Caught a virus and starting to experience severe headaches? If you start to have severe viral infection headaches, then you should check them out. It will be a good idea to ensure that your symptoms do not point to a case of meningitis. There are serious consequences from having meningitis.So what is meningitis all about? This is an infection in the membrane that surrounds your brain. Brain and spinal cord infections can be very dangerous because they cause inflammation, which places pressure on your nerves.

This will cause you to have a viral infection headache.Inflammation can also cause the following symptoms:* Fever* Severe headache* Feeling confusedSevere inflammation can cause these symptoms:* Brain damage * Stroke* Seizures * DeathA bacterial infection or virus causes meningitis. The body can usually fight and beat an infection. However, when the infection travels into the blood stream, it can then go into your brain and spinal cord fluid. It can then affect your nerves and move into the brain causing inflammation and swelling.

This can damage or kill nerve cells and cause bleeding in the brain. It can also cause you to have a viral infection headache.Brain swelling is very dangerous because the brain is a soft organ in a hard box (the skull). If the brain swells, there is nowhere for it to go, except against the walls of the skull. This is what causes the most damage.

There are several causes of meningitis.

These include
* Bacterial infection
* Viral infection
* Fungal infection
* A reaction to medications
* A reaction to medical treatments
* Lupus
* Some forms of cancer
* A trauma to the head or back

Bacterial meningitis is the worst type because it can kill you. It often begins as an upper respiratory tract infection. From there it travels through your blood vessels to your brain. Then it can block up your blood vessels inside your brain triggering a stroke and brain damage. Viral meningitis is the most common form.

Usually viruses that enter your body through your mouth before going to your brain and multiplying cause it. You can find these viruses in the mucus, saliva and feces.

Other viruses that may cause meningitis include:
* Chicken pox
* Flu
* Mumps
* Genital herpes

Anyone can catch meningitis. This is especially true if your immune system is weak. Meningitis often begins like the flu does. You may get a rash.

The major symptoms include:
* Running a sudden fever
* A severe headache
* Stiff neck
* Dislike of light

Bacterial meningitis must be treated quickly. Severe bacterial meningitis will require intravenous antibiotics. On the other hand, antibiotics cannot be used to treat viral meningitis because they do not kill viruses. Whether you are having bacterial or viral meningitis, what would be best for yourself is to get plenty of rest and give your body a break. In the meantime, drink plenty of water to flush out the toxins and go easy on your diet.

Do follow the recommendations by your doctor during this period. Your viral infection headache and other symptoms will start to subside as your body recovers.

About the author Drugs are not stopping your headaches? Then, you need to read more research on natural headache remedies by acclaimed author Sandra Kim Leong. Sign up for her newsletter here at


cause of lupus headaches

26 thoughts on “Cause Of Lupus Headaches

  1. julie

    What kind of Neurological symptoms do you have with Lupus?
    I’m being tested for lupus after being sick for 2 yrs and I have tons of neurological symptoms just wondering if these are common symptoms for lupus. here are my symptoms.
    Burning stinging headaches, dizzy, lightheaded,vertigo, seizure type incidents, sharp shooting pains in head, also get weard sensations on my body like warm water pouring on me. Any info will be appreciated. If you have any neurological symptoms from Lupus pleas list them for me. Thanks!

    1. Linda R

      Some lupus patients have neurological symptoms, some do not. Lupus symptoms vary widely from patient to patient.

      Headaches could be caused by lupus or by Raynaud’s phenomenon or other things. Many lupus patients have Raynaud’s, a condition in which stress or cool temperatures cause the nerves to tell the blood vessels to clamp down and restrict blood flow, usually to hands and feet, but can also cause headaches.

      Lightheadedness can be caused by a number of things as well. Lupus patient are often anemic, When you are anemica, there is not enough available oxygen in your blood, which could account for light headedness or dizziness.

      Vertigo usually has to do with the inner ear. Lupus can cause inflammation anywhere, including the inner ear.

      I am not sure what you mean my “seizure type” incidents. Do you lose consciousness? Do you convulse? Some lupus patients do have seizures. But seizures can be caused by many other things.

      Lupus patients with antiphospholipid antibody syndrome (sticky blood) which causes clots may have TIAs or ministrokes. This could account for your head pain and seizure type incidents. Ask to have your blood tested for this.

