Trimethoprim-sulfamethoxazole exacerbates posthypoxic action myoclonus in a patient with suspicion of Pneumocystis jiroveci infection

Item Type:	Article
Title:	Trimethoprim-sulfamethoxazole exacerbates posthypoxic action myoclonus in a patient with suspicion of Pneumocystis jiroveci infection
Creators Name:	Jundt, F. and Lempert, T. and Doerken, B. and Pezzutto, A.
Abstract:	We describe a 58-year-old patient with relapsing high-grade non-Hodgkin’s lymphoma who exhibited exacerbation of posthypoxic action myoclonus during high-dose intravenous trimethoprim-sulfamethoxazole (TMP-SMX) treatment for highly suspicious Pneumocystis jiroveci pneumonia (PCP). Three months previously the patient had experienced a hypoxic insult caused by respiratory arrest due to an anaphylactic reaction to antibiotic therapy. He had developed posthypoxic action myoclonus (Lance-Adams syndrome), which was well controlled by oral treatment with piracetam. However, after TMP-SMX therapy (115 mg/kg daily) was started for suspicion of newly developed PCP, posthypoxic action myoclonus worsened dramatically resulting in complete disability. Anti-myoclonic therapy with increased doses of piracetam and valproic acid did not significantly improve his clinical condition. Only when TMPSMX doses were reduced (38 mg/kg daily) on day 12 did action myoclonus cease within 2 to 3 days. We suggest that TMP-SMX can exacerbate posthypoxic action myoclonus.
Keywords:	Anoxia, Anti-Infective Agents, Immunocompromised Host, Myoclonus, Pneumocystis, Pneumocystis Pneumonia, Trimethoprim-Sulfamethoxazole Combination
Source:	Infection
ISSN:	0300-8126
Volume:	32
Number:	3
Page Range:	176-178
Date:	1 June 2004
Official Publication:	https://doi.org/10.1007/s15010-004-3011-6
PubMed:	View item in PubMed

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