{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,7,23]],"date-time":"2023-07-23T01:40:27Z","timestamp":1690076427270},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"7-8","license":[{"start":{"date-parts":[[2021,12,15]],"date-time":"2021-12-15T00:00:00Z","timestamp":1639526400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,22]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>Trimethoprim-sulfamethoxazole-induced aseptic meningitis (TSIAM) is a rare adverse reaction to a commonly prescribed antibiotic. We describe a case of severe TSIAM which resembled septic shock. A 30-year-old male with relapsed Hodgkin\u2019s lymphoma 25\u2009days status post autologous stem cell transplant presented to our clinic for evaluation of trimethoprim-sulfamethoxazole (TMP-SMX) hypersensitivity. After review of patient\u2019s history and records, we had a low suspicion for a TMP-SMX adverse reaction and conducted an oral challenge to one 160 mg\/800 mg tab of TMP-SMX. Four hours later, the patient developed vomiting, lightheadedness, and disorientation with progression to rigors, fever, tachycardia, and hypotension. He was admitted for fluid resuscitation and broad-spectrum antibiotic coverage for neutropenic fever and possible septic shock. A lumbar puncture performed due to complaints of headache, photophobia, and neck pain showed 375 white blood cells\/\u00b5L with 73% neutrophil predominance, normal glucose (75\u2009mg\/dL), and elevated protein (101\u2009mg\/dL); additional cerebrospinal fluid (CSF) studies were negative for infectious etiologies. Fever and headache resolved by hospital day 4, at which time patient was discharged home. We believe this case represents TSIAM given the characteristic timing of symptom onset, CSF findings, and timing of symptom resolution without other clear etiology found on extensive infectious evaluation. It is important for allergists to recognize TSIAM, including its potential presentation as shock, in order to appropriately diagnose and counsel patients who seek evaluation for TMP-SMX adverse reactions.<\/jats:p>","DOI":"10.1093\/milmed\/usab524","type":"journal-article","created":{"date-parts":[[2021,12,15]],"date-time":"2021-12-15T15:44:43Z","timestamp":1639583083000},"page":"e2755-e2757","source":"Crossref","is-referenced-by-count":1,"title":["A Case of Trimethoprim-Sulfamethoxazole-Induced Aseptic Meningitis Masquerading as Septic Shock"],"prefix":"10.1093","volume":"188","author":[{"given":"Vishaka R","family":"Hatcher","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Wright-Patterson Medical Center , Wright-Patterson AFB, OH 45433, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert M","family":"Brooks","sequence":"additional","affiliation":[{"name":"Department of Allergy and Immunology, Wilford Hall Ambulatory Surgical Center , Lackland AFB, TX 78236, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen B","family":"Barker","sequence":"additional","affiliation":[{"name":"Coastal Allergy and Asthma , Daphne, AL 36526, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher A","family":"Coop","sequence":"additional","affiliation":[{"name":"Department of Allergy and Immunology, Wilford Hall Ambulatory Surgical Center , Lackland AFB, TX 78236, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,12,15]]},"reference":[{"key":"2023072301084701300_R1","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1517\/14740338.4.2.285","article-title":"Drug-induced aseptic meningitis","volume":"4","author":"Hopkins","year":"2005","journal-title":"Expert Opin Drug 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