug Intelligence and Clinical Pharmacy 1991; 25: 1183-1184.
2. Dang CT, Riley DK. Aseptic meningitis secondary to carbamazepine
therapy. Clin Infect Dis 1996; 22: 729-730[Medline].
3. Durand JM, Suchet L. Ranitidine and aseptic meningitis. BMJ 1996; 312:
886.4. Sekul EA, Cupler EJ, Dalakas MC. Aseptic meningitis associated with
high-dose intravenous immunoglobulin therapy: frequency and risk factors.
Ann Intern Med 1994; 121: 259-262[Medline].
5. River Y, Averbuch-Heller L, Weinberger M, Meiner Z, Mevorach D,
Schlesinger I, et al. Antiobiotic induced meningitis. J Neurol Neurosurg
Psychiatry 1994; 57: 705-708[Abstract].------------------------------------------------------------------------
© British Medical Journal 1999
A second case of recurrent aseptic meningitis due to amoxicillin
Tony Reiman, Assistant Chief Medical Resident , Dalhousie Uinversity
eBMJ, 5 Jun 1999 [Response]A second case of recurrent aseptic meningitis due to amoxicillin
I recently admitted a 50 year old woman to the hospital with a 12 hour
history of fever, headache, nausea/vomiting and conjunctival injection. She
had recently been diagnosed with mitral regurgitation, and had been to the
dentist that morning. She had taken oral amoxicillin prior to her dental
cleaning as prophylaxis against endocarditis. Lumbar puncture on the night
of admission revealed a white blood cell count of over 600 white cells per
high power field, predominantly neutrophils, with a normal glucose level
and a protein level twice the upper limit of normal. Gram's stain and
culture of the CSF were negative, although the patient was initially
treated with antibiotics because of the high CSF neutrophil count. A repeat
lumbar puncture several days later revealed a modest pleocytosis with a
predominance of monocytes. This patient had two previous episodes of a
similar nature.
Two years previously, she had been admitted with aseptic meningitis that
followed the administration of amoxicillin for an upper respiratory tract
infection. One year prior to that, she had been diagnosed with a serum
sickness related to oral cefuroxime; in retrospect, it was clear that she
had received amoxicillin before developing this illness as well. The
patient was discharged home in good condition after bacterial meningitis
had been ruled out. I believe that this woman had an adverse reaction to
amoxicillin, just as your patient did. One of our junior residents
performed a computer search for other cases of amoxicillin-induced
meningitis, and tells me that one other case in Sweden has been reported
previously.7 June 1999
Tony Reiman,
Assistant Chief
Medical Resident
Dalhousie
UinversitySend response to journal:
Re: A second case of recurrent aseptic meningitis due to amoxicillinEmail Tony Reiman: [EMAIL PROTECTED]
Wassalam,
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