We describe a case of rhabdomyolysis associated with trimethoprim-sulphamethoxazole (TMP-SMZ) in a HIV-infected patient. A 33-year-old African American man with newly diagnosed AIDS initially presented with persistent, high-grade fevers suspected to be TMP-SMZ-related drug fever. The antibiotic was discontinued while in the hospital, but the patient was restarted on TMP-SMZ following discharge. Two days later, he returned to the hospital with severe muscle pain, acute renal failure and a significantly elevated creatine phosphokinase consistent with rhabdomyolysis. The patient gradually improved following discontinuation of TMP-SMZ.
Product information. Bactrim DS (sulfamethoxazole and trimethoprim). Mutual Pharmaceutical Company Inc, PA: AR Scientific, 2006
2.
SingerSJ, RacoosinJA, ViraraghavanR. Rhabdomyolysis in human immunodeficiency virus-positive patients taking trimethoprim-sulfamethoxazole. Clin Infect Dis1998;26:233–34
3.
WalkerS, NorwoodJ, ThorntonC, SchabergD. Trimethoprim-sulfamethoxazole associated rhabdomyolysis in a patient with AIDS: case report and review of the literature. Am J Med Sci2006;331:339–41
4.
BeversdorfD, MattisonHR. Rhabdomyolysis and the acquired immunodeficiency syndrome. Neurology1996;46:1498
5.
ArnoldPA, GuglielmoBJ, HollanderH. Severe hypersensitivity reaction upon rechallenge with trimethoprim-sulfamethoxazole in a patient with AIDS. Drug Intell Clin Pharm1988;22:43–5
6.
McDonaghCA, HolmanRP. Primary human immunodeficiency virus type 1 infection in a patient with acute rhabdomyolysis. South Med J2003;96:1027–30
7.
NaranjoCA, BustoU, SellersEM, A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther1981;30:239–45