      As for the weird sensations, please find a clearer way to describe that as well. If you tell the doctor that you have “seizure type incidents” and “weird sensations on your body” you are not helping the doctor get to the root cause of your problem. If these weird sensations are painful, you could have neuropathy which sometimes comes with lupus, or diabtetes, or multiple sclerosis, or other things.

      As a patient your job is to give the doctor the best and clearest information possible. It is the doctor’s job to connect the dots. A diagnosis of lupus is made based on family history, your medical history, a wide variety of lab tests and after everything else is ruled out. There is no definitive lab test for lupus.

      To do your job, keep a symptom journal including
      1. a clear description of the symptom
      2. when it started
      3. how often it happens
      4. how long it lasts
      5. what makes it feel better
      6. what makes it feel worse
      7. to what degree does it interfere with your activities of daily living

      Then create a concise summary and bring a copy for your doc and a copy for you.

  2. Chicken

    Have had a mild fever for 3 days without the other symptoms of a virus or bacteria, any thoughts?
    Basically my temperature went from 98.7 to 99.5 and it has stayed there for three days. There are the usual symptoms of a mild fever like aches and feeling out of it, but there are no other symptoms such as a headache, cough, or even a sore throat.

    Any chance it might be an infectious disease?

    1. rosieC

      99.5 is a low grade fever. Fever, body aches, and feeling out of it might be all due to a variety of causes ranging from infection or allergic reaction to some drugs or foods.

      Causes of fever in adults:
      1) Viral fever – frequent cause.For the most part, these viral illnesses will improve simply with time. Antibiotics will not treat a virus.

      2) Bacterial fever
      Bacterial illnesses causing fever can affect almost any organ system in the body. They can be treated with antibiotics
      Central nervous system (brain and spinal cord) infections can cause fever
      Lower resp system infections include Pneumonia and bronchitis
      •Upper respiratory system infections occur in the throat, ears, nose, and sinuses.
      Infection of the genitourinary system include the bladder, kidney or urinary tract
      •Reproductive system is affected such as PID
      •Gastrointestinal system (digestive system) infections ;such as appendicitis and gastroenteritis.
      Circulatory system including the heart and lungs. Sepsis is an example.
      •Skin, the largest organ in our body, can also be the source of a bacterial infection. Skin abscess; and from trauma.

      Fungal fever

      Animal exposure fever

      Travelers’ fever-Anyone who travels, especially outside the United States, may develop fever after exposure to various new foods, toxins, insects, or vaccine-preventable diseases

      Insect bites

      Drug Fever

      Blood clot Fever

      Tumor Fever

      Environmental Fever- such as Hyperthermia

      Special medical conditions

      Many people have medical illnesses that prevent their immune system (defense system) from working normally

      Causes of a weakened immune system


      •Cancer treatment medication

      •Organ transplant medication

      •Steroid therapy for a long time


      •Age older than 65

      •No spleen





      •Heavy alcohol or drug use

      Any person with one of these illnesses or conditions and a fever should see a doctor or go to a hospital’s emergency department quickly. It is important for the proper treatment to be started right away. Quick action may save the person’s life.

  3. no

    What happens when you stop eating gluten but later you start eating it again.?
    I was told I had a gluten intolerance by my doctor. But after 6 months of not eating any gluten my symptoms have not changed. My doctor has giving me the go ahead to start eating gluten again. What will happen when I do. Will I get headaches, and very tired. My body isn’t used to having it, so I am worried.

  4. ssspphttt!

    What condition could cause these symptoms?
    Numbness in hands and feet
    Inability to Concentrate
    Impaired Short Term Memory
    Body Aches
    Achy joints
    I have a theory but want to see what others who might think this could be.

    1. jenijaz

      MS, Lupus, Polymyositis and Fibromyalgia – to name a few.

      See your MD for simple blood tests to rule out Rheumatoid Arthritis and any other inflammatory processes.

      Good luck, and let us know how it all works out!

    1. xonora5

      This level is used for a diagnosis of lupus, and without proper diagnosis from a doctor, hard to determine because each person has slightly different symptoms that can range from mild to severe and may come and go over time. However, some of the most common symptoms can include painful or swollen joints (arthritis), unexplained fever, and extreme fatigue. A characteristic red skin rash-the so-called butterfly or malar rash-may appear across the nose and cheeks. Rashes may also occur on the face and ears, upper arms, shoulders, chest, and hands. Because many people with lupus are sensitive to sunlight (called photosensitivity), skin rashes often first develop or worsen after sun exposure.

