Trimethoprim-sulfamethoxazole-induced hypersensitivity syndrome associated with reactivation of human herpesvirus-6.
A 27-year-old man who had a history of bronchial asthma, eosinophilic enteritis, and eosinophilic pneumonia presented with fever, skin eruptions, cervical lymphadenopathy, hepatosplenomegaly, atypical lymphocytosis, and eosinophilia two weeks after receiving trimethoprim (TMP)-sulfamethoxazole (SMX) treatment. After the withdrawal of TMP-SMX and the administration of high-dose steroid, these systemic symptoms gradually resolved. During the disease course, the patient showed a transient increase in anti-human herpesvirus (HHV)-6 antibody titers and HHV-6 DNA in the peripheral blood, indicating the reactivation of a latent HHV-6 infection. This is the first case of TMP-SMX-induced hypersensitivity syndrome associated with the reactivation of a latent viral infection.
Morimoto
Taisuke
T
Department of Respiratory Medicine, Japanese Red Cross Medical Center, Tokyo.
Sato
Takeo
T
Matsuoka
Akihiro
A
Sakamoto
Tetsu
T
Ohta
Keisuke
K
Ando
Tsunehiro
T
Ikushima
Soichiro
S
Hagiwara
Kiyofumi
K
Matsuno
Hiroaki
H
Akiyama
Osamu
O
Oritsu
Masaru
M
D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D019072:Antibiotic Prophylaxis; D000914:Antibodies, Viral; D001249:Asthma / Q000150:complications; D004279:DNA, Viral; D003875:Drug Eruptions / Q000209:etiology*; D004751:Enteritis / Q000150:complications; D005938:Glucocorticoids / Q000627:therapeutic use; D015654:Herpesvirus 6, Human / Q000276:immunology / Q000302:isolation & purification / Q000502:physiology*; D006801:Humans; D008297:Male; D009894:Opportunistic Infections / Q000209:etiology / Q000517:prevention & control; D011657:Pulmonary Eosinophilia / Q000150:complications / Q000188:drug therapy; D012008:Recurrence; D019349:Roseolovirus Infections / Q000209:etiology*; D016896:Treatment Outcome; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000009:adverse effects*; D014775:Virus Activation / Q000187:drug effects
D000900:Anti-Bacterial Agents; D000914:Antibodies, Viral; D004279:DNA, Viral; D005938:Glucocorticoids; D015662:Trimethoprim, Sulfamethoxazole Drug Combination