Trimethoprim/sulfamethoxazole desensitization in an HIV-positive patient with previous Stevens-Johnson syndrome; a failed study.
Desensitization
HIV
Pneumocystis pneumonia (PCP)
Stevens-Johnson syndrome (SJS)
Trimethoprim/sulfamethoxazole (TMP/SMX)
Journal
Daru : journal of Faculty of Pharmacy, Tehran University of Medical Sciences
ISSN: 2008-2231
Titre abrégé: Daru
Pays: Switzerland
ID NLM: 101125969
Informations de publication
Date de publication:
Jun 2023
Jun 2023
Historique:
received:
13
09
2022
accepted:
05
03
2023
pmc-release:
31
03
2024
medline:
5
6
2023
pubmed:
1
4
2023
entrez:
31
3
2023
Statut:
ppublish
Résumé
Drug-induced Stevens-Johnson syndrome (SJS) is a rare but life-threatening hypersensitivity reaction. Drug desensitization might be considered in drug-allergic patients with no therapeutic alternative. A 29-year-old man with a recent diagnosis of HIV and HBV (CD4 count: 4 cells/mm3) who has been receiving Trimethoprim/sulfamethoxazole (TMP/SMX) for Pneumocystis pneumonia (PCP) prophylaxis was admitted at Imam Khomeini hospital complex affiliated to Tehran University of Medical Sciences, with the diagnosis of SJS due to TMP/SMX. After 45 days of supportive care, the patient was a candidate for TMP/SMX desensitization due to our region's unavailability of alternative agents. A 9-day desensitization protocol was used, but the patient complained about diarrhea with severe pain in the rectal mucosa, and macules developed over his lips again on the third day. As a result, the desensitization process immediately stopped, and after the signs and symptoms were resolved, the patient was discharged with Clindamycin tablet 600 mg TDS. Unfortunately, two weeks after discharge, the patient experienced acute kidney injury (AKI) and expired after two dialysis sessions.
Identifiants
pubmed: 37002421
doi: 10.1007/s40199-023-00457-z
pii: 10.1007/s40199-023-00457-z
pmc: PMC10238334
doi:
Substances chimiques
Trimethoprim, Sulfamethoxazole Drug Combination
8064-90-2
Anti-Infective Agents
0
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
69-73Informations de copyright
© 2023. The Author(s), under exclusive licence to Tehran University of Medical Sciences.
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