Successful desensitization of trimethoprim-sulfamethoxazole in Stenostrophomonas maltophilia osteomyelitis

Sujeong Kim; Kyung-Hwan Lim; Min-Gyu Kang; Han-Ki Park; Sang-Heon Cho; Kyung-Up Min; Sae-Hoon Kim; Yoon-Seok Chang

doi:10.4168/aard.2014.2.3.218

Journal List > Allergy Asthma Respir Dis > v.2(3) > 1059029

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Kim, Lim, Kang, Park, Cho, Min, Kim, and Chang: Successful desensitization of trimethoprim-sulfamethoxazole in Stenostrophomonas maltophilia osteomyelitis

Case Report

Allergy, Asthma & Respiratory Disease 2014; 2(3): 218-221.

Published online: 31 July 2014

DOI: https://doi.org/10.4168/aard.2014.2.3.218

Successful desensitization of trimethoprim-sulfamethoxazole in Stenostrophomonas maltophilia osteomyelitis

Sujeong Kim^1,^2,³, Kyung-Hwan Lim^1,^3,⁴, Min-Gyu Kang^1,^3,⁴, Han-Ki Park^1,³, Sang-Heon Cho^1,³, Kyung-Up Min^1,³, Sae-Hoon Kim^1,^3,⁴, Yoon-Seok Chang^1,^3,⁴

¹Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.

²Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.

³Institute of Allergy and Clinical Immunology, Medical Research Council, Seoul National University College of Medicine, Seoul, Korea.

⁴Division of Allergy and Clinical Immunology, Seoul National University Bundang Hospital, Seongnam, Korea.

Correspondence to: Yoon-Seok Chang. Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam 463-707, Korea. Tel: +82-31-787-7023, Fax: +82-31-787-4052, addchang@snu.ac.kr

Received 1 October 2013 Revised 1 March 2014 Accepted 5 March 2014

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/).

Abstract

Stenotrophomonas maltophilia is an emerging pathogen associated with morbidity and mortality in hospitalized patients. The treatment of S. maltophilia infection is challenging because clinical isolates are frequently resistant to most antimicrobial agents except trimethoprim-sulfamethoxazole (TMP-SMX). S. maltophilia osteomyelitis is a rare disease and requires a prolonged treatment with TMP-SMX. Here, we report an interesting case of a patient with S. maltophilia osteomyelitis who developed a delayed hypersensitivity reaction during TMP-SMX treatment and successfully treated after desensitization. TMP-SMX desensitization should be considered in patients with hypersensitivity to TMP-SMX, especially when there are no effective alternative drugs in S. maltophilia infection.

Keywords: Immunologic desensitization, Hypersensitivity, Trimethoprim-sulfamethoxazole combination, Stenotrophomonas maltophilia

Figures and Tables

Table 1

Protocol for oral desensitization with trimethoprim/sulfamethoxazole in delayed hypersensitivity reaction

TMP, trimethoprim; SMX, sulfamethoxazole; T, tablet; q.d., once a day; b.i.d., twice a day; t.i.d., three times a day.

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