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June 20, 1980

Eosinophilic Meningitis Following Myelography

JAMA. 1980;243(23):2396-2397. doi:10.1001/jama.1980.03300490014009

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To the Editor.—  If the recently reported case of eosinophilic meningitis following myelography (242:2432, 1979) is only the third reported such case, it appears reasonable to report a fourth case.

Report of a Case.—  Our patient was a 32-year-old woman who had undergone an uneventful iophendylate injection (Pantopaque) myelogram and an L5-S1 diskectomy. Her postoperative course was uneventful until 30 days after the myelogram was performed. She then had an acute onset of headache and anterior thigh pain. She was afebrile and exhibited a positive Kernig sign, and the straight-leg raising test was normal bilaterally at 20 degrees. Analysis of CSF showed an elevated eosinophil count and an increased protein level (Table). Culture yields for bacteria, viruses, and fungi were all negative. Her blood sample showed a WBC count of 5,500/cu mm, with 45% segmented neutrophils, 6% eosinophils, and 49% lymphocytes. An unsuccessful attempt to remove a small amount of