Severe sulfadiazine hypersensitivity in a child with reactivated congenital toxoplasmic chorioretinitis.
A 7-year-old with congenital toxoplasmosis who took pyrimethamine and sulfadiazine for reactivated chorioretinitis developed fever, severe cutaneous involvement, swelling, abdominal pain and transaminitis, persisting weeks after withholding medicines. Symptoms resolved when systemic corticosteroids were administered. This case underscores problems in clinical management with sulfadiazine hypersensitivity, potential immunosuppression from corticosteroids and selection of medications for recurrences of toxoplasmic chorioretinitis.
McLeod
Rima
R
Department of Ophthalmology, The University of Chicago, Chicago, IL 60637, USA. rmcleod@midway.uchicago.edu
Khan
Asif Rashid
AR
Noble
Gwendolyn A
GA
Latkany
Paul
P
Jalbrzikowski
Jessica
J
Boyer
Kenneth
K
D000818:Animals; D000981:Antiprotozoal Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D002825:Chorioretinitis / Q000151:congenital* / Q000188:drug therapy / Q000469:parasitology; D004342:Drug Hypersensitivity / Q000209:etiology / Q000503:physiopathology*; D004359:Drug Therapy, Combination; D004802:Eosinophilia / Q000209:etiology; D005260:Female; D006801:Humans; D011739:Pyrimethamine / Q000008:administration & dosage / Q000627:therapeutic use; D012008:Recurrence; D012720:Severity of Illness Index; D013411:Sulfadiazine / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D014122:Toxoplasma / Q000187:drug effects; D014126:Toxoplasmosis, Ocular / Q000151:congenital* / Q000188:drug therapy / Q000469:parasitology
D000981:Antiprotozoal Agents; D013411:Sulfadiazine; D011739:Pyrimethamine