Tissue adhesive and postoperative allergic meningitis

Adhesives containing cyanoacrylate are used in many surgical procedures, including closure of skin wounds and reinforcement of intracranial aneurysm repairs. A 61-year-old woman developed fever, neck stiffness, and cerebrospinal fluid eosinophilia after an operation for an intracranial aneurysm. We suspected allergic meningitis due to a foreign substance. To detect the cause of this disorder, we did 2-day closed patch testing with the substances thought to be possible allergens. We recorded a positive reaction to methyl-2-cyanoacrylate, the main ingredient of Biobond, the tissue adhesive used in the surgery. This substance could have caused postoperative allergic meningitis.