Co-trimoxazole induced aseptic meningitis.

Pashankar, Dinesh S.; McArdle, Michael; Robinson, Andrea

doi:10.1136/adc.73.3.257

Cited by 15 publications

(3 citation statements)

References 5 publications

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“…Although high leukocyte count, normal glucose, and elevated protein CSF levels are usually observed in patients with aseptic meningitis, Matsuura-Otsuki et al 14 reported normal CSF findings of a patient with psoriatic arthritis who developed infliximab-associated aseptic meningitis. 15 Pashankar et al 16 also found normal CSF results in a child that presented with aseptic meningitis after co-trimoxazole treatment. It has been reported that many drugs lead to aseptic meningitis.…”

Section: Discussionmentioning

confidence: 93%

A case report of intracranial hypertension and aseptic meningitis: anti-tumor necrosis factor associated or juvenile idiopathic arthritis related

Akça¹,

Sokmen²,

Bolek³

et al. 2021

Turk J Pediatr

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Background. The adverse effects of tumor necrosis factor alpha inhibitors (TNFi) are well characterized but rare adverse events are increasing day by day. Case.We presented an 18-year-old girl with rheumatoid factor positive polyarticular juvenile idiopathic arthritis (JIA) who developed fever, headache, and nausea after the second dose of adalimumab. In addition to her suspicious complaints for meningitis, she had bilateral papilledema and partial abducens nerve palsy. Leptomeningeal contrast enhancement was noted in magnetic resonance imaging (MRI) of the brain. Brain MRI venography was normal. The cerebrospinal fluid (CSF) opening pressure was high but CSF analysis was normal. She was diagnosed with non-infectious subacute meningitis. Since brain biopsy was not performed, no definite distinction could be made between TNFi related aseptic meningitis or cerebral involvement of JIA. Due to the onset of neurological complaints after initiation of adalimumab treatment and rare cerebral involvement in JIA, the drug-associated aseptic meningitis was likely to be responsible in our patient. Adalimumab was discontinued and methylprednisolone followed by methotrexate treatment were initiated. Her symptoms resolved and control brain MRI was normal. Conclusion.Pediatric rheumatologists should be aware of this potentially severe side effect of anti-TNF treatment.

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Section: Discussionmentioning

confidence: 93%

A case report of intracranial hypertension and aseptic meningitis: anti-tumor necrosis factor associated or juvenile idiopathic arthritis related

Akça¹,

Sokmen²,

Bolek³

et al. 2021

Turk J Pediatr

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“…Many drugs have been associated with aseptic meningitis (Table 4 1,2,5,7–9 ), and the diagnosis is mainly one of exclusion. 1,2 The intensity of symptoms can vary and can appear anywhere from 4 hours to 4 months after the use of the drug.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, it is important to note the time of symptom onset with regard to the beginning of the drug therapy. 1,2,5,7,9…”

Section: Discussionmentioning

confidence: 99%

Possible Trimethoprim/Sulfamethoxazole-Induced Aseptic Meningitis

Therrien

2004

Ann Pharmacother

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The Challenge of Drug-Induced Aseptic Meningitis

Morís¹,

1999

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Several drugs can induce the development of aseptic meningitis. Drug-induced aseptic meningitis (DIAM) can mimic an infectious process as well as meningitides that are secondary to systemic disorders for which these drugs are used. Thus, DIAM constitutes a diagnostic and patient management challenge. Cases of DIAM were reviewed through a MEDLINE literature search (up to June 1998) to identify possible clinical and laboratory characteristics that would be helpful in distinguishing DIAM from other forms of meningitis or in identifying a specific drug as the culprit of DIAM. Our review showed that nonsteroidal anti-inflammatory drugs (NSAIDs), antibiotics, intravenous immunoglobulins, and OKT3 antibodies (monoclonal antibodies against the T3 receptor) are the most frequent cause of DIAM. Resolution occurs several days after drug discontinuation and the clinical and cerebrospinal fluid profile (neutrophilic pleocytosis) do not allow DIAM to be distinguished from infectious meningitis. Nor are there any specific characteristics associated with a specific drug. Systemic lupus erythematosus seems to predispose to NSAID-related meningitis. We conclude that a thorough history on prior drug intake must be conducted in every case of meningitis, with special focus on those aforementioned drugs. If there is a suspicion of DIAM, a third-generation cephalosporin seems a reasonable treatment option until cerebrospinal fluid cultures are available.

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Co-trimoxazole induced aseptic meningitis.

Cited by 15 publications

References 5 publications

A case report of intracranial hypertension and aseptic meningitis: anti-tumor necrosis factor associated or juvenile idiopathic arthritis related

A case report of intracranial hypertension and aseptic meningitis: anti-tumor necrosis factor associated or juvenile idiopathic arthritis related

Possible Trimethoprim/Sulfamethoxazole-Induced Aseptic Meningitis

The Challenge of Drug-Induced Aseptic Meningitis

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