      Common Symptoms of Lupus:
      Painful or swollen joints and muscle pain
      Unexplained fever
      Red rashes, most commonly on the face
      Chest pain upon deep breathing
      Unusual loss of hair
      Pale or purple fingers or toes from cold or stress (Raynaud’s phenomenon)
      Sensitivity to the sun
      Swelling (edema) in legs or around eyes
      Mouth ulcers
      Swollen glands
      Extreme fatigue
      Symptoms can range from mild to severe and may come and go over time.

      Other symptoms of lupus include chest pain, hair loss, anemia (a decrease in red blood cells), mouth ulcers, and pale or purple fingers and toes from cold and stress. Some people also experience headaches, dizziness, depression, confusion, or seizures. New symptoms may continue to appear years after the initial diagnosis, and different symptoms can occur at different times. In some people with lupus, only one system of the body, such as the skin or joints, is affected. Other people experience symptoms in many parts of their body. Just how seriously a body system is affected varies from person to person. The following systems in the body also can be affected by lupus: Kidneys, Lungs, Central Nervous system, Blood, Blood Vessels, and Heart.

  5. brlayer18

    what are all the possibilities of health problems coming from a prolonging severe headache?
    My girlfriend is in the hospital and I just want some answers. She has had a headache for the past 24 hours and I just called her, and her head is still hurting real bad. She has dizziness. I’m worried about her and just want know all the possibilities of what she may have.

  6. BranBear

    What could be the cause of my itchy rash?
    A few days ago I started to develop a very itchy rash. It is mostly on my arms and legs (the inside of my arms, inside of my thighs, back of calfs, back of biceps).

    It looks like little red bumps all over. And it does itch! I don’t know of any different lotions or sheets or food or anything that I have done different lately.

    Is this most likely an allergic reaction to something? Or what could it be caused from? I have no other symptoms. But I am freaking out! Any thoughts?

    1. Ribbons

      If you have slept in a new location you may have been victim to bedbugs.

      If you have been home and nothing new it may be dry skin.

      It may be a food allergy – if this is the case try to limit yourself to bland food like sweet potatoes for a day and see if it helps.

      It may be dry skin – apply lotion over the body.

      You may have poison oak – don’t take a bath.

      If you have pets you may have a reaction to them suddenly – take a shower and wash all clothing and bedding. in fact, you should just do this no matter what.

      The location of the rash makes me suspect that you may have been exposed to scabies, wash all clothing and see a doctor or nurse. Some hospitals allow you to call the advice line at 8am and request a same day appointment in the urgent care clinic – this will save you the $$ copay of the ER. for some reason scabies are found in nursing homes, and I hear rumor that you can get it from rotting oak branches. If it is scabies you need a really toxic lotion that only the doctor can give you.

      If it is fungal – a flat rash with hardened skin, no bumps or obvious breaks in the skin, – put tea tree lotion on it, and possibly get a prescription for fluconizole lotion. also try using Lotrimin.

      If it seems prickly and moves on to become a more fluid filled mass of blistering skin then most likely it’s Shingles – don’t go near children under 1 year old since if it is shingles you can give them chickenpox !!! It’s how the virus has stayed alive for so many centuries. Shingles is treated by doctors. Valtrex is the brand name and there is alternative generic stuff out there for less $$ so if you are diagnosed with shingles I recommend asking for something covered by your insurance or a generic form.
      Heat rash makes good sense to me, but just to be safe, take some Benedryl if you are not allergic to anything you know of. If Benedryl makes your rash die down a little, you may be having an allergic reaction. Measure the circumference of your biceps and thighs, arms and calfs, and make note of the size, measure again in the morning if you have not seen a doctor yet. If it has become worse you may need Emergency treatment.

      Make a note to take to the doctor which needs to include:
      color, size, location, when did it erupt, any changes in the rash since it erupted (like spreading), if it’s painful or tender, list the symptoms like fever, headache or intestinal distress you are having. Have a history of prior allergies on that list, and any history of skin disorders, infections, sexual history, or recent bites by any insect or rodent exposure. Also bring a complete drug history for at least the past 6 months.

      To be safe get tested for syphillys and HIV while at the doctors.

