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Published on: July 1, 2018

Sulfasalazine-induced aseptic meningitis

Emily McHale1, Andrew Dermawan1, Raymond Tang2

  • 1Department of General Medicine, Sir Charles Gairdner Hospital, Nedlands, WA, Australia.

Modern Rheumatology Case Reports
|July 10, 2026
PubMed

Insights

Sulfasalazine can cause drug-induced aseptic meningitis, a rare condition characterized by meningeal inflammation. This case highlights the importance of considering sulfasalazine as a potential cause when meningitis symptoms appear after starting the drug.

Area of Science:

  • Neurology
  • Rheumatology
  • Pharmacology

Background:

  • Aseptic meningitis presents as meningeal inflammation without a clear infectious cause.
  • Drug-induced aseptic meningitis is a known adverse effect of various medications.
  • Sulfasalazine-induced aseptic meningitis is rarely reported.

Purpose of the Study:

  • To report a case of aseptic meningitis potentially induced by sulfasalazine.
  • To raise awareness among clinicians about this rare adverse drug reaction.

Main Methods:

  • A case report of a male patient in his 60s is presented.
  • Cerebrospinal fluid analysis revealed mononuclear pleocytosis, elevated protein, and normal glucose.
  • Cerebrospinal fluid testing excluded bacterial and viral meningitis.

Main Results:

  • The patient developed aseptic meningitis one month after initiating sulfasalazine for seronegative arthritis.
  • Cerebrospinal fluid findings were consistent with aseptic meningitis.
  • Symptoms resolved upon discontinuation of sulfasalazine.

Conclusions:

  • Sulfasalazine should be considered a potential cause of aseptic meningitis in patients presenting with relevant symptoms.
  • Early recognition and cessation of the drug can lead to symptom resolution.
Keywords:
DIAMDMARDSIAMSulfasalazinedrug reaction

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