Fatal hepatotoxicity is a known complication of sulfamethoxazole and sulfamethoxazole-trimethoprim. We report a case of a man previously exposed to sulfamethoxazole-trimethoprim who died of liver failure following subsequent ingestion of only two tablets of the drug (160 mg trimethoprim and 800 mg sulfamethoxazole). This case indicates the danger to a susceptible patient of even small (e.g., "rechallenge") doses of sulfamethoxazole.