Abstract
Pneumocystis pneumonia (PCP), a common opportunistic infection in HIV-infected individuals, is generally treated with high doses of co-trimoxazole. However, treatment is often limited by adverse effects. Here, we report two cases of severely immunocompromised HIV-infected patients who developed severe intrahepatic cholestasis, and in one patient lesions mimicking liver abscess formation on radiologic exams, during co-trimoxazole treatment for PCP. Whereas patient 1 showed lesions of up to 1 cm readily detectable on magnetic resonance imaging under prolonged co-trimoxazole treatment, therapy of patient 2 was switched early.
MeSH terms
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AIDS-Related Opportunistic Infections / drug therapy*
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AIDS-Related Opportunistic Infections / microbiology
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Adult
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Anti-Infective Agents / administration & dosage
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Anti-Infective Agents / adverse effects*
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Anti-Infective Agents / therapeutic use
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Cholestasis, Intrahepatic / chemically induced*
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Cholestasis, Intrahepatic / pathology
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Cholestasis, Intrahepatic / physiopathology
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Humans
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Immunocompromised Host
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Magnetic Resonance Imaging
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Male
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Pneumocystis carinii* / drug effects
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Pneumonia, Pneumocystis / drug therapy*
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Pneumonia, Pneumocystis / microbiology
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Trimethoprim, Sulfamethoxazole Drug Combination / administration & dosage
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Trimethoprim, Sulfamethoxazole Drug Combination / adverse effects*
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Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use
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Young Adult
Substances
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Anti-Infective Agents
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Trimethoprim, Sulfamethoxazole Drug Combination