      It could be anything like, acne vulgaris, dermatomyositis, follicular mucinosis, fox-fordyce disease, lichen planus, mono, vasculitis, pityriasis rosea, polymorphic light eruption, psoriasis, rosacea, seborrheic keratosis, syringoma, or signs of Lupus. It could also be a reaction to antibiotics, benzodiazepines, lithium, phenylbutazone, gold salts, allopurinol, isoniazid, or salicylates. It could also be a result of Dermatitis, Erythema Multiforme, Herpes simplex or Zoster (aka; Shingles), insect bites, tinea, or ???

  7. tiffany_hagar

    Anyone From Texas Know of a REALLY good Neurologist in dallas?
    I have terrible migraines headaches and pain everyday. I have been to 3 neurologist and none of them seem to care or help. They just keep putting you on diffferent meds and send you on your way. So if anyone knows of a really good neurologist in dallas texas or around there please let me know thanks!

    1. Smart Nurse

      Long but worth the reading.

      Make the connection….This is the best headache and Migraine info.

      Being a nurse with over 25 years experience, I have seen a lot of patients with various illnesses and disorders.

      Many headaches are caused from common everyday chemicals and fragranced products as well as VOC’s in homes, schools and workplace.

      This is a growing problem for many people and most are not even aware that it exists as more and more chemicals are being introduced and used on a daily basis.

      Many people believe that because a product smells good or cleans well and it is on a store shelf that it is tested, approved and safe for use.
      Think again !

      We are now seeing more and more children and adults with skin disorders, nausea, dizziness, nausea, Chronic Headaches, Sinusitis, Migraines, Asthma, Allergies, Hives, Chronic Hives, Eczema, sinus / respiratory illnesses and Hormone related disorders.

      I can not emphasize how important it is to educate yourself about MULTIPLE CHEMICAL SENSITIVITY (MCS) and the harm you may be doing to your health by using chemicals and fragranced products.

      If you or a loved one has symptoms of or suffers from chronic headaches, reproductive problems, Migraines, Chronic Fatigue Syndrome, Lupus or Fibromyalgia, you need to read further and learn about the signs and symptoms of MCS – Multiple Chemical Sensitivity.

      Most doctors will not inform you about this because patients as a whole like to walk out of a doctors office with a prescription for some magical medicine and they do not want to be told that their expensive new perfume or newly installed carpet may be the culprit. So, the doctor will give you medications and many of these meds either do not work or cause other health problems.

      Chemicals and fragranced products are often the root of many disorders and illnesses when it comes to your health. Many of the below mentioned items are common triggers to sinus, asthma, itching, headaches, Migraines and allergy problems amongst other health issues. Get rid of them and your immune and respiratory system will thank you and you will breathe easier.

      And, it is not only personal body or cleaning products causing havoc on your health….many people become ill after wearing brand new clothing, dry-cleaned clothes, installing new carpet, painting, buying a new mattress or after home renovations because of the Flame Retardants, Antimony, Benzenes, Formaldehydes, etc. used in these products. So the answer is NO, you are not imagining that 2 weeks after your home, office or classroom got renovated you started to become ill, get dizzy or have headaches. This is happening more and more these days and adults as well as children are becoming sicker and sicker.

      Unfortunately, too many doctors compound the problem by prescribing chemical medications to try to alleviate the symptoms of an already chemical overloaded body and they rarely tell the patient to eliminate the chemical offenders. How many times have I seen people in the grocery store with Bounce, Glade Plug-Ins and Febreeze in their shopping cart along with a bottle of Benadryl , Migraine Excedrin and a box of Allergy Tablets ? Why don’t they make the connection?

      Keep in mind that your skin is the largest organ of your body and what you put on your skin gets absorbed into your body. Then … well… then it has to be filtered by your organs which are already working real hard.

      BIG NO-NO’s —- I would SERIOUSLY recommend removing all of the below from your living / working area.

      No Bounce or dryer sheets – these are VERY toxic
      No Febreeze – your pets will even thank you for this
      No Glade Plug-ins – VERY toxic
      No Scented candles
      No Scented Dish Detergents
      No Fragranced Products on Body, Hair or Clothing
      No Smoke
      No Newspapers and Magazines – The ink is a huge irritant.
      No Dander
      No Sprays
      No Sharpies (marker pens)
      New Cartpeting, mattresses, paint, contain toxins that can trigger severe respiratory disorders as well as headaches and Asthma flare-ups.
      And remember, it is NOT the smell it is the Chemicals that make up the smell. So, even if something is “Fragrance Free” these products often mask the smell with another chemical ! There are plenty of safe healthy products out there that work well and do not have added chemical fragrances.

