ABSTRACT
Acute interstitial nephritis accounts for about 10 % of the cases of acute renal failure. An adverse drug reaction caused by an immunoallergic mechanism is suggested when fever, skin rash, eosinophilia, and eosinophiluria are associated. The outcome is favorable after withdrawal of drug therapy in most cases. We report a case of acute interstitial nephritis induced by immunoallergic drug mechanisms, in a 3-week-old infant who presented with acute renal failure associated with eosinophilia and hepatitis and who had received cefotaxime and gentamicin. The patient's progression was favorable with normalization of renal and liver function 1 week after suspension of antibiotic drugs.
Subject(s)
Anti-Bacterial Agents/adverse effects , Cefotaxime/adverse effects , Gentamicins/adverse effects , Nephritis, Interstitial/chemically induced , Acute Disease , Eosinophilia/chemically induced , Hepatitis/etiology , Humans , Infant, Newborn , MaleABSTRACT
We report a 38-year-old man who presented successively a thrombosis of the right popliteal vein and the right popliteal artery, responsible of a painful edema of the leg. There was no known thrombophilic predisposing condition. Radiologic assessment, guided by clinical findings, evidenced bilateral femoral and tibial exostosis resulting in a diagnosis of hereditary multiples exostosis. Although anticoagulant treatment with unfractioned heparin was instituted, distal ischemia of the right lower limb developed. Resection of the compressive osteochondroma and an arterial femorotibial bypass venous graft were performed in addition to prolonged anticoagulant therapy. Outcome was eventually favorable. Hereditary multiple exostosis may be asymptomatic for long time. Compression of adjacent vascular structures by an osteochondroma is a rare and potentially serious complication.
Subject(s)
Exostoses, Multiple Hereditary/diagnosis , Popliteal Artery , Venous Thrombosis/etiology , Adult , Exostoses, Multiple Hereditary/complications , Humans , Male , Thrombosis/etiologyABSTRACT
INTRODUCTION: Metronidazole is a widely prescribed treatment for amoebic and anaerobic germ infections. Its neurologic toxicity is rare but can be serious. CASE REPORT: We report the case of a 27-year-old male patient, treated with metronidazole for a cerebral abscess. He presented with a cerebellar syndrome and peripheral neuropathy at a cumulative metronidazole dose of 60g. The MRI aspect of the cerebellar lesions in addition to their reversibility after treatment cessation led to the diagnosis of metronidazole induced neurologic toxicity. CONCLUSION: The occurrence of neurologic disorders in patients treated with metronidazole must suggest drug toxicity and lead to cessation of treatment.
Subject(s)
Brain Abscess/drug therapy , Cerebellar Diseases/chemically induced , Metronidazole/adverse effects , Peripheral Nervous System Diseases/chemically induced , Adult , Cerebellar Diseases/diagnosis , Consciousness Disorders/chemically induced , Humans , Magnetic Resonance Imaging , Male , Metronidazole/therapeutic use , Sensation Disorders/chemically inducedABSTRACT
We report 32 cases of acute encephalitis consecutively hospitalized in one hospital, from January 1991 to December 2002. The causative agent was identified in 26 cases (81%). The main associated viruses were varicella-zoster (10 children; 31%), Herpes simplex (6 children; 19%), and enteroviruses (4 children; 13%). At the acute phase, the most relevant biological findings were electroencephalogram results and CSF analysis. The initial encephalic imaging was primarily helpful to exclude other acute neurological diseases whereas long-term imaging was a prognostic factor for necrotizing encephalitis. The microbiological diagnosis required several days or weeks to be determined. It did not influence the initial management. In addition to the 6 cases of herpetic encephalitis, 19 children (78% altogether) were then treated by acyclovir before a definitive diagnosis was made. Twenty-two children (69%) had a favorable outcome, 2 (6%) had moderate sequels, 2 (6%) had important ones, and 5 (16%) had major ones. One (3%) child died. The outcome was highly dependant on the causative agent and the mechanism of encephalitis. This series gives information on the epidemiology of encephalitis in children in our region over a period of 12 years.
Subject(s)
Encephalitis, Viral/diagnosis , Acute Disease , Adolescent , Age Distribution , Child , Child, Preschool , Encephalitis, Viral/classification , Encephalitis, Viral/epidemiology , France , Hospitals, University , Humans , Infant , Viruses/classification , Viruses/isolation & purificationABSTRACT
The nasal angiocentric T-cell-natural killer cell lymphoma is an aggressive tumor, exceptional in Tunisia, which is observed especially in Asia, Mexico and South America. We report the case of an 11-year-old boy, presenting with an exuberant and ulcerative tumor of the right nasal pit. Radiological investigation evidenced a right ethmoïdo-frontal tumor. Evolution was characterized by the installation of abdominal pain and fever, the evidenciation of a mass within the head of the pancreas that compressed the extra hepatic biliary duct and Wirsung's canal and was associated to hyperamylasemia. Biopsy under ultrasound revealed a histiocytic nature. Nasal biopsy found histiocytic and lymphocytic cells and led to a diagnosis of rhinoscleroma. The absence of improvement under antibiotic treatment and the development of fever with leuconeutropenia oriented towards the diagnosis of a non-Hodgkinian malignant lymphoma. Medullary biopsy and immunohistochimic study confirmed a T/NK cells lymphoma, with medullary invasion. The child died from acute respiratory distress syndrome. The authors insist on the rarity of this bipolar location, in particular in children, emphasize the difficulty of the diagnosis and review the literature.
