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Suzanne M. DE la Monte, MD, MPH; Grover M. Hutchins, MD; Prabodh K. Gupta, MD
Massachusetts General Hospital Boston

JAMA. 1985;253(15):2192.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

The CASE REPORT, "Trimethoprim-Induced Aseptic Meningitis," by Dr Derbes¹ published recently in THE JOURNAL describes a patient with Sjörgen's syndrome who, on several well-documented occasions, exhibited an allergic response or hypersensitivity to trimethoprimsulfamethoxazole. While the patient clearly manifested central nervous system (CNS) signs and symptoms after taking sulfa drugs, the author does not demonstrate that the exudate in the cerebrospinal fluid (CSF) was related to or caused by its administration. The abruptness and rapidity of onset of neurologic symptoms following the use of trimethoprim strongly suggest that her response was probably vascular in origin. In contrast to Dr Derbes' statement, our recent studies demonstrated that aseptic meningitis occurs commonly in patients with Sjögren's syndrome.^2,3 Patients with Sjögren's syndrome frequently have polymorphous inflammatory infiltrates in the leptomeninges, and characteristic atypical mononuclear cells are usually present in CSF. The neurologic symptoms associated with the polymorphous meningitis of . . . [Full Text PDF of this Article]

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