      More and more workplaces & schools are implementing Fragrance Free policies and creating “Fragrance Free Zones”… why do you think this is? Make the connection, your lungs , immune system and your general health will thank you

  8. poisoned_delyriumz

    What would cause me to get low grade fevers at night?
    I am 26 yrs old, I suffer from severe headaches that come on suddenly. They ruled out migraines. I also am extremely fatigued. Recently I began my third experience in three years of getting aches and fevers at night. By morning, the fever is gone, but when the evening begins to set in, the aches begin and I know a fever isn’t far behind. The first time this happened, it happened for three weeks. Doctor couldn’t find solution.

    1. hello

      Well, I get this way now and I have Lupus and APS. I was having those symptoms well before I was diagnosed. You may want to talk to your doctor about testing you for autoimmune disorders.

      Each person with lupus has slightly different symptoms that can range from mild to severe and may come and go over time. However, some of the most common symptoms of lupus include painful or swollen joints (arthritis), unexplained fever, and extreme fatigue. A characteristic red skin rash-the so-called butterfly or malar rash-may appear across the nose and cheeks. Rashes may also occur on the face and ears, upper arms, shoulders, chest, and hands. Because many people with lupus are sensitive to sunlight (called photosensitivity), skin rashes often first develop or worsen after sun exposure.

      Common Symptoms of Lupus

      *Painful or swollen joints and muscle pain
      *Unexplained fever
      *Red rashes, most commonly on the face
      *Chest pain upon deep breathing
      *Unusual loss of hair
      *Pale or purple fingers or toes from cold or stress (Raynaud’s phenomenon)
      *Sensitivity to the sun
      *Swelling (edema) in legs or around eyes
      *Mouth ulcers
      *Swollen glands
      *Extreme fatigue

      Symptoms can range from mild to severe and may come and go over time.

      Other symptoms of lupus include chest pain, hair loss, anemia (a decrease in red blood cells), mouth ulcers, and pale or purple fingers and toes from cold and stress. Some people also experience headaches, dizziness, depression, confusion, or seizures. New symptoms may continue to appear years after the initial diagnosis, and different symptoms can occur at different times. In some people with lupus, only one system of the body, such as the skin or joints, is affected. Other people experience symptoms in many parts of their body. Just how seriously a body system is affected varies from person to person. The following systems in the body also can be affected by lupus.

  9. Janice W

    Why does morphine sulphate 10 mg give me a migraine?
    I have lupus, fibromyalgia and arthritis and I take morphine about once a month if I cannot cope withthe pain but periodically I get a severe headache, migraine type. What causes that and should I discontinue taking it?

    1. Sandy Sandals

      Morphine is a vasodialator and it also causes a histamine response similar to pollen (you may notice you itch around your nose). You may want to discuss the headaches with your doctor to rule out the possibility of an anuerysm. If you have an area in your brain with an enlarged blood vessel and then further enlarge it by take a vasodialator it puts pressure on the surrounding tissue and will cause a bad headache.

  10. Samantha D

    What can cause a low WBC and should I be worried?
    My son has been having a lot of issues lately with frequent infections (scarlet fever, ear infections, colds, etc), then when everything seems to get better he gets a fever with no other symptoms. The past week has been fevers from 105 – 100.1 with no apparant signs of infection. The family doc. recently did a CBC test along with others and found his white blood cell count to be low. Now we have to go back and do another test for comparative reasons. My son is also experiencing fatigue, headaches, bright red lips, and frequent nosebleeds. Any thoughts? The Dr. says it could be some type of bone marrow problem and he should be sent to a hemotologist. Is there anything else that could cause these problems? My son is 7.

