Trimethoprim-sulfamethoxazole-induced aseptic meningitis.
We present a 46-year-old African-American man with AIDS who was admitted on two different occasions within three weeks for signs and symptoms of meningitis after using trimethoprim/sulfamethoxazole (TMP/SMX). TMP/SMX is primarily used for the treatment of pneumocystis carinii pneumonia prophylaxis in AIDS patients. Drug-induced aseptic meningitis (DIAM) is commonly seen with nonsteroidal anti-inflammatory drugs (NSAIDS), antibiotics (with TMP/SMX being the most frequently implicated), intravenous immunoglobulins and OKT3 antibodies. However, the implication of TMP/SMX inducing aseptic meningitis has been underreported to FDA/MEDWATCH program. This might be due to the fact that it has also been used to treat bacterial meningitis from organisms like Listeria monocytogenes, which is a common pathogen in the elderly and in infants. We reviewed the literature in an attempt to characterize the pattern and predictors of TMP/SMX-induced aseptic meningitis.
Wambulwa
Charles
C
Howard University College of Medicine, Washington, DC, USA.
Bwayo
Salome
S
Laiyemo
Adeyinka O
AO
Lombardo
Fredric
F
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D016907:Adverse Drug Reaction Reporting Systems; D000890:Anti-Infective Agents / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008582:Meningitis, Aseptic / Q000139:chemically induced* / Q000175:diagnosis; D008875:Middle Aged; D011020:Pneumonia, Pneumocystis / Q000188:drug therapy; D012307:Risk Factors; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000009:adverse effects*
D000890:Anti-Infective Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination