Trimethoprim-sulfamethoxazole-induced cholestatic hepatitis. Inadvertent rechallenge

Arch Intern Med. 1984 Aug;144(8):1691-2. doi: 10.1001/archinte.144.8.1691.


Trimethoprim-sulfamethoxazole is known to produce hepatitis. We report a case involving the inadvertent rechallenge with trimethoprim-sulfamethoxazole (Bactrim) in a patient with a previous episode of drug-induced hepatitis. A liver biopsy specimen showed both cholestatic and cytotoxic changes consistent with drug-induced damage. Comparison with existing cases is presented and an immunologic cause is considered.

Publication types

  • Case Reports

MeSH terms

  • Biopsy
  • Chemical and Drug Induced Liver Injury / etiology*
  • Chemical and Drug Induced Liver Injury / pathology
  • Cholestasis, Intrahepatic / chemically induced*
  • Cholestasis, Intrahepatic / pathology
  • Drug Combinations / adverse effects
  • Humans
  • Liver / pathology
  • Male
  • Middle Aged
  • Sulfamethoxazole / adverse effects*
  • Trimethoprim / adverse effects*
  • Trimethoprim, Sulfamethoxazole Drug Combination


  • Drug Combinations
  • Trimethoprim, Sulfamethoxazole Drug Combination
  • Trimethoprim
  • Sulfamethoxazole