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Trimethoprim-sulfamethoxazole acute respiratory distress syndrome requiring lung transplantation

Matthew Donnan1, Miranda Siemienowicz2,3, Hui Sien Tay4

  • 1Department of Respiratory Medicine Alfred Health Melbourne Victoria Australia.

Respirology Case Reports
|July 17, 2024
PubMed

Insights

Trimethoprim-sulfamethoxazole (TMP-SMX) can cause rare but severe acute respiratory distress syndrome (ARDS), particularly in young individuals with specific HLA types. This condition has a high mortality rate and requires further research for effective treatments.

Area of Science:

  • Pharmacology
  • Immunology
  • Pulmonology

Background:

  • Trimethoprim-sulfamethoxazole (TMP-SMX) is a widely used antibiotic.
  • Acute respiratory distress syndrome (ARDS) is a severe lung condition.
  • TMP-SMX-induced ARDS is a rare but serious adverse drug reaction.

Observation:

  • This condition predominantly affects young, healthy patients.
  • Specific human leukocyte antigen (HLA) types, namely HLA-B*07:02 and HLA-C*07:02, are associated with increased risk.
  • The case presented involves an 18-year-old female with a complex urinary tract infection treated with TMP-SMX.

Findings:

  • The patient developed rapid respiratory failure requiring intensive care.
  • Treatment involved extracorporeal membrane oxygenation (ECMO) and ultimately lung transplantation.
  • The exact pathological mechanisms and unique features of TMP-SMX-induced ARDS remain poorly understood.

Implications:

  • There is currently no targeted treatment for TMP-SMX-induced ARDS.
  • The high mortality rate underscores the severity of this complication.
  • Further research is crucial to elucidate pathogenesis and develop therapeutic interventions.
Keywords:
ARDScritical care medicineinflammationpathologyrare lung diseases

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