amoxicillin-potassium-clavulanate-combination and Granuloma

An African penguin (Spheniscus demersus) presented with a large peri-cloacal mass. The mass was diagnosed as a pyogranuloma histologically, with multifocal to coalescing inflammatory responses in the subcutis and keratinized simple stratified squamous epithelium overlying the surface. The patient was prescribed 125 mg/kg oral clavulanic acid/amoxycillin twice a day and 20 mg/kg oral terbinafine once a day for 14 days, but there was no change in the size of the mass 4 days after therapy, so a decision was made to administer 1 mg/kg of intralesional methylprednisolone. Fourteen days later, the mass resolved with no further recurrence. This case demonstrated that intralesional methylprednisolone used with antibiotic and antifungals was effective in resolving a peri-cloacal pyogranuloma and without any side effects.

Topics: Amoxicillin-Potassium Clavulanate Combination; Animals; Animals, Zoo; Anti-Bacterial Agents; Antifungal Agents; Bird Diseases; Granuloma; Injections, Intralesional; Male; Methylprednisolone; Spheniscidae; Terbinafine

Nontuberculous mycobacterial (NTM) disease is commonly an opportunistic infection frequently found in immunocompromised individuals, but sometimes can also be found in the immunocompetent hosts, especially in East Asians. The NTM separation rate in China is increasing, which reminds us to focus on NTM infections in immunocompromised populations.. A 43-year-old woman with a recurrent fever for more than 8-month and a right forehead surgical wounds unhealed for more than 6-month was admitted to our hospital on February 22, 2018. On arrival, several elliptic ulcers were obvious on the right forehead with pus and fibrin exudation, and the skin around the lesions was tender, reddish, no sense of fluctuation. The result of HIV serology test was negative. CD4+ T cell count was normal and tuberculosis antibody was negative. CT of the chest and head showed bone destruction. Skin biopsy on the right forehead was performed on March 13, 2018, and pathological examination of the excisional biopsy specimen found inflammatory granuloma and suppurative inflammatory changes. Broad-spectrum antibiotics were treated but the effect seemed discontent. Then debridement and skin grafting were performed on the right frontal ulcer under general anesthesia on April 3, 2018. The skin tissue culture that resected on March 13, 2018 found Nontuberculous mycobacteria grown after 78 days, so clarithromycin, ethambutol, protionamide, and amoxicillin clavulanate potassium were prescribed for anti-nontuberculous mycobacteria treatment beginning on May 31, 2018. In reviewing the case, Mycobacterium avium (M. avium) was identified in the skin tissue resected on April 3, 2018 by polymerase chain reaction (PCR) and the serum test of anti-interferon-γ autoantibodies was positive.. This is a case report of "Mycobacterium avium SSTI (skin and soft tissue infection) and OM (osteomyelitis) with possible secondary immunodeficiency syndrome induced by anti-interferon-γ autoantibody".

Topics: Adult; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Autoantibodies; Clarithromycin; Ethambutol; Female; Granuloma; Humans; Interferon-gamma; Microbial Sensitivity Tests; Mycobacterium avium; Mycobacterium Infections, Nontuberculous; Osteomyelitis; Scalp; Soft Tissue Infections

An 8-year-old, male neutered Siamese cat was presented with Horner syndrome and right head tilt. A soft tissue mass was observed in the right tympanic cavity, and bulla osteotomy was performed. Tissue samples retrieved from the tympanic cavity were sent for histology, and a middle ear fluid swab was sent for bacterial culture and sensitivity. Histologic diagnosis was of otitis media associated with cholesterol granuloma (CG). Bacterial culture yielded Pasteurella multocida and Leifsonia (Corynebacterium) aquaticum. Middle ear CG is frequently seen in human beings and is associated with a variety of middle ear diseases including otitis media. Cholesterol granuloma of the middle ear has been experimentally induced in cats. The clinical and pathological findings of a spontaneous case of CG in the tympanic cavity of a cat with otitis media are described herein.

Topics: Amoxicillin-Potassium Clavulanate Combination; Animals; Cat Diseases; Cats; Granuloma; Histocytochemistry; Male; Otitis Media

Two cases (first cases from Poland and Eastern Europe) with liver injury due to amoxycillin-clavulanic acid (augmentin) are reported. Pruritus and jaundice were the main symptoms. Liver biopsy revealed mixed hepatocellular-cholestatic liver injury in both cases. In addition, in one case the microgranulomalike aggregate of inflammatory cells was found. Clinical and laboratory abnormalities returned to normal within 13 weeks.

Topics: Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Chemical and Drug Induced Liver Injury; Cholestasis, Intrahepatic; Clavulanic Acid; Clavulanic Acids; Drug Combinations; Drug Therapy, Combination; Female; Granuloma; Humans; Male; Middle Aged; Respiratory Tract Infections; Tonsillitis