{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T23:27:54Z","timestamp":1783121274045,"version":"3.54.6"},"reference-count":9,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,9,17]],"date-time":"2021-09-17T00:00:00Z","timestamp":1631836800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,9,17]],"date-time":"2021-09-17T00:00:00Z","timestamp":1631836800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Urol"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Drug-induced urolithiasis falls into two categories: drug-induced and metabolically-induced. Certain antimicrobials are associated with each; sulfonamides are associated with drug- or metabolite-containing calculi when taken in large doses over a long period of time. Trimethoprim-sulfamethoxazole, a member of the sulfonamide family, is a rare cause of drug-induced calculi. Cases of sulfonamide urolithiasis occurring in patients with known stone disease have rarely been reported.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>We report a case of a patient with a brief history of recurrent calcium oxalate nephrolithiasis requiring 2 ureteroscopic procedures whose existing 6\u00a0mm lower pole renal stone more than quadrupled in size to form a 4\u00a0cm renal staghorn after 4\u00a0months of high-dose treatment for <jats:italic>Nocardia<\/jats:italic> pneumonia with trimethoprim-sulfamethoxazole. After ureteroscopy with laser lithotripsy and basketing of fragments, the stone was found to be predominantly composed of N<jats:sup>4<\/jats:sup>-acetyl-sulfamethoxazole, a metabolite of sulfamethoxazole.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Stones composed of sulfamethoxazole or its metabolites are rare but have known associated risk factors that should be considered when prescribing this antibiotic. This case report illustrates additional risk factors for consideration, including pre-existing urinary calculi that may serve as a nidus for sulfamethoxazole deposition, and reviews treatment and prevention methods.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12894-021-00894-5","type":"journal-article","created":{"date-parts":[[2021,9,17]],"date-time":"2021-09-17T13:04:08Z","timestamp":1631883848000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Sulfamethoxazole-induced sulfamethoxazole urolithiasis: a case report"],"prefix":"10.1186","volume":"21","author":[{"given":"Megan M.","family":"Roedel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen Y.","family":"Nakada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina L.","family":"Penniston","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,9,17]]},"reference":[{"key":"894_CR1","doi-asserted-by":"publisher","unstructured":"Daudon M, Frochot V, Bazin D, Jungers P. Drug-induced kidney stones and crystalline nephropathy: pathophysiology, prevention and treatment [Internet]. Drugs. Springer International Publishing; 2018 [cited 2021 Jun 1]. p. 163\u2013201. Available from: https:\/\/doi.org\/10.1007\/s40265-017-0853-7","DOI":"10.1007\/s40265-017-0853-7"},{"key":"894_CR2","doi-asserted-by":"publisher","unstructured":"Albala DM, Galal HA, Prien EL. Urolithiasis as a hazard of sulfonamide therapy. J Endourol [Internet]. 1994 [cited 2021 May 8];8:401\u20133. Available from: https:\/\/www.liebertpub.com\/doi\/abs\/https:\/\/doi.org\/10.1089\/end.1994.8.401","DOI":"10.1089\/end.1994.8.401"},{"key":"894_CR3","doi-asserted-by":"crossref","unstructured":"Miller AW, Orr T, Dearing D, Monga M. Loss of function dysbiosis associated with antibiotics and high fat, high sugar diet. ISME J [Internet]. Nature Publishing Group; 2019 [cited 2021 Jun 2];13:1379\u201390. Available from: http:\/\/www.nature.com\/articles\/s41396-019-0357-4","DOI":"10.1038\/s41396-019-0357-4"},{"key":"894_CR4","doi-asserted-by":"crossref","unstructured":"Cockerill FR, Edson RS. Trimethoprim-sulfamethoxazole. Mayo Clin Proc [Internet]. Mayo Clin Proc; 1991 [cited 2021 May 25];66:1260\u20139. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/1749295\/","DOI":"10.1016\/S0025-6196(12)62478-1"},{"key":"894_CR5","doi-asserted-by":"publisher","first-page":"482","DOI":"10.1016\/S0022-5347(17)61764-6","volume":"104","author":"LE Dorfman","year":"1970","unstructured":"Dorfman LE, Smith JP. Sulfonamide crystalluria: a forgotten disease. J Urol. 1970;104:482\u20133.","journal-title":"J Urol"},{"key":"894_CR6","doi-asserted-by":"publisher","unstructured":"DeMasi MS, Bernstein AP, Schulster M, Silva M V. 100% N4-acetyl-sulfamethoxazole stone induced by trimethoprim-sulfamethoxazole in an HIV patient being treated for toxoplasmosis. Urol Case Reports [Internet]. Elsevier Inc.; 2021;34:101453. Available from: https:\/\/doi.org\/10.1016\/j.eucr.2020.101453","DOI":"10.1016\/j.eucr.2020.101453"},{"key":"894_CR7","first-page":"324","volume":"49","author":"RW Barnes","year":"1943","unstructured":"Barnes RW, Kawaichi GK. Factors influencing the formation of sulfonamide urinary concretions. J Urol Ovid Technologies (Wolters Kluwer Health). 1943;49:324\u201330.","journal-title":"J Urol Ovid Technologies (Wolters Kluwer Health)"},{"key":"894_CR8","doi-asserted-by":"crossref","unstructured":"Maalouf NM, Cameron MA, Moe OW, Sakhaee K. Metabolic basis for low urine pH in type 2 diabetes. Clin J Am Soc Nephrol [Internet]. Am Soc Nephrol.; 2010;5:1277. Available from: \/pmc\/articles\/PMC2893060\/","DOI":"10.2215\/CJN.08331109"},{"key":"894_CR9","doi-asserted-by":"crossref","unstructured":"Siegel WH. Unusual complication of therapy with sulfamethoxazole trimethoprim. J. Urol. No longer published by Elsevier; 1977. p. 397.","DOI":"10.1016\/S0022-5347(17)58476-1"}],"container-title":["BMC Urology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12894-021-00894-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12894-021-00894-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12894-021-00894-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,17]],"date-time":"2021-09-17T13:05:11Z","timestamp":1631883911000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcurol.biomedcentral.com\/articles\/10.1186\/s12894-021-00894-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,17]]},"references-count":9,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["894"],"URL":"https:\/\/doi.org\/10.1186\/s12894-021-00894-5","relation":{},"ISSN":["1471-2490"],"issn-type":[{"value":"1471-2490","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,17]]},"assertion":[{"value":"29 July 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 September 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 September 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Written informed consent to participate was obtained from the patient of this case report. A copy of the written consent is available for review by the Editor of this journal.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"133"}}