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Aseptic meningitis, hepatitis and cholestasis induced by trimethoprim/sulfamethoxazole: a case report

J A A van Asperdt1, R A De Moor2

  • 1Department of Paediatrics, Elisabeth-Tweesteden Hospital, Hilvarenbeekseweek 60, 5022 GC, Tilburg, The Netherlands. joycevanasperdt@gmail.com.

BMC Pediatrics
|August 17, 2021
PubMed
Abstract

Insights

Trimethoprim/sulfamethoxazole (TMP/SMX) can cause rare but serious side effects, including aseptic meningitis and liver injury. This case highlights the importance of considering drug reactions in pediatric patients presenting with these symptoms.

Area of Science:

  • Pediatric Pharmacology
  • Clinical Toxicology
  • Infectious Disease

Background:

  • Drug-induced aseptic meningitis is a rare adverse reaction, often linked to NSAIDs and antibiotics.
  • Trimethoprim/sulfamethoxazole (TMP/SMX), a common antibiotic, has been associated with serious side effects, including liver injury and aseptic meningitis.

Observation:

  • A 2.5-year-old Dutch girl developed both aseptic meningitis and drug-induced liver injury during TMP/SMX prophylaxis.
  • Cholestatic liver injury was treated with ursodeoxycholic acid.

Findings:

  • This is the first reported case of a young child experiencing both aseptic meningitis and drug-induced liver injury from TMP/SMX.
  • Full recovery occurred within weeks after discontinuing TMP/SMX.

Implications:

  • Clinicians must consider drug-induced aseptic meningitis and cholestatic hepatitis in patients presenting with these symptoms.
  • Awareness of these potential adverse drug reactions is crucial for timely diagnosis and management, especially in pediatric populations.
Keywords:
Aseptic meningitisCase reportDrug-inducedHepatitisTrimethoprim-sulfamethoxazole

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