Severe hypersensitivity reaction upon rechallenge with trimethoprim-sulfamethoxazole in a patient with AIDS.
A patient with acquired immunodeficiency syndrome (AIDS) developed rash, fever, neutropenia, and elevated liver function tests during an initial course of trimethoprim-sulfamethoxazole (TMP-SMX) therapy. Upon reexposure to the drug, the patient experienced a severe anaphylactoid reaction associated with pulmonary edema and rhabdomyolysis. Reactions associated with TMP-SMX rechallenge in this patient population have been previously reported but have not been associated with this degree of severity. TMP-SMX therapy should be instituted with extreme caution in patients with AIDS who have demonstrated a prior hypersensitivity reaction to the drug.
Arnold
P A
PA
Department of Pharmacy Services, Good Samaritan Medical Center, Phoenix, AZ 85006.
Guglielmo
B J
BJ
Hollander
H
H
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D003873:Dermatitis, Exfoliative / Q000139:chemically induced; D004338:Drug Combinations / Q000009:adverse effects; D004342:Drug Hypersensitivity / Q000209:etiology*; D005334:Fever / Q000139:chemically induced; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000139:chemically induced*; D008297:Male; D011020:Pneumonia, Pneumocystis / Q000188:drug therapy* / Q000209:etiology; D011654:Pulmonary Edema / Q000139:chemically induced; D012206:Rhabdomyolysis / Q000139:chemically induced; D013420:Sulfamethoxazole / Q000009:adverse effects*; D014295:Trimethoprim / Q000009:adverse effects*; D015662:Trimethoprim, Sulfamethoxazole Drug Combination
D004338:Drug Combinations; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D014295:Trimethoprim; D013420:Sulfamethoxazole