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July 20, 1984

Trimethoprim-Sulfamethoxazole: Another Cause of Recurrent Meningitis

JAMA. 1984;252(3):346. doi:10.1001/jama.1984.03350030020014

To the Editor.—  Recurrent meningitis usually suggests an incompletely healed fracture of the cribriform plate of the skull. It can also be seen with Behçet's disease, Mollaret's meningitis, familial Mediterranean fever, and with various immunodeficiencies such as complement deficiency, agammaglobulinemia, and asplenia.1 We recently encountered another cause that might be of interest to practicing physicians.

Report of a Case.—  A 52-year-old woman was referred on May 13, 1983, for evaluation of recurrent meningitis. The results of analysis at the beginning of her previous attacks are listed in the Table. All cultures were sterile. The May 6, 1983, lumbar puncture was done soon after the onset of symptoms; the attack itself was clinically indistinguishable from her other episodes. She was receiving cefotaxime sodium at the time of referral. The patient complained that severe sinus congestion had preceded many of her attacks of meningitis. She remembered taking Septra for symptoms of