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INTRODUCTION: Disseminated tuberculosis can involve several organs and clinically present with a potpourri of signs and symptoms. Early diagnosis and timely initiation of proper treatment are of great importance in preventing the later complications of the disease. CASE PRESENTATION: We report a case with disseminated tuberculosis who exhibited a wide spectrum of extrapulmonary involvement. The present case had lung and lymph node tuberculosis with abscess formation and remained undiagnosed for two years. Thereafter, multiple splenic abscesses developed that necessitated splenectomy, and at the final stage, he presented with scrotal abscesses. CONCLUSION: This paper highlights the diverse clinical appearances of disseminated tuberculosis and the significant importance of early diagnosis and treatment.
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BACKGROUND: Antibacterial activity of local anesthetics especially lidocaine has been shown previously. In this study, the antibacterial effect of ketamine, a general anesthetic agent was investigated. METHODS: The antibacterial effect of ketamine was studied using six different strains of bacteria (Staphylococcus aureus, Staphylococcus epidermidis, Entecoccus faecalis, Streptococcus pyogenes, Pseudomonas aeruginosa and Escherichia coli) with disc diffusion method. Ciprofloxacine discs (CIP, oxoid) were used as a control to verify the methodology. Minimal inhibition concentration (MIC) and minimal bactericidal concentration (MBC) of ketamine for these bacteria were also determined. RESULTS: No inhibition was evident in discs containing 62.5 microg of ketamine. Ketamine 125 microg showed activity on all the bacteria tested with the exception of E. coli. The inhibition rates of Ketamine were more prominent at the doses of 250 microg and 500 microg similar to the inhibition rate of CIP. Whereas MIC and MBC values of ketamine for S. aureus and S. pyogenes were 500 microg mL(-1), MIC and MBC values for P. aeruginosa were above 2000 microg mL(-1). For other bacteria, these values ranged between these levels. CONCLUSIONS: Ketamine with higher doses showed antibacterial activity. We thought that it will be proper to use ketamine hesitantly in experimental animal studies like sepsis and translocation.
