{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T18:33:21Z","timestamp":1789842801060,"version":"4.0.1"},"reference-count":13,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T00:00:00Z","timestamp":1739923200000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Most cases of aseptic meningitis, or nonsuppurative meningitis, are caused by viruses or systemic diseases. Nonetheless, drug\u2010induced aseptic meningitis should be considered in the differential diagnosis, particularly with the recent use of antibiotics and nonsteroidal anti\u2010inflammatory drugs. We describe a case of meningitis associated with the use of Trimethoprim\u2010Sulfamethoxazole (TMP\u2010SMX) in a 72\u2010year\u2010old male with comorbidities. A 72\u2010year\u2010old male with a history of diabetes, hypertension, Parkinson's disease, benign prostatic hyperplasia, and a recent use of TMP\u2010SMX for a urinary tract infection (UTI) presented with altered mental status, neck rigidity, tachycardia, and a fever of 102.8\u00b0F. CT scan of the head and abdomen and chest x\u2010ray revealed no significant findings. Empiric treatment with ampicillin, vancomycin, acyclovir, and ceftriaxone was initiated after two failed attempts at lumbar puncture, resulting in the improvement of all symptoms except for altered mental status within 24\u2009h. Analysis of CSF, obtained via a successful subsequent lumbar puncture, was negative for microorganisms. The patient was labeled as a case of TMP\u2010SMX\u2010induced aseptic meningitis (TSIAM) due to the recent use of the drug for UTI. All the antibiotics and antivirals were discontinued, and all his symptoms resolved within 5\u2009days of presentation. TSIAM is a diagnosis of exclusion, and a low threshold of suspicion should be maintained when CSF microscopy and culture show no microorganisms. This case illustrates the significance of prompt recognition of TSIAM and highlights the importance of thorough history\u2010taking in preventing complications associated with drug\u2010induced aseptic meningitis, thereby improving patient outcomes.<\/jats:p>","DOI":"10.1002\/ccr3.70244","type":"journal-article","created":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T05:55:06Z","timestamp":1740030906000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Case of Trimethoprim\u2010Sulfamethoxazole Associated Aseptic Meningitis"],"prefix":"10.1002","volume":"13","author":[{"given":"Malik W. Z.","family":"Khan","sequence":"first","affiliation":[{"name":"Yale University School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdul","family":"Moeez","sequence":"additional","affiliation":[{"name":"Khyber Medical College  Peshawar Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sameen","family":"Farooq","sequence":"additional","affiliation":[{"name":"Montefiore Medical Center  New Rochelle NYC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Saeed","sequence":"additional","affiliation":[{"name":"Khyber Medical College  Peshawar Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1008-8275","authenticated-orcid":false,"given":"Salma","family":"Qudrat","sequence":"additional","affiliation":[{"name":"Khyber Medical College  Peshawar Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farishta","family":"Ali","sequence":"additional","affiliation":[{"name":"Montefiore Medical Center  New Rochelle NYC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faheemullah","family":"Khan","sequence":"additional","affiliation":[{"name":"Section of Cardiovascular Imaging, Diagnostic Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,19]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S425464"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.159.11.1185"},{"issue":"6","key":"e_1_2_13_4_1","first-page":"129","article-title":"A Case Report of Antibiotic\u2010Induced Aseptic Meningitis in Psoriasis","volume":"80","author":"Ko A. 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