title: Fulminant hepatic failure in a child as a potential adverse effect of trimethoprim-sulphamethoxazole.
abstract: Trimethoprim-sulphamethoxazole (TMP-SMZ) is considered a safe drug for treatment of infectious bacterial diseases in children. Side-effects are rare and generally take the form of a hypersensitivity reaction to the sulphamethoxazole component of the drug. Hepatic injury usually presents as a transient elevation of liver enzymes, which is of little clinical relevance. Fulminant liver failure due to TMP-SMZ has been reported in only six adults and never in children. We here report a 5-year-old girl who developed fulminant liver failure 3 weeks after her third exposure to TMP-SMZ. After a biphasic clinical course she underwent successful liver transplantation.
  
  
  CONCLUSIONS
  Trimethoprim-Sulphamethoxazole may cause fulminant liver failure in children. The disease can run a biphasic clinical course and liver transplantation must be considered as the therapeutic option for these patients.
authors.affiliation: Department of Paediatrics, University of Innsbruck, Austria.
authors.forename: B
authors.initials: B
authors.lastname: Simma
authors.forename: B
authors.initials: B
authors.lastname: Meister
authors.forename: J
authors.initials: J
authors.lastname: Deutsch
authors.forename: W
authors.initials: W
authors.lastname: Sperl
authors.forename: F
authors.initials: F
authors.lastname: Fend
authors.forename: D
authors.initials: D
authors.lastname: Ofner
authors.forename: R
authors.initials: R
authors.lastname: Margreiter
authors.forename: W
authors.initials: W
authors.lastname: Vogel
mesh_terms: D001706:Biopsy; D002675:Child, Preschool; D004927:Escherichia coli Infections / Q000188:drug therapy*; D005260:Female; D006501:Hepatic Encephalopathy / Q000139:chemically induced* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008099:Liver / Q000473:pathology; D008111:Liver Function Tests; D016031:Liver Transplantation; D012008:Recurrence; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000008:administration & dosage / Q000009:adverse effects*; D014552:Urinary Tract Infections / Q000188:drug therapy*
chemical_list: D015662:Trimethoprim, Sulfamethoxazole Drug Combination