100% N(4)-acetyl-sulfamethoxazole stone induced by Trimethoprim-Sulfamethoxazole in an HIV patient being treated for toxoplasmosis

Trimethoprim-Sulfamethoxazole is a common antibiotic used to treat urinary tract infections, as well as a prophylactic agent in HIV patients with low CD4 counts. Exceedingly rare are stones consisting purely of its metabolite, N(4)-acetyl-sulfamethoxazole, and management strategies are not well docu...

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Detalles Bibliográficos
Autores principales: DeMasi, Matthew S., Bernstein, Ari P., Schulster, Michael, Silva, Mark V.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Endourology
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7607417/
https://www.ncbi.nlm.nih.gov/pubmed/33163365
http://dx.doi.org/10.1016/j.eucr.2020.101453
Descripción
Sumario:Trimethoprim-Sulfamethoxazole is a common antibiotic used to treat urinary tract infections, as well as a prophylactic agent in HIV patients with low CD4 counts. Exceedingly rare are stones consisting purely of its metabolite, N(4)-acetyl-sulfamethoxazole, and management strategies are not well documented in the literature. We present a case of a patient with HIV who was found to have obstructing ureteral calculi composed of 100% N(4)-acetyl-sulfamethoxazole. Our report contributes a unique case of a Bactrim-induced stone in an immunocompromised patient. Similar patients can be prophylactically treated with diuresis and urinary alkalinization, as well as consideration for alternative medication use.

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