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[Trimethoprim-sulphamethoxazole-induced meningitis]

L Poles1, E Theodor

  • 1Medical Dept. E, Beilinson Medical Center, Petah Tikva.

Harefuah
|June 16, 1996
PubMed

Insights

Recurrent aseptic meningitis can be caused by trimethoprim-sulphamethoxazole. Prompt drug withdrawal led to rapid symptom resolution, highlighting the importance of considering drug-induced meningitis in differential diagnoses.

Area of Science:

  • Neurology
  • Pharmacology
  • Infectious Diseases

Background:

  • Aseptic meningitis is often recurrent and challenging to diagnose.
  • Drug-induced meningitis is infrequently considered in the differential diagnosis.
  • Trimethoprim-sulphamethoxazole is a common antibiotic with potential adverse effects.

Observation:

  • A 74-year-old male presented with recurrent aseptic meningitis.
  • Symptoms mimicked bacterial meningitis, except for normal cerebrospinal fluid glucose.
  • Recurrence was linked to re-exposure to trimethoprim-sulphamethoxazole (Resprim).

Findings:

  • Extensive investigations including microbiological, serologic, and imaging studies were negative.
  • Cessation of trimethoprim-sulphamethoxazole resulted in rapid and complete resolution of symptoms.
  • Follow-up lumbar puncture confirmed normalization of cerebrospinal fluid parameters.

Implications:

  • Drug-induced meningitis should be considered in cases of recurrent aseptic meningitis.
  • Identifying and withdrawing the causative drug is crucial for patient recovery.
  • This case underscores the importance of a thorough drug history in meningitis workups.

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