trimethoprim/sulfamethoxazole / Generic mfg. - LARVOL DELTA

Case report: Cervical suppurative lymphadenitis caused by burkholderia multivorans in a healthy child. (PubMed, BMC Infect Dis) - "This study aims to raise awareness among all specialists about BM as a potential causative agent in cervical suppurative lymphadenitis. Early recognition and timely intervention can reduce misdiagnosis and missed diagnoses, improving patient outcomes."

Journal • Inflammation

DRESS syndrome presenting with acute hypoxic respiratory failure and delayed eosinophilia. (PubMed, BMJ Case Rep) - "Here, we describe an otherwise healthy male patient in his mid-50s who presented with a rash, myalgia, shortness of breath and delayed eosinophilia that rapidly progressed to acute respiratory failure with hypoxia after starting trimethoprim-sulfamethoxazole. Prompt identification and treatment of atypical manifestations of DRESS syndrome is critical to reduce morbidity and mortality."

Journal • Acute Respiratory Distress Syndrome • Critical care • Eosinophilia • Immunology • Musculoskeletal Pain • Pain • Pulmonary Disease • Respiratory Diseases

The evaluation of antimicrobial resistance rates in infections caused by uropathogenic Escherichia coli strains collected from the south of Lebanon. (PubMed, Iran J Microbiol) - "Antimicrobial resistance phenotype of 104 urine samples was tested to determine the resistance percentages for various antibiotics including ampicillin, gentamicin, ciprofloxacin, tetracycline, bactrim, meropenem, and imipenem using disk diffusion test. The high rates of antibiotic resistance observed, particularly to ampicillin and tetracycline, highlight the need for more judicious antibiotic use and the development of alternative treatment strategies to combat UPEC infections. These results can inform antimicrobial stewardship programs and guide the selection of appropriate empiric therapy for urinary tract infections."

Journal • Infectious Disease • Nephrology

The evaluation of antimicrobial resistance rates in infections caused by uropathogenic Escherichia coli strains collected from the south of Lebanon. (PubMed, Iran J Microbiol) - "Antimicrobial resistance phenotype of 104 urine samples was tested to determine the resistance percentages for various antibiotics including ampicillin, gentamicin, ciprofloxacin, tetracycline, bactrim, meropenem, and imipenem using disk diffusion test. The high rates of antibiotic resistance observed, particularly to ampicillin and tetracycline, highlight the need for more judicious antibiotic use and the development of alternative treatment strategies to combat UPEC infections. These results can inform antimicrobial stewardship programs and guide the selection of appropriate empiric therapy for urinary tract infections."

Journal • Infectious Disease • Nephrology

Pneumocystis Pneumonia in a Patient With Colorectal Cancer Receiving Bevacizumab and mFOLFOX6 Therapy. (PubMed, Cancer Diagn Progn) - "We report a case of PCP in a 75-year-old male with colorectal cancer receiving bevacizumab plus mFOLFOX6 (oxaliplatin, leucovorin, and 5-fluorouracil) therapy. Early imaging and prophylactic TMP-SMX administration should be considered in high-risk patients. Early intervention is crucial to prevent PCP progression to ARDS in patients with solid tumors."

Journal • Acute Respiratory Distress Syndrome • Colorectal Cancer • Febrile Neutropenia • Hematological Disorders • Infectious Disease • Neutropenia • Oncology • Pneumonia • Pulmonary Disease • Respiratory Diseases • Solid Tumor

Refractory Gemcitabine-Induced Pneumonitis in Metastatic Testicular Cancer (ATS 2025) - "The chemotherapy regimen was switched from gemcitabine + oxaliplatin to bevacizumab + oxaliplatin...Treatment included prophylactic trimethoprim/sulfamethoxazole, oral prednisone at 1 mg/kg, bronchodilators, and broad-spectrum antibiotics...Corticosteroids were increased to 1.5 mg/kg, and empirical intravenous voriconazole was initiated...Conclusion Clinicians should remain vigilant when treating gemcitabine-induced pneumonitis. Future research should focus on optimal initiation, dosing, and duration of corticosteroids to positively impact respiratory status in this immunosuppressed population."

