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Trimethoprim associated aseptic meningitis
1Department of Drugs, University Hospital, Uppsala, Sweden.
Abstract:
We report 5 patients with repeated episodes of meningitis related to intake of trimethoprim containing compounds. On at least one occasion the patients received pure trimethoprim prior to reaction. Autoimmune disease was established in 3 of the patients. A close temporal relationship between drug intake and reaction was noted: symptoms appeared often within minutes. No evidence of infections was found. Lumbar puncture after recovery revealed normal values in 2 patients. This aseptic meningitis is most likely an adverse drug reaction and associated with trimethoprim intake. The reaction is infrequently reported in relation to drug sales but its incidence has probably been underestimated.
Insights
Trimethoprim-containing medications can cause recurrent aseptic meningitis, a likely adverse drug reaction. Symptoms appear rapidly after intake, and the condition
Area of Science:
- Pharmacology
- Neurology
- Immunology
Background:
- Trimethoprim is an antibiotic commonly used to treat bacterial infections.
- Recurrent meningitis is a serious condition requiring prompt diagnosis and management.
Observation:
- Five patients experienced recurrent meningitis episodes temporally linked to trimethoprim intake.
- Some patients received pure trimethoprim before the reaction.
- Three patients had established autoimmune diseases.
Findings:
- A close temporal relationship was observed, with symptoms appearing within minutes of drug intake.
- No infectious agents were identified, indicating aseptic meningitis.
- Lumbar punctures normalized after recovery in observed patients.
Implications:
- Aseptic meningitis is a probable adverse drug reaction associated with trimethoprim.
- The incidence of this reaction may be underestimated in clinical practice.
- Clinicians should consider trimethoprim as a potential cause of recurrent aseptic meningitis.