RESUMO

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.

Assuntos

Doença Hepática Induzida por Substâncias e Drogas/etiologia , Colestase/induzido quimicamente , Sulfametizol/efeitos adversos , Trimetoprima/efeitos adversos , Adulto , Biópsia , Doença Hepática Induzida por Substâncias e Drogas/diagnóstico por imagem , Doença Hepática Induzida por Substâncias e Drogas/patologia , Colestase/diagnóstico por imagem , Colestase/patologia , Diagnóstico Diferencial , Combinação de Medicamentos , Humanos , Masculino , Índice de Gravidade de Doença , Sulfametizol/uso terapêutico , Tomografia Computadorizada por Raios X , Trimetoprima/uso terapêutico , Infecções Urinárias/tratamento farmacológico