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Sulfasalazine-induced aseptic meningitis.
Emily McHale1, Andrew Dermawan1, Raymond Tang2
1Department of General Medicine, G Block, Sir Charles Gairdner Hospital, Nedlands, WA, Australia.
Modern Rheumatology Case Reports
|July 10, 2026
Summary
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.
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