A case series suggests there may be a link between trimethoprim-sulfamethoxazole treatment and the development of acute respiratory failure in five previously healthy adolescents.

However, even if confirmed, the complication would still be a very rare occurrence, an expert says.

The patients in the case series were identified after a story about one of them was published in a news outlet.

Dr Jenna Miller, of Children’s Mercy Hospital and Clinics in Kansas City, US, had cared for the patient and was subsequently contacted by four additional patients or family members who reported similar clinical events.