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Medical Science Monitor Basic Research


Methemoglobinemia in a Pediatric Oncology Patient Receiving Sulfamethoxazole/Trimethoprim Prophylaxis

Unusual or unexpected effect of treatment, Unexpected drug reaction , Rare disease, Educational Purpose (only if useful for a systematic review or synthesis)

Timothy G. Carroll, Megan G. Carroll

USA Department of Pediatrics, Section of Critical Care, University of Oklahoma Health Science Center, Oklahoma City, OK, USA

Am J Case Rep 2016; 17:499-502

DOI: 10.12659/AJCR.897820

Available online:

Published: 2016-07-18

BACKGROUND: Methemoglobinemia due to the administration of sulfamethoxazole/trimethoprim has been documented in a series of case reports. However, all of these reports are on adult patients, and all patients received at least daily administration of sulfamethoxazole/trimethoprim for the treatment of active or suspected infection.
CASE REPORT: Herein we report the development of methemoglobinemia in a pediatric patient receiving sulfamethoxazole/trimethoprim three times weekly for the prophylaxis of opportunistic infections.
CONCLUSIONS: The clinician should always consider sulfamethoxazole/trimethoprim, even when administered for opportunistic infection prophylaxis at reduced doses and intervals, as a possible cause of methemoglobinemia.

Keywords: Leukemia, Myelomonocytic, Juvenile - complications, Methemoglobinemia - chemically induced, Opportunistic Infections - prevention & control, Trimethoprim, Sulfamethoxazole Drug Combination - therapeutic use