Acute Meningoencephalitis

MENINGITIS from drug hypersensitivity is a rare phenomenon.1The, following case report illustrates the occurrence of severe aseptic purulent meningoencephalitis in a patient who had received prophylactic isoniazid therapy. Report of a Case A 27-year-old man was hospitalized on Jan 4, 1974, because of fever, chills, myalgia, arthralgia, nausea, vomiting, and severe generalized headache. In August 1973, pleuritic chest pain— thought to be of viral origin—developed. Results of a physical examination and a chest x-ray film were normal. An intermediate purified protein derivative test was again positive (10 mm of induration), as it had been since 1967. Prophylactic isoniazid therapy was initiated with a dose of 300 mg/day. After three days of treatment, fever, weakness, malaise, nausea, and vomiting developed. Findings of a physical examination and liver function studies were normal. When isoniazid therapy was discontinued, the patient rapidly recovered. In December 1973, while in good health and receiving