title: Recurrent trimethoprim-sulfamethoxazole-induced aseptic meningitis with associated ampicillin-induced myoclonic twitches .
abstract: OBJECTIVE
  To report a case of recurrent trimethoprim-sulfamethoxazole-induced aseptic meningitis with associated ampicillin-induced myoclonic twitches.
  
  
  METHODS
  The patient was investigated using cerebral computed tomography, magnetic resonance imaging, cerebrospinal fluid examination, and electroencephalography. Written informed consent was obtained from the patient for access to clinical files for research purposes and publication.
  
  
  RESULTS
  We present a middle-aged woman with two recurrent episodes of aseptic meningitis after treatment with trimethoprim-sulfamethoxazole. Additionally, she developed myoclonic twitches as a rare side effect of ampicillin.
  
  
  CONCLUSIONS
  Aseptic meningitis is a rare adverse reaction to medications like antibiotics. The pathogenesis of trimethoprim-sulfamethoxazole-induced aseptic meningitis is not yet completely understood, but an immune-mediated hypersensitivity reaction is suspected. If patients with an antibiotic therapy due to a systemic or local infection present with severe headache, not only common diagnosis of a parainfectious headache, but also antibiotic-induced aseptic meningitis should be considered. .
authors.forename: Anna L
authors.initials: AL
authors.lastname: Fisse
authors.forename: Katrin
authors.initials: K
authors.lastname: Straßburger-Krogias
authors.forename: Ralf
authors.initials: R
authors.lastname: Gold
authors.forename: Gisa
authors.initials: G
authors.lastname: Ellrichmann
mesh_terms: D000667:Ampicillin / Q000009:adverse effects*; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008582:Meningitis, Aseptic / Q000139:chemically induced* / Q000175:diagnosis; D008875:Middle Aged; D009207:Myoclonus / Q000139:chemically induced* / Q000175:diagnosis; D012008:Recurrence; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000009:adverse effects*
chemical_list: D000900:Anti-Bacterial Agents; D000667:Ampicillin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination