15 March 2012

Ibuprofen-induced meningitis

An interesting case history, published in Discover Magazine's Vital Signs feature in June of 2011.  Some relevant excerpts:
“John was hospitalized uptown four days ago,” she told me. “It started then just like it did tonight, with a headache and confusion.” The 
spinal tap done uptown had shown a high white blood cell count, indicative of infection, but all the cultures were negative. John had stayed in the ICU and gotten better overnight—a surprise for the uptown staff, who then diagnosed viral meningitis....

In a Vital Signs column in this magazine 17 years ago, infectious-disease physician Abigail Zuger described the conundrum of a young woman with recurrent meningitis. Hospitalized four times in a matter of months, the patient exhibited high fevers, delirium, and a stiff neck—all signs of life-threatening 
bacterial, septic meningitis. CAT scans were normal. Spinal taps revealed high white cell counts in the cerebrospinal fluid—usually a harbinger of severe infection—but bacterial and viral cultures grew nothing. The patient was becoming ill and then abruptly getting better. The fourth time, to general eye-rolling, a medical student was tasked with asking the woman for the umpteenth time whether she had taken anything, anything, prior to getting sick. He hit pay dirt: Advil...

No more than 100 cases of ibuprofen-induced meningitis have been reported in the 
literature. But you have to 
wonder, given that ibuprofen 
is practically in the drinking water, how many more mistaken cases of “viral meningitis” are out there.


  1. I have Idiopathic Intracranial Hypertension (a.k.a. Pseudotumor Cerebri) which essentially means my body overproduces cerebrospinal fluid to the extent that my brain is constantly being squashed.

    I've long known (and have been advised for years by my neurologist) that ibuprofen raises intracranial pressure - my painkiller of choice is paracetamol (acetaminophen? Sorry, I'm British, I hope that's the US name) or aspirin as the IC pressure hike from ibuprofen makes it pointless for me to take.

    On a similar note, caffeine - despite being a diuretic - also raises intracranial pressure. This may be why a couple of ibuprofen and a strong cup of coffee are such common hangover 'cures' - they both act to reverse the dehydration around the brain that gives the infamous alcohol-induced headache. (For myself, I've never experienced a hangover, alcohol actually makes me feel much much better than usual!)


  2. This is kind of scary because due to ongoing thoracic back pain, I've been pretty much living on Advil since before Xmas. Myotheraphy and Physiotherapy (including manipulation, dry-needling and taping) haven't helped much. I'm getting some relief from a chiropractor but still taking the Advil at least twice a day!

    1. Jen, I suspect the meningeal symptoms reflect a hypersensitivity response, rather than a dosage- or duration-related phenomenon. So if you've used the med with success and without meningeal side effects so far, you're unlikely to experience such in the future.

  3. I am not surprised by this.

    Some years ago I read in passing - and give it some credence - that Nutrasweet causes symptoms that appear to be Multiple Sclerosis.

    The reason I give it credence is that back in about 1985 I rad in Science magazine that Nutrasweet by its previous name Aspartame had been tested and shown to cause brain lesions. Immediately after that the name was changed to Nutrasweet and sales for Searle just kept going.

    Hardly a woman I know doesn't drink artificially sweetened soft drinks. I personally have only heard of women getting 'MS', and several of those over the years - but never a guy.

    [I myself choose to take my chances with sugar-sweetened soft drinks, if any - not those with high-fructose corn syrup, no matter how much it helps the US farmers.]

    With just those few pieces of info, I suggest that some cases of MS are not MS, but whatever brain lesions do. Along the same train of thought, brain lesions and the destruction of the myelin sheathe around nerves are similar in principle, so it may be that MS is the same thing as brain lesions, just on the nerves instead.

    ...Well, I guess I got that more or less correct. A quick look in Wikipedia started out with this:

    "Multiple sclerosis is a condition in which the CNS of a person present a special kind of distributed lesions (sclerosis) whose pathophysiology is complex and still under investigation."

    I had no idea that 'sclerosis' meant lesions. I knew there was a similarity, but not that they are the same thing.

    So that leaves the question if Nutrasweet IS causing MS, doesn't it?


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