Trimethoprim-sulfamethoxazole-induced Steven Johnson syndrome in an HIV-infected patient

Indian J Pharmacol. 2012 Jul-Aug;44(4):533-5. doi: 10.4103/0253-7613.99346.

Abstract

Trimethoprim-sulfamethoxazole (TMP/SMX) is a widely prescribed antimicrobial for the management of several uncomplicated infections. It is commonly used for the treatment and prophylaxis of Pneumocystis jirovecii pneumonia (PCP) in the HIV-infected population. The adverse reaction to TMP/SMX is more frequent and severe in HIV-infected patients as compared to the general population. Here, we report a case of Stevens-Johnson syndrome (SJS) secondary to TMP/SMX. The patient had a generalized cutaneous reaction with involvement of the eyes, oral cavity, and genitals. He had elevated hepatic alanine aminotransferase and aspartate aminotransferase enzyme. TMP/SMX therapy was stopped and supportive treatment was started. His condition improved after eight days of stopping TMP/SMX therapy.

Keywords: Desensitization; HIV infection; P. jirovecii pneumonia; Steven Johnson syndrome; glutathione enzyme; trimethoprim-sulfamethoxazole.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Infective Agents / adverse effects
  • HIV Infections / complications
  • HIV Infections / drug therapy*
  • Humans
  • Male
  • Stevens-Johnson Syndrome / chemically induced*
  • Stevens-Johnson Syndrome / complications
  • Stevens-Johnson Syndrome / diagnosis*
  • Trimethoprim, Sulfamethoxazole Drug Combination / adverse effects*

Substances

  • Anti-Infective Agents
  • Trimethoprim, Sulfamethoxazole Drug Combination