ASEPTIC MENINGITIS AS A RARE MANIFESTATION OF SAPHO SYNDROME

Abstract

Synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO) syndrome is characterized by multifocal aseptic osteomyelitis of an uncertain etiology. In 1987, it was first proposed as a unifying concept to describe the association between musculoskeletal disorders and various dermatologic conditions.1 Recently, we encountered a patient with SAPHO syndrome who exhibited aseptic meningitis and lower cranial nerve palsies. ### Case report. A 52-year-old woman was admitted to our hospital because of severe headache and a mild fever of 37.5°C. Her past and family histories were unremarkable; however, 2 months before admission, she felt some precordial pain and noticed eruptions on her palms and soles of her feet. On admission, her general condition was unremarkable. There were no palpable lymph nodes, though there were a few pustular eruptions on her palms and soles. On neurologic examination, she had no neurologic deficits except for mild neck stiffness. Brain CT and MRI results were normal. Her CSF showed a mild pleocytosis (101/mm3, 98% lymphocytes, 2% polymorphs), and slightly high protein (52 mg/dL) and normal glucose (58 mg/dL) levels. CSF culture was negative. PCR tests for herpes simplex virus and anti-varicella zoster virus antibody in the CSF were also negative. She was diagnosed with …