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Drug-induced meningitis. A case involving trimethoprim-sulfamethoxazole
J G Wong1, S C Hathaway, J J Paat
1Division of General Internal Medicine, Duke University Medical Center, Durham, North Carolina.
Abstract:
Drug-induced meningitis should be considered in differential diagnosis of meningeal irritation in patients receiving therapy with anti-infective, nonsteroidal anti-inflammatory, immunosuppressive, or other selected agents. This report describes a case of aseptic meningitis associated with use of trimethoprim-sulfamethoxazole in a patient without apparent underlying autoimmune disease. The patient recovered promptly after the offending agent was withdrawn. No specific treatment other than symptomatic and supportive care need be given. In all instances, however, infection must be excluded.
Insights
Drug-induced meningitis is a rare but important diagnosis to consider. This case highlights aseptic meningitis caused by trimethoprim-sulfamethoxazole, emphasizing the need to exclude infection in such cases.
Area of Science:
- Neurology
- Pharmacology
- Infectious Diseases
Background:
- Drug-induced meningitis is a potential adverse effect of various medications.
- It is crucial to consider in patients presenting with meningeal irritation symptoms.
Observation:
- A case of aseptic meningitis was observed in a patient treated with trimethoprim-sulfamethoxazole.
- The patient had no identifiable underlying autoimmune conditions.
Findings:
- Discontinuation of trimethoprim-sulfamethoxazole led to prompt recovery.
- No specific treatment beyond symptomatic and supportive care was required.
Implications:
- Healthcare providers should include drug-induced meningitis in the differential diagnosis for meningeal irritation.
- Excluding infectious meningitis is paramount before attributing symptoms to medication side effects.