Related Experiment Video
Updated: Sep 19, 2025
Inducing Meningococcal Meningitis Serogroup C in Mice via Intracisternal Delivery
Published on: November 5, 2019
Agranulocytosis and Aseptic Meningitis Induced by Sulfamethoxazole-Trimethoprim
Alison A Bunnell1, Kimberly D P Hammer1,2,3, Regan R Miller1
1Fargo Veterans Affairs Health Care System, North Dakota.
Background:
Sulfamethoxazole-trimethoprim is an antibiotic that can cause rare and potentially life-threatening adverse effects. This case describes an immunocompetent patient who developed acute agranulocytosis complicated with aseptic meningitis after being prescribed sulfamethoxazole-trimethoprim.
Case Presentation:
A healthy 39-year-old male veteran presented to the emergency department with worsening left testicular pain and increased urinary urgency and frequency. The patient was diagnosed with left epididymo-orchitis and prescribed oral sulfamethoxazole-trimethoprim 800-160 mg every 12 hours for 30 days. Two weeks later, the patient returned to the emergency department with fever, headache, chills, and generalized body aches that led to hospitalization. It was discovered that he had not finished the full course of antibiotics due to symptoms resolution and had restarted the medication to finish the course of therapy. The patient was diagnosed with agranulocytosis and aseptic meningitis secondary to sulfamethoxazole-trimethoprim.
Conclusions:
This case highlights the rare potential for acute agranulocytosis in combination with aseptic meningitis following the use of sulfamethoxazole-trimethoprim in an immunocompetent patient.
Insights
Sulfamethoxazole-trimethoprim can cause rare adverse effects. An immunocompetent patient developed agranulocytosis and aseptic meningitis after taking this antibiotic.
Area of Science:
- Pharmacology
- Infectious Diseases
- Neurology
Background:
- Sulfamethoxazole-trimethoprim is a commonly prescribed antibiotic.
- It carries a risk of rare but severe adverse effects.
- This case focuses on an immunocompetent individual.
Observation:
- A healthy 39-year-old male presented with epididymo-orchitis.
- He was treated with sulfamethoxazole-trimethoprim.
- He later developed fever, headache, and body aches, leading to hospitalization.
Findings:
- The patient was diagnosed with acute agranulocytosis.
- Aseptic meningitis was also identified as a complication.
- Both conditions were secondary to sulfamethoxazole-trimethoprim use.
Implications:
- This case underscores the potential for severe hematologic and neurologic adverse events with sulfamethoxazole-trimethoprim.
- It highlights the importance of recognizing these rare complications, even in immunocompetent patients.
- Clinicians should maintain a high index of suspicion for drug-induced conditions when evaluating patients with these symptoms.
More Related Videos
Related Concept Videos
01:27Combined Effects of Drugs: Synergism
Such synergistic combinations...
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
01:27Acute Pyelonephritis I: Introduction
01:19Phase II Reactions: Sulfation and Conjugation with α-Amino Acids