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Aseptic meningitis: case report A 28-year-old woman developed aseptic meningitis during treatment with immune globulin for miller fisher syndrome (MFS). The woman, who was diagnosed with MFS secondary to influenza A infection, started receiving IV immune globulin 2 g/kg over five consecutive days. An improvement in her symptoms were observed; however, she experienced nausea and persistent headache. On the fourth day of therapy clinical examination showed mental slowing and nuchal rigidity. Control CSF studies showed increased protein levels and pleocytosis. Based on these findings and clinical presentation, she was suspected with immune globulin-induced aseptic meningitis, which was additionally supported by the delayed appearance of drug-induced dyshidrosis on her soles and palms following the immune globulin course [duration of treatment to reaction onset not stated]. The woman was treated with unspecified symptomatic therapy. Within 10 days of immune globulin treatment, a complete neurological recovery was observed. Follow-up CSF studies revealed lower pleocytosis and higher protein levels. After clinical recovery, electroneuromyography follow-up revealed a continuing aspecific decrease of F-waves persistence. Maldonado Slootjes S, et al. Intravenous immunoglobulin-induced aseptic meningitis in a patient with Miller Fisher syndrome. Acta Neurologica Belgica 120: 1015-1016, No. 803497206 4, 2020. Available from: URL: http://doi.org/10.1007/s13760-020-01389-0

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Reactions 22 Aug 2020 No. 1818