    1. Meka

      Sometimes the cause of a low white blood cell count can’t be determined (idiopathic). Known causes of a low white blood cell count (leukopenia) include:

      Infections, such as viral infections and HIV
      Autoimmune disorders, such as lupus
      Certain medications, especially those used in chemotherapy and some antibiotics
      Radiation therapy
      Bone marrow disease, such as leukemia or myelodysplastic syndromes
      White blood cells help fight infection in your body. A normal white blood cell count ranges from 4,500 to 10,000 cells per microliter of blood. A mild decrease in white blood cells below 4,500 cells per microliter doesn’t necessarily indicate a serious illness. However, a dangerously low white blood cell count — below 2,500 cells per microliter — increases the risk of serious infection. I WANT TO SAY TRY NOT TO WORRY, BUT AS A MOM IS IT POSSIBLE NOT TO? I HOPE YOUR SON IS OKAY.

  11. Hoping he will bless me with #1

    I always feel feverish and swollen and have headaches. What could be the cause?
    I have already made an appointment to see my doctor, so please don’t suggest that. Until I can get in I wanted to see if others can tell me what they THINK may be going on with me. I was diagnosed with PCOS about 8 years ago so I am wondering if my problem is strictly hormonal.

    I am overweight for my height so perhaps the extra weight is what’s causing me to feel bogged down. I am 30 so I am not terribly old. I always feel hot (feverish) and swollen and I often have headaches, especially when waking up from a nap. My stomach always feels extra full and it always feels tight. always feel tired, especially after I eat. Sometimes I feel lightheaded, dizzy and nauseaus.

    I was checked for diabetes about 4-5 months ago and I didn’t have it. I have been checked several times over the past few years and didn’t have it.

    Do you have any idea as to what this might be?
    Also, I was checked for cholesterol, etc. several months ago and everything turned out fine. I did have high blood pressure a couple of times when I went t the doctor, but that was it. I think that was due to the hot weather here in Texas.

    1. tracy

      When you get in to see your regular doctor, you might want to request a referral to see a Rheumatologist. You may be experiencing symptoms related to an autoimmune disorder. The symptoms you are describing could be attributed to anything from the common cold to gallstones to lupus.

  12. Z W

    What would cause Abnormal Sweating in a healthy 28 yr old male?
    I have recently started sweating profusely for no reason and it has me slightly concerned. I am 28 years old and have never had a problem with sweating outside of exercising. Now I am sweating while typing. I have tried switching to a different deodorant, but it does not seem to be working. Does anyone have any insight they could share? Thanks!

    1. :)

      Excessive sweating is called diaphoresis and can sometimes be a sign of serious underlying conditions.

      How long has the sweating been going on?
      When does the sweating occur? All day or only at night?
      Is there a fever? Does the person feel sick?
      Is there a family history of excessive sweating?
      Is the person taking any medications or illegal drugs?
      Does the sweating occur in only some areas of the body or all over?

      Excessive sweating has many causes, including: hyperhidrosisstrenuous activityhot weather or wearing too much clothing for the temperatureinherited factors, as some people sweat more than othersmigraine headaches almost any infection, such as pneumonia, tuberculosis or a serious heart infection called endocarditis hyperthyroidism, an increased level of thyroid hormone in the bodypain, stress, anxiety or fearhypoglycemia, that is, low blood sugarserious heart conditions, such as a heart attack or congestive heart failure serious lung conditions, such as emphysema, pulmonary edema or a pulmonary embolus medications, such as haloperidol, which is used to treat psychosis illegal drugs, such as cocainecancer or other tumors autoimmune disorders, in which a person’s immune system attacks the body. Some examples are rheumatoid arthritis and systemic lupus erythematosus.strokes, which can affect the temperature control center of the brain

      You need to see your Doctor.

  13. vixy_1269

    What are the long term effects of Bactrim/Septra.?
    My mother (she’s 50) has been on Bactrim for several years now due to reoccurent UTI caused by a bladder ulcer. What are the major concerns for taking this over the long term (other than bacteria resistant infections) Also she had an episode of tachycardia (160-172) for an hour and the next day she checked her B/P and it was 86/72. Her pulse is usually in the 60’s and her B/P is normally 110/70-ish. Could this have anything to do with her long term Bactrim use? (And yes I already told her to go to the Dr.’s, she is there at this moment…I am just trying to find out for my own information) Thank you everyone who answers.

    1. Dr.Qutub

      Sulfamethoxazole (as in Bactrim, Septra, Septrin etc)

      Adverse effects and treatment

      Nausea, vomiting, anorexia, and diarrhoea are relatively common following the administration of sulfamethoxazole and other sulfonamides.

