Trimethoprim-sulfamethoxasole induced meningitis in systemic lupus erythematosus

Most reports of drug induced meningitis in systemic lupus erythematosus (SLE) have implicated ibuprofen. We desribe a 46-year-old woman with SLE who developed aseptic meningitis abruptly fter ingesting trimethoprim-sulfamethoxasole (TMP-SMX). This patient had received TMP-SMX twice before; each was associated with increasingly severe reactions, whose relationship with the use of TMP-SMX became apparent only in retrospect. A history of medication use should be sought in all patients with meningitis who have an underlying autoimmune disorder.