Negative myoclonus associated with high-dose trimethoprim-sulfamethoxazole for treating Nocardia brain abscess

Key Points

• To explore the relationship between high-dose trimethoprim-sulfamethoxazole treatment and the onset of negative myoclonus in a patient with a Nocardia brain abscess.
• Patient treated with trimethoprim-sulfamethoxazole and ceftriaxone for Nocardia abscess.
• Monitored for symptoms including consciousness impairment and negative myoclonus.
• Ceftriaxone was paused for assessment of its role in symptom development.
• Negative myoclonus and consciousness impairment appeared during treatment.
• Symptoms resolved quickly after discontinuing trimethoprim-sulfamethoxazole.
• Ceftriaxone was deemed unlikely to be the cause based on symptom timing.