      Hypersensitivity reactions to sulfonamides have proved a problem. Fever is relatively common, and reactions involving the skin may include rashes, pruritis, photosensitivity reactions, exfoliative dermatitis, and erythema nodosum. Severe, potentially fatal, skin reactions including toxic epidermal necrolysis and the Stevens-Johnson syndrome have occurred in patients treated with sulfonamides. Dermatitis may also occur from contact of sulfonamides with the skin. Systemic lupus erythematosus, particularly exacerbation of pre-existing disease, has also been reported.

      Nephrotoxic reactions including interstitial nephritis and tubular necrosis, which may result in renal failure, have been attributed to hypersensitivity to sulfamethoxazole. Lumbar pain, haematuria, oliguria, and anuria may also occur due to crystallisation in the urine of sulfamethoxazole or its less soluble acetylated metabolite. The risk of crystalluria can be reduced by the administration of fluids to maintain a high urine output. If necessary, alkalinisation of the urine by administration of sodium bicarbonate may increase solubility and aid the elimination of sulfonamides.

      Blood disorders have occasionally occurred during treatment with the sulfonamides including sulfamethoxazole, and include agranulocytosis, aplastic anaemia, thrombocytopenia, leucopenia, hypothrombinaemia, and eosinophilia. Many of these effects on the blood may result from hypersensitivity reactions. Sulfonamides may rarely cause cyanosis due to methaemoglobinaemia. Acute haemolytic anaemia is a rare complication which may be associated with glucose-6-phosphate dehydrogenase deficiency.

      Other adverse effects which may be manifestations of a generalised hypersensitivity reaction to sulfonamides include a syndrome resembling serum sickness, liver necrosis, hepatomegaly and jaundice, myocarditis, pulmonary eosinophilia and fibrosing alveolitis, and vasculitis including polyarteritis nodosa. Anaphylaxis has been reported only very rarely.

      Other adverse reactions that have been reported after the administration of sulfamethoxazole or other sulfonamides include hypoglycaemia, hypothyrodism, neurological reactions including aseptic meningitis, ataxia, benign intracranial hypertension, convulsions, dizziness. drowsiness, fatigue, headache, insomnia, mental depression, peripheral or optic neuropathies, psychoses, tinnitus, vertigo, and pancreatitis.

      Sulfonamides may displace serum-bound biluribin, resulting in jaundice and kernicterus in premature neonates.

      As with other antimicrobials, sulfamethoxazole may cause alterations of the bacterial flora in the gastrointestinal tract. There is, therefore, the possibility, although it appears to be small, that pseudomembranous colitis may occur.

      Slow acetylators of sulfamethoxazole may be at greater risk of adverse reactions than fast acetylators.


      In patients receiving sulfamethoxazole, adequate fluid intake is necessary to reduce the risk of crystalluria; the daily urine output should be 1200 to 1500 mL or more. The administration of compounds which render the urine acidic may increase the risk of crystalluria; the risk may be reduced with alkaline urine.

      Treatment with sulfonamides should be discontinued immediately a rash appears because of the danger of severe allergic reactions such as the Stevens-Johnson syndrome.

      Sulfamethoxazole should be given with care to patients with renal or hepatic impairment and is contra-indicated in patients with severe renal or hepatic failure or with blood disorders. Dosage reduction may be necessary in renal impairment. Complete blood counts and urinalyses with microscopic examination should be carried out particularly during prolonged therapy. Sulfamethoxazole should not be given to patients with a history of hypersensitivity to sulfonamides as cross-sensitivity may occur between drugs of this group. Care is generally advisable in patients with a history of allergy or asthma. Caution is also needed in the elderly, who may be more likely to have other risk factors for reactions. Some authorities consider sulfamethoxazole to be contra-indicated in lupus erythematosus as it may exacerbate the condition. Patients with glucose 6-phosphate dehydrogenase deficiency may be at risk of haemolytic reactions.

      Sulfamethoxazole and other sulfonamides are not usually given to infants within 1 to 2 months of birth because of the risk of kernicterus; for the same reason, they are generally contra-indicated in women prior to delivery, and in breast-feeding mothers.

      Patients with Aids may be particularly prone to adverse reactions, especially when sulfamethoxazole is given in combination with trimethoprim as co-trimoxazole.

      Sulfonamides have been reported to interfere with some diagnostic tests, including those for urea, creatinine, and urinary glucose and urobilinogen.

Leave a Reply

Your email address will not be published. Required fields are marked *