amoxicillin-potassium-clavulanate-combination and Myocardial-Infarction

The incidence of infection following TEVAR is low. To the best of our knowledge, this is the first case report of post thoracic endovascular aortic repair (TEVAR) with Streptococcus viridans graft infection. A 54-year-old male underwent TEVAR for dissecting thoracic aneurysm with spinal ischaemia. He had an eventful recovery with prolonged period of stay in intensive care unit. Three months later, he presented with persistent chest discomfort and fever. Computed tomography (CT) of the thorax revealed evidence of graft infection and the blood culture grew Streptococcus viridans. The rarity of TEVAR graft infection due to Streptococcus viridans and its management are being discussed.

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Aortic Aneurysm, Thoracic; Aortic Dissection; Bacteremia; Blood Vessel Prosthesis Implantation; Endovascular Procedures; Esophageal Fistula; Fever; Humans; Ischemia; Male; Middle Aged; Myocardial Infarction; Paraplegia; Penicillins; Postoperative Complications; Prosthesis-Related Infections; Radiography; Spinal Cord; Streptococcal Infections; Vascular Fistula; Viridans Streptococci

The association of an acute coronary syndrome with mast cell activation secondary to allergen exposure is known as the Kounis syndrome. We present two cases of the Kounis syndrome: (i) one was misdiagnosed as acute ST elevation myocardial infarction and treated with thrombolytics; (ii) the second diagnosis was made after a recurrence two months after the first incident.

Topics: Acute Coronary Syndrome; Adult; Aged, 80 and over; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Ceftriaxone; Coronary Angiography; Coronary Stenosis; Coronary Vasospasm; Diagnosis, Differential; Drug Hypersensitivity; Female; Humans; Male; Mast Cells; Myocardial Infarction; Recurrence; Syndrome

Low-molecular-weight heparins are used extensively in acute medicine. They are generally well tolerated but may cause a rare, eczema-like type IV hypersensitivity reaction. We report 3 cases of this eruption and speculate that it may be significantly under-reported due to misidentifying the causal drug, which may have serious consequences. We discuss treatment alternatives such as fondaparinux sodium, which may rarely cross-react.

Topics: Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Anticoagulants; Diagnosis, Differential; Drug Therapy, Combination; Eczema; Enoxaparin; Humans; Injections, Subcutaneous; Male; Middle Aged; Myocardial Infarction; Venous Thrombosis; Wound Infection