Metastases • Genito-urinary Cancer • Germ Cell Tumors • Infectious Disease • Oncology • Pneumonia • Solid Tumor • Testicular Cancer • Tuberculosis

Ectopic Cushing's Syndrome due to a Pulmonary NET: Diagnostic Challenges and the Need for a Multidisciplinary Approach (ESPE-ESE 2025) - "Treatment with metyrapone and ketoconazole was initiated, rapidly escalating doses with a block-and-replace strategy using hydrocortisone. Spironolactone was added for hypokalemia and hypertension control. Thromboprophylaxis with heparin and antibiotic prophylaxis with TMP-SMX were implemented... A multidisciplinary approach is essential for diagnosing and treating NET-associated CS. Advanced techniques such as 68Ga-DOTATOC PET/CT are crucial for early diagnosis. Management of complications are fundamental to successful treatment and patient recovery."

Cardiovascular • CNS Disorders • Cushing’s Disease • Depression • Diabetes • Endocrine Cancer • Endocrine Disorders • Genetic Disorders • Hypertension • Metabolic Disorders • Neuroendocrine Tumor • Obesity • Oncology • Psychiatry • Rare Diseases • Sarcopenia • Solid Tumor • NKX2-1 • SSTR • SYP

Elevated Liver Enzymes in a Patient with Obesity and Sleep-Related Eating Disorder During Semaglutide Therapy (ESPE-ESE 2025) - "Semaglutide and amoxicillin were discontinued, but liver enzymes further increased (AST 600 U/L, ALT 342 U/L) before gradually declining. Subsequent use of Bactrim led to a transient rise in liver enzymes... This case underscores the importance of monitoring liver function in patients receiving semaglutide, especially those with complex medical histories and concurrent medication use. Further research is warranted to elucidate the hepatic effects of semaglutide and its safety profile in patients with predisposing factors for liver dysfunction."

Clinical • Diabetes • Fatigue • Fibrosis • Genetic Disorders • Hepatology • Immunology • Infectious Disease • Liver Cirrhosis • Liver Failure • Metabolic Dysfunction-Associated Steatohepatitis • Novel Coronavirus Disease • Obesity • Obstructive Sleep Apnea • Respiratory Diseases • Sleep Disorder • Type 2 Diabetes Mellitus

A Parakeet Owner's Pulmonary Puzzle: Severe Asthma, Sarcoidosis, and Allergic Bronchopulmonary Aspergillosis (ABPA) Complicated by Stenotrophomonas maltophilia and Hypersensitivity Pneumonitis (ATS 2025) - "Case Report: A 71-year-old male with a history of sarcoidosis, severe persistent asthma on biologic therapy and home oxygen, ABPA, bronchiectasis (recently complicated by Proteus bronchitis treated with trimethoprim/sulfamethoxazole), morbid obesity, and obstructive sleep apnea presented with worsening dyspnea over 6 months. He had a remote smoking history, increasing oxygen requirements, and was on high-dose steroids, ipratropium-albuterol nebulizers, triple therapy inhaler, montelukast, tezepelumab, and omalizumab...He was initially treated with ceftriaxone and azithromycin, later switched to levofloxacin, and discharged on a 10-day course of minocycline with a prednisone taper...Biologic therapies, while effective for severe asthma, can increase susceptibility to infections, necessitating careful management of comorbid conditions. This case illustrates the need for a multidisciplinary approach in managing such patients, integrating pulmonology, infectious disease, and..."

Allergic Bronchopulmonary Aspergillosis • Asthma • Bronchiectasis • Genetic Disorders • Immunology • Infectious Disease • Inflammation • Obesity • Obstructive Sleep Apnea • Pneumonia • Pulmonary Disease • Respiratory Diseases • Sarcoidosis • Sleep Disorder

Characteristics of the Mare-Uterine-Culture-Based Bacterial Composition Using Practical Clinical Evaluation Methods. (PubMed, Pathogens) - "The most efficient antimicrobials were gentamicin, trimethoprim-sulfamethoxazole, and enrofloxacin and resistance was detected mainly for doxycycline, penicillin, and ceftiofur. This was a routine standard breeding evaluation of broodmares in the management of a stud farm, hence displaying the characteristics of a field study. The antimicrobial resistance findings reinforce the importance of performing microbiology and susceptibility tests, even under field conditions, to maximize targeted antimicrobial therapy efficiency and minimize the worldwide problem of antimicrobial resistance, promoting antimicrobial stewardship."

