ABSTRACT
Nocardia infection is an uncommon and rare condition in immunocompetent patient. A case of cutaneous nocardiosis complicated with osteomyelitis of the vault scalp in a 64-year-old man, with no remarkable past medical history, is reported. Treatment with trimethoprime-sulfamethoxazole than doxycycline for 12 months led to complete resolution and no evidence of recurrence was noted. Nocardia infection should be considered even in immunocomptent patients and doxycycline is a good alternative for treatment.
Subject(s)
Anti-Bacterial Agents/administration & dosage , Nocardia Infections/diagnosis , Osteomyelitis/diagnosis , Skull/pathology , Doxycycline/administration & dosage , Humans , Male , Middle Aged , Nocardia Infections/complications , Nocardia Infections/drug therapy , Osteomyelitis/drug therapy , Osteomyelitis/microbiology , Skull/microbiology , Trimethoprim, Sulfamethoxazole Drug Combination/administration & dosageABSTRACT
Infections are an important cause of morbidity and mortality in Systemic Lupus Erythematosus (SLE). Mediterranean spotted fever (MSF) is a tick-borne disease caused by Rickettsia conorii. This infection is endemic in Tunisia with summer seasonality. Herein, the case of a 45 years old woman, admitted to hospital with fever and erythema nodosum. On examination, she had a diffuse skin rash, malar rash, and polyarthritis. Serology demonstrated Rickettsia Conoriiinfection. The diagnosis of MSF was made and the patient had a course of doxycycline for 5 days with a prompt improvement of the fever, the skin lesions but she had a persistent malar rash, polyarthritis, and lymphopenia. The immunological profile was positive for antinuclear antibodies (ANA), anti-DNA antibodies, anti-nucleosomes antibodies, and anti-citrullinated protein antibodies (ACPA). The diagnosis of SLE was established. We report the first case of SLE associated with MSF and with erythema nodosum as the initial presentation.
Subject(s)
Boutonneuse Fever/diagnosis , Doxycycline/administration & dosage , Lupus Erythematosus, Systemic/diagnosis , Boutonneuse Fever/drug therapy , Female , Humans , Lupus Erythematosus, Systemic/pathology , Middle Aged , Rickettsia conorii/isolation & purificationABSTRACT
We report a case of a 64-year-old woman treated with meglumine antimoniate (Glucantime®). On day 20, she developed fever, a pruriginous skin rash and myalgia. The blood tests showed eosinophilia and hepatic cytolysis. The clinico-biological picture improved gradually and the symptoms disappeared 4 weeks after the drug withdrawal. Six weeks later, intradermal tests to Glucantime® were performed and were positive at 48 hour-reading. This clinical picture suggests DRESS induced by meglumine antimoniate. To the best of our knowledge, only one case of meglumine antimoniate-induced DRESS has been reported in the literature and we are the first to report a case confirmed by skin tests.
Subject(s)
Antiprotozoal Agents/adverse effects , Drug Hypersensitivity Syndrome/etiology , Leishmaniasis, Cutaneous/drug therapy , Meglumine Antimoniate/adverse effects , Animals , Antiprotozoal Agents/therapeutic use , Cryotherapy , Eosinophilia/chemically induced , Exanthema/chemically induced , Female , Humans , Intradermal Tests , Leishmaniasis, Cutaneous/therapy , Meglumine Antimoniate/therapeutic use , Metronidazole/therapeutic use , Middle AgedABSTRACT
Tigecycline is a broad-spectrum antibiotic with activity against multidrug-resistant (MDR) bacteria. It has limited indications. Studies are necessary to elaborate new guidelines. Here we report a case of postoperative MDR Acinetobacter baumannii meningitis treated by tigecycline combined with colimycin for 21 days. The treatment was well tolerated with a favourable outcome. In conclusion, tigecycline was shown to be effective in a case of MDR A. baumannii meningitis.
