Recurrent pulmonary embolism associated with a hemostatic drug: tranexamic acid.

Tranexamic acid (TA) used in a variety of conditions associated with bleeding has been associated with potential thrombotic side effects such as formation of thrombi and pulmonary embolism (PE). We describe a case of a woman with chronic hemoptysis and a history of PE, who recently used TA as a prophylactic measure, which could have resulted in a new episode of PE. Tranexamic acid probably played a contributory role in the development of her second PE.

[Three patients with thoracic actinomycosis]. / Drie patiënten met thoracale actinomycose.

Thoracic actinomycosis was diagnosed in 3 patients. A 39-year-old man with no relevant medical history was admitted with syncope and hemiparesis. Radiological examination of the thorax and cerebrum revealed abnormalities. The second patient was a 50-year-old man with pneumonia that had not responded to multiple courses of different antibiotics. The third patient was a 42-year-old man admitted for evaluation and treatment of hepatopulmonary abnormalities. Actinomyces was cultured from purulent material obtained under anaerobic conditions as far as possible from the first 2 patients; the third patient was diagnosed by histopathological examination. All 3 patients recovered completely after long-term antibiotic therapy. Actinomycosis remains a diagnostic challenge due to the inherent difficulties in culturing anaerobic bacteria. In addition, false-positive results are possible because Actinomyces is present in the oropharynx, digestive tract and female genital tract under normal conditions.