Journal • Endometriosis • Infectious Disease • Inflammation

From Symptoms to Solution: A Diagnostic Challenge of Whipple's Disease. (PubMed, Cureus) - "The patient was treated with ceftriaxone for a four-week course, followed by Bactrim DS for one year. Physicians should maintain a high level of suspicion for this disease and include it in their differential diagnosis. A prompt diagnosis and appropriate treatment will yield better outcomes."

Journal • Cardiovascular • Chronic Cough • Cough • Gastrointestinal Disorder • Infectious Disease • Musculoskeletal Pain • Pain • Pulmonary Disease • Respiratory Diseases

Escherichia coli in septic arthritis: prevalence and antibiotics susceptibility patterns. (PubMed, Iran J Microbiol) - "The identified E. coli strain showed significant resistance to common antibiotics: amoxicillin, amoxicillin-clavulanate, ceftriaxone, sulfamethoxazole/trimethoprim, gentamicin, tetracycline, and erythromycin. Antibiotic resistance in E. coli from SA patients suggests the need for accurate antibiotic selection to ensure prompt treatment."

Journal • Hematological Disorders • Immunology • Orthopedics • Rheumatology • CRP

Antimicrobial susceptibility, biofilm formation, and virulence genes among atypical enteropathogenic Escherichia coli stool isolates in Tehran, Iran. (PubMed, Iran J Microbiol) - "coli comprised 14% of all isolates were EPEC isolates that showed the highest sensitivity to imipenem (IPM) (100%) and gentamicin (GEN) (89%). However, susceptibility to ciprofloxacin and cotrimoxazole or trimethoprimsulfamethoxazole (SXT) was only 28% and 39%, respectively...Preventive measures by public health authorities can thwart the imminent crisis of widespread zoonotic contamination of the food chain in Iran. Our results may help clinicians make optimal therapeutic choices during the treatment of patients with severe EPEC infections, and assist epidemiologists devise policies for effective control of outbreaks."

Journal • Infectious Disease • Pediatrics

Molecular epidemiology of New Delhi metallo-β-lactamase-producing Escherichia coli in retail market chickens, Shandong, China. (PubMed, Front Microbiol) - "All of these isolates were multidrug-resistant (MDR), with a majority exhibiting resistance to meropenem, ampicillin, ceftazidime, cefotaxime, florfenicol, sulfamethoxazole/trimethoprim, and tetracycline. Phylogenomic analysis showed that NDM-positive E. coli isolates from chickens were closely related to those of human origin. This study provides a new insight into the spread of NDM-positive E. coli isolates from retail chicken, and offers essential data for public health management."

Journal

A Rare Case of Hypoxia and Cyanosis Secondary to Multifactorial Medication-Induced Sulfhemoglobinemia. (PubMed, Am J Case Rep) - "CASE REPORT A 37-year-old woman presented with acute dyspnea, lethargy, and hypoxia after exposure to severe oxidizing agents, including first-time use of trimethoprim-sulfamethoxazole and phenazopyridine, as well as lidocaine during a recent dental procedure (not her first exposure)...CONCLUSIONS Sulfhemoglobinemia is a rare and often missed diagnosis, as most blood gases analyzers do not measure sulfhemoglobin. Despite this, this diagnosis requires great clinical suspicion, as patients are at high risk for repeated exposure to offending agents and recurrence of life-threatening hypoxia."

Journal • Cardiovascular • Fatigue • Hematological Disorders • Pulmonary Disease

Severe hyponatremia due to trimethoprim-sulfamethoxazole: a case report. (PubMed, AME Case Rep) - "Trimethoprim-sulfamethoxazole (TMP-SMX) and spironolactone are two frequently administered medications; regrettably, most healthcare professionals are not aware that these medications might cause hyponatremia...Structurally akin to the potassium-sparing diuretic amiloride, TMP-SMX is linked to hyperkalemia and hyponatremia by obstructing epithelial sodium channels in the distal nephron...Thus, this report underscores the importance of vigilant monitoring and prompt identification of hyponatremia in patients undergoing TMP-SMX treatment. Further research is warranted due to limited data on the precise mechanisms of TMP-SMX-induced hyponatremia."

