A rare case of pure N4-acetyl-sulfamethoxazole nephrolithiasis associated with trimethoprim-sulfamethoxazole treatment of pulmonary nocardiosis

Andrew Shanholtzer; Alexander Geisenhoff; Mit Shah; Sugandh Shetty

doi:10.1016/j.eucr.2022.102179

A rare case of pure N4-acetyl-sulfamethoxazole nephrolithiasis associated with trimethoprim-sulfamethoxazole treatment of pulmonary nocardiosis

Urol Case Rep. 2022 Aug 3;45:102179. doi: 10.1016/j.eucr.2022.102179. eCollection 2022 Nov.

Authors

Andrew Shanholtzer¹, Alexander Geisenhoff², Mit Shah², Sugandh Shetty²

Affiliations

¹ Oakland University William Beaumont School of Medicine, United States.
² Beaumont Health, Department of Urology, United States.

Abstract

Trimethoprim-Sulfamethoxazole is a commonly used antibiotic for treatment of urinary tract infections, but also used to treat less common conditions such as pulmonary nocardiosis. N4-acetyl-sulfamethoxazole is the main active metabolite of Sulfamethoxazole. Pure stones of this compound are very rare with only a few cases documented in the literature. Here we present a case of a patient treated with long term trimethoprim-sulfamethoxazole therapy for pulmonary nocardiosis who developed pure N4-acetyl-sulfamethoxazole nephrolithiasis resulting in upper tract obstruction. This report provides an additional data point for this unique calculus etiology.

Publication types

Case Reports