Intravenous trimethoprim-sulfamethoxazole and ataxia
Liu, L.X.; Seward, S.J.; Crumpacker, C.S.
Annals of Internal Medicine 104(3): 448
1986
ISSN/ISBN: 0003-4819 PMID: 3484928 Document Number: 275064
Two cases of severe reversible ataxia that developed in patients with Pneumocystis carinii infections, during therapy with i.v. trimethoprim-sulphamethoxazole are reported. The first patient may have had subacute encephalitis described in AIDS patients but his ataxia resolved with dosage reduction followed by cessation of trimethoprim-sulphamethoxazole therapy, and ataxia has not been reported in patients with AIDS except in association with demonstrated cerebellar lesions (absent in this patient). The 2nd patient developed ataxia associated with toxic serum levels of trimethoprim; the ataxia resolved and did not recur with lower dosages of i.v. and oral trimethoprim-sulphamethoxazole. Monitoring of serum levels of trimethoprim may be helpful in avoiding and managing ataxia due to the drug.