ABSTRACT
BACKGROUND: Disseminated Nocardia infection is a disease that is easily overlooked in patients with lesions occupying the intracranial space complicated with coma. Early diagnosis and treatment are crucial. CASE PRESENTATION: A 65-year-old man was admitted to the First Affiliated Hospital of Zhejiang University in October 2018 with weakness in the right limbs for 3 days and altered consciousness for 1 day. Five months earlier, he had been diagnosed with membranous kidney disease and had received cyclophosphamide and prednisone. At admission, the white blood cell count was 1.37 × 1010/L (with 86.4% neutrophils), and C-reactive protein was 115.60 mg/L. Imaging examinations revealed a lesion occupying the intracranial space, lung infection, and multiple abscesses in the rhomboid muscle. The abscesses were drained. Pus culture confirmed Nocardia cyriacigeorgica infection. With antibiotics and vacuum-sealed drainage of the back wound, the patient improved and was discharged from the hospital. CONCLUSIONS: This case report shows that infection should be considered during the differential diagnosis of lesions in the intracranial space, especially in patients receiving immunosuppressive treatment. In patients with disseminated N. cyriacigeorgica infection, combination antibiotic therapy and surgical drainage of localised abscesses can be effective.
Subject(s)
Coma/complications , Mesencephalon/diagnostic imaging , Nocardia Infections/complications , Nocardia Infections/diagnosis , Nocardia/isolation & purification , Thalamus/diagnostic imaging , Aged , Anti-Bacterial Agents/therapeutic use , Cyclophosphamide/adverse effects , Diagnosis, Differential , Drainage , Follow-Up Studies , Humans , Immunosuppressive Agents/adverse effects , Magnetic Resonance Imaging , Male , Mesencephalon/pathology , Nocardia Infections/drug therapy , Nocardia Infections/microbiology , Thalamus/pathology , Tomography Scanners, X-Ray Computed , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To establish the processing method of fructus evodiae and its standard for quality control, toxicity aspects and pharmacodynamics were carried out at the same time.</p><p><b>METHOD</b>In the studies of processing techniques, the optimized technical parameters were determined by the contents of evodiamine and evodine. And the acute toxicity and pharmacodynamics were studied by rats.</p><p><b>RESULT</b>The process was that the liquorice-processed fructus evodiae was wetted by liquorice decoction by sixth of raw fructus evodiae (V/W) and fried below 230 degrees C. The method of detecting the contents of evodiamine and evodine was that Alltima ODS C18 (4.6 mm x 250 mm, 5 microm); mobile phase acetonitrile-water-tetrahydrofuran-phosphoric acid (51:48: 1: 0.05); column temperature 25 degrees C; mobile rate 0.8 mL x min(-1); wave length 225 nm. The toxicity experimentation show that rats didnt show any notable changes after affused the raw material and the processed fructus evodiae's decotion 40 g x kg(-1) b. w. at one time seven days constantly. The analgesic effect was observed after 0.6 g (material) x kg(-1) (weight) b. w.</p><p><b>CONCLUSION</b>The toxicity of the raw material and the processed one were low and the liquorice-processed fructus evodia analgesic effect was good.</p>
Subject(s)
Animals , Female , Male , Mice , Analgesics , Pharmacology , Therapeutic Uses , Toxicity , Chromatography , Drugs, Chinese Herbal , Pharmacology , Therapeutic Uses , Toxicity , Glycyrrhiza , Chemistry , Linear Models , Mice, Inbred ICR , Pain , Drug Therapy , Reproducibility of Results , Rutaceae , Chemistry , TemperatureABSTRACT
<p><b>OBJECTIVE</b>To investigate the equivalent relationship between granule for clinical prescription and clincal decoction by use of fructus evodiae as a demonstrated object.</p><p><b>METHOD</b>Compared the equivalent ratio relationship of granule for clincal prescription and clincal decoction by determination of evodiamine, rutaecarpine, evodine, total alkaloids and dried extract ratio as markers, ten batches reference decoctions were prepared according to clinical usage as evaluation standards, common-use processed fructus evodiae products, such as salt-processed fructus evodiae, liquorice-proccesed fructus evodiae, as researching objects, and finally validated by pharmacological trials.</p><p><b>RESULT</b>Equivalent ratios of granule for clical prescription to clincal decoction are about two in all processed products, and the pharmacological evaluation showed no siginificant difference in this ratio.</p><p><b>CONCLUSION</b>This equivalent ratio model could be referenced in the production. But, it must be noticed that different herbal medicines perhaps have different equivalent ratio, which should be studied further according to its techniques and production conditions, and finally need to be revalidated by clinical trial.</p>