Chronic granulomatous disease: effect of sulfamethoxazole/trimethoprim on neutrophil microbicidal function.

During phagocytosis, neutrophil granulocytes exhibit a burst of metabolic activity characterized by an increase in oxygen consumption. Oxygen is reduced to Superoxide anion by an NADPH-oxidase-system in the neutrophil plasma membrane, and is then rapidly converted into microbicidal hydrogen peroxide. The best-studied condition with aberrations in this respiratory burst is chronic granulomatous disease (CGD). This syndrome is clinically manifested by severe, recurrent infections of the skin, lymph nodes, lungs, liver, and bone by Staphylococcus aureus, gram-negative enteric bacilli and fungi. In vitro, the neutrophils and monocytes of these patients phagocytose these organisms normally, but fail to kill them because of a lack of Superoxide and hydrogen peroxide production.