Journal • Cardiovascular • Coronary Artery Disease • Diabetes • Dyslipidemia • Heart Failure • Hypertension • Infectious Disease • Metabolic Disorders • Type 2 Diabetes Mellitus

Chorioretinal involvement in a patient with paracoccidioidomycosis: a case report. (PubMed, AME Case Rep) - "The patient was treated with systemic Amphotericin B followed by sulfamethoxazole-trimethoprim that resulted in notable improvements either in the palpebral cutaneous lesions of the OD and the chorioretinal lesion observed in OS...Early intervention with appropriate systemic antifungal therapy can significantly improve outcomes, preserving vision and mitigating systemic complications. Enhanced awareness among clinicians in endemic areas is essential for timely diagnosis and management."

Journal • Infectious Disease • Keratitis • Mycosis Fungoides • Ocular Infections • Ocular Inflammation • Ophthalmology • Respiratory Diseases

Evaluation of the relatedness between the biofilm-associated genes and antimicrobial resistance among Acinetobacter baumannii isolates in the southwest Iran. (PubMed, Iran J Microbiol) - "All isolates displayed multi-drug resistance, with the highest resistance rates observed against ceftazidime, cefotaxime, and trimethoprim/sulfamethoxazole (100%). Gentamicin and amikacin showed the lowest resistance rates at 70% and 84%, respectively...Biofilm production significantly contributes to the prevalence of multi-drug resistant A. baumannii strains. It is essential to implement effective antimicrobial stewardship and develop innovative anti-biofilm strategies to address this global health issue."

Journal • Critical care • Infectious Disease • PER1

Development and Implementation: The Registry for Autoimmunity and Infections in Female Carriers of Chronic Granulomatous Disease: Surveillance and Evaluation (RAISE) Study (CIS 2025) - "Five (41%) participants received infection prophylaxis, including trimethoprim-sulfamethoxazole (n = 5), itraconazole (n = 3), and interferon gamma-1b (n = 1). To our knowledge, this is the first national patient registry for XLCGD carriers. The majority of XLCGD carriers were symptomatic, had a long duration of symptoms, and had a high symptom burden including infections and autoimmunity. A lower DHR percentile was associated with increased infections."

Cardiovascular • Celiac Disease • Dermatology • Endocrine Disorders • Gastroenterology • Gastrointestinal Disorder • Immunology • Infectious Disease • Inflammation • Inflammatory Arthritis • Inflammatory Bowel Disease • Lupus • Nephrology • Ocular Inflammation • Ophthalmology • Pneumonia • Primary Immunodeficiency • Psoriasis • Psoriatic Arthritis • Pyoderma Gangrenosum • Respiratory Diseases • Rheumatology • Seronegative Spondyloarthropathies • Uveitis

Homozygous STAT-1 Loss of Function Presenting with Recurrent Respiratory Infections and Pneumocystis jirovecii Pneumonia (CIS 2025) - "She was started on prophylactic IVIG and acyclovir and regularly screened for EBV, CMV, and HHV-6...Ultimately, Pneumocystis jirovecii pneumonia was diagnosed by PCR from bronchoalveolar lavage; she improved with trimethoprimsulfamethoxazole...Given high risk for myco-bacterial infection, empiric treatment with azithromycin, amikacin, and linezolid was initiated...Planned conditioning regimen was rituximab, targeted dosing rATG, targeted busulfan, targeted fludarabine, and thiotepa...Graft-versus-host prophylaxis was tocilizumab and abatacept... Complete STAT1 deficiency is a severe immunodeficiency that is historically fatal in early life without curative HSCT. Our case supports the need for early transplant before the acquisition of and complications due to severe infections."

