Trimethoprim/sulfamethoxazole-induced toxic epidermal necrolysis.
OBJECTIVE
To report a case of toxic epidermal necrolysis (TEN) associated with trimethoprim/sulfamethoxazole (TMP/SMX).


METHODS
A 34-year-old Asian woman developed a severe, desquamating mucocutaneous reaction (TEN) after six days of taking TMP/SMX to treat a presumed urinary tract infection (UTI).


CONCLUSIONS
TMP/SMX is often recommended as first-line therapy for UTIs, sinusitis, bronchitis, and as prophylaxis and treatment for Pneumocystis carinii pneumonia. TEN is a rare, but severe condition associated with sulfonamide use. This article describes a typical case and offers an opportunity for review of this potentially serious reaction.


CONCLUSIONS
Sulfonamides are often implicated in the majority of drug-induced cases of TEN. This case report illustrates the typical presentation of sulfonamide-induced TEN with a prodrome, characteristic rash, mucous membrane lesions, and systemic involvement. Practitioners should be aware of this rare adverse effect and closely observe patients for cutaneous manifestations or complaints. Any suspected drug should be discontinued if clinical evaluation leads to the suspicion of Stevens-Johnson syndrome or TEN.
See
S
S
St. John's University College of Pharmacy and Allied Health Professions, Jamaica, NY, USA.
Mumford
J M
JM
D000328:Adult; D004338:Drug Combinations; D005260:Female; D006801:Humans; D013262:Stevens-Johnson Syndrome / Q000209:etiology*; D013419:Sulfamethizole / Q000009:adverse effects* / Q000627:therapeutic use; D014295:Trimethoprim / Q000009:adverse effects* / Q000627:therapeutic use; D014570:Urologic Diseases / Q000188:drug therapy; D000096926:Benzenesulfonamides
D004338:Drug Combinations; D013419:Sulfamethizole; D014295:Trimethoprim; C029078:trimethoprim sulfamethizole; D000096926:Benzenesulfonamides