Cholestatic hepatitis with severe systemic reactions induced by trimethoprim-sulfamethoxazole

Ann Hepatol. 2007 Jan-Mar;6(1):63-5.


Trimethoprim-Sulfomethoxazole (TMP-SMX) related hepatotoxicity and associated severe systemic reaction are not frequent and documented only in case reports. We report a case of a 30-year-old man, who underwent a 15-day therapy with TMP-SMX for urinary tract infection and two weeks later developed acute cholestatic hepatitis, fever and a skin rash followed by severe systemic reaction. He was admitted in Intensive Care unit and with supportive therapy and prednisolone administration, he showed subsequent improvement over a period of few days. He had fully recovered months later. All tests for other causes of liver disease were negative and his liver biopsy showed evidence of drug-induced hepatic injury.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Biopsy
  • Chemical and Drug Induced Liver Injury / diagnostic imaging
  • Chemical and Drug Induced Liver Injury / etiology*
  • Chemical and Drug Induced Liver Injury / pathology
  • Cholestasis / chemically induced*
  • Cholestasis / diagnostic imaging
  • Cholestasis / pathology
  • Diagnosis, Differential
  • Drug Combinations
  • Humans
  • Male
  • Severity of Illness Index
  • Sulfamethizole / adverse effects*
  • Sulfamethizole / therapeutic use
  • Tomography, X-Ray Computed
  • Trimethoprim / adverse effects*
  • Trimethoprim / therapeutic use
  • Urinary Tract Infections / drug therapy


  • Drug Combinations
  • Sulfamethizole
  • trimethoprim sulfamethizole
  • Trimethoprim