Bone Marrow Transplantation • Graft versus Host Disease • Immunology • Infectious Disease • Novel Coronavirus Disease • Pneumonia • Primary Immunodeficiency • Pulmonary Disease • Respiratory Diseases • Respiratory Syncytial Virus Infections • IFNG • STAT1

WHIM Syndrome Diagnosis in a Parent and Child (CIS 2025) - "Mavorixafor was started and pegfilgrastim discontinued with no sinopulmonary infections or hospitalizations since initiation. However, skin rashes worsened, and he developed an axillary abscess requiring trimethoprim-sulfamethoxazole and cephalexin therapy...PIDs with milder phenotypes are often not considered in adult patients until severe manifestations occur, as seen in Case 1. Diagnosis of PIDs should prompt early immune evaluation with consideration of genetic testing in family members."

Clinical • Dermatology • Immunology • Infectious Disease • Otorhinolaryngology • Pneumococcal Infections • Pneumonia • Primary Immunodeficiency • Respiratory Diseases • Tetanus • CD4 • CD8 • CXCR4

FOXI3 Variant Associated with Persistent T Cell Lymphopenia (CIS 2025) - "At 20 months of age, she remains clinically stable on trimethoprim-sulfamethoxazole prophylaxis without significant infections, and live viral vaccines have been withheld. This case highlights the potential role of FOXI3 in thymic function and T cell development. The long-term prognosis remains uncertain, underscoring the need for further biochemical and functional studies to clarify the pathogenicity of FOXI3 variants and optimize clinical management strategies."

Lymphopenia • Hematological Malignancies • Infectious Disease • CD4 • CD8

Primary Intestinal Lymphangiectasia as a Cause of Combined Immunodeficiency (CIS 2025) - "After initiating treatment with subcutaneous immunoglobulin and trimethoprim/sulfamethoxazole prophylaxis, immune parameters remained suboptimal (total IgG: 515 mg/dL; CD4+ count: 150 cells/µL; CD8+ count: 153 cells/µL)...In this report, we discuss the clinical course of this patient and provide an overview of the published literature regarding clinical manifestations and diagnostic laboratory values of immunodeficiency associated with PIL. We conclude that PIL should be considered as a cause of combined immunodeficiency or hypogammaglobulinemia in the absence of an alternative explanation in both adult and pediatric patients."

Fatigue • Gastroenterology • Immunology • Infectious Disease • Inflammation • Inflammatory Bowel Disease • Pain • Pediatrics • Primary Immunodeficiency • Rare Diseases • CD4 • CD8

CGD Female Carriers Can Be Highly Symptomatic due to Lyonization: A de novo CYBB Variant (CIS 2025) - "The patient was recommended triple therapy (TMP-SMX, itraconazole, and IFN-gamma) prophylaxis; however, parents opted for TMP-SMX only. Skin biopsy also showed cutaneous lupus, well controlled after starting daily hydroxychloroquine. The lack of awareness of highly symptomatic CGD carriers can lead to significant delay in diagnosis and management of their CGD phenotype with recurrent infections and multiple autoimmunity phenomena."

Cutaneous Lupus Erythematosus • Dermatitis • Dermatology • Immunology • Infectious Disease • Inflammatory Arthritis • Lupus • Otorhinolaryngology • Primary Immunodeficiency • Respiratory Diseases • CYBB • IFNG

A Case of Smear-negative, PCR-positive Pneumocystis Jirovecii Pneumonia in a Patient With Crohn's Disease (ATS 2025) - "She was treated with fidaxomicin and metronidazole...Despite diuresis and antibiotic therapy with piperacillin-tazobactam, her condition continued to deteriorate, necessitating transfer to the ICU and subsequent intubation...TMP-SMX is effective for treatment and prophylaxis. Guidelines recommend primary PJP prophylaxis for IBD patients on triple immunosuppression and recommend its consideration for dual immunosuppression, especially with calcineurin inhibitors. Our patient was on prednisone and infliximab, highlighting the importance of assessing individual risk factors when determining appropriateness of PJP prophylaxis."

Clinical • Crohn's disease • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Hematological Malignancies • Immunology • Infectious Disease • Inflammatory Bowel Disease • Oncology • Pneumonia • Respiratory Diseases • Solid Organ Transplantation