amoxicillin-potassium-clavulanate-combination and Syndrome

The authors report a case of Lemierre's syndrome. This uncommon clinical entity is characterized by a septic internal jugular vein thrombosis with secondary metastatic abscesses and Fusobacterium necrophorum septicemia, following an acute oropharyngeal infection. The diagnosis is primarily clinical and it should be suspected when a severe septicaemic illness, with pulmonary symptoms, occurs after an acute pharyngotonsillar infection. This article reviews the clinical picture, microbiology and treatment of this forgotten complication of acute tonsillitis.

Topics: Abscess; Acute Disease; Aged; Amoxicillin-Potassium Clavulanate Combination; Angina Pectoris; Anti-Bacterial Agents; Anticoagulants; Clindamycin; Drug Therapy, Combination; Female; Fusobacterium Infections; Fusobacterium necrophorum; Heparin; Humans; Jugular Veins; Metronidazole; Pharyngitis; Sepsis; Syndrome; Thrombosis; Tonsillitis; Ultrasonography, Doppler

The chronic diffuse sclerosing osteomyelitis (CDSO) of the mandible has been described as an inflammatory disease characterized by recurrent episodes of intense pain in the mandible, often accompanied by trismus, paresthesia and progressive mandibular deformity. The etiopathogeny of this entity is not fully known. The differential diagnosis must be carried out very carefully, and the treatment results are very disappointing. Recently, evidence that suggests that CDSO may be the mandibular location of a more diffuse condition, the synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome, has been offered. We describe two clinical cases of CDSO of typical evolution which fulfill the criteria for SAPHO syndrome, offering us an occasion for a review of the current literature.

Topics: Acne Vulgaris; Adult; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Anti-Inflammatory Agents, Non-Steroidal; Chronic Disease; Clavulanic Acids; Diagnosis, Differential; Drug Therapy, Combination; Follow-Up Studies; Humans; Hyperostosis; Male; Mandibular Diseases; Middle Aged; Osteitis; Osteomyelitis; Penicillin V; Penicillins; Psoriasis; Sclerosis; Syndrome; Synovitis

Kounis syndrome (KS) is characterized by concurrent presence of anaphylactic and cardiac components. Available evidence suggests that antibiotics are frequently associated to KS. We therefore analyzed KS cases associated with antibiotics use from the two largest pharmacovigilance databases.. Two pharmacovigilance databases, EudraVigilance and VigiLyze, were searched for cases reporting the adverse reaction "Kounis Syndrome" with antibiotics as suspected active substance. We analyzed the period from December 1st, 2001 to February 16th, 2016. For the most reported active substance, proportional reporting ratio (PRR) was calculated.. A total of 10 cases of KS associated with antibiotic use were retrieved from EudraVigilance database. Mean patients' age was 58.2years and 70% were male. The most frequently reported suspected antibiotic was the combination amoxicillin/clavulanic acid (four cases). VigiLyze database reported 13 KS cases associated to antibiotics. Mean age was 56years and 61% of patients were male. The most frequently reported antibiotic was again the combination amoxicillin/clavulanic acid (five cases). Seven duplicate cases were identified, leaving a total of 16 cases of KS, with six of them associated to amoxicillin/clavulanic acid use. The PRR value for amoxicillin/clavulanic acid against other kinds of antibiotics was 2.62 considering EudraVigilance data and 1.61 considering VigiLyze data.. This analysis provided a complete picture of the cases of KS associated with antibiotic use and identified a possible association between amoxicillin/clavulanic acid and KS. Since the number of cases is low, especially considering its wide use, further analyses are needed to confirm the association.

Topics: Acute Coronary Syndrome; Amoxicillin-Potassium Clavulanate Combination; Anaphylaxis; Anti-Bacterial Agents; Coronary Vasospasm; Databases, Factual; Female; Glucocorticoids; Histamine Antagonists; Humans; Male; Middle Aged; Pharmacovigilance; Rare Diseases; Syndrome

Topics: Adolescent; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Humans; Male; Myocardial Ischemia; Radiography; Syndrome

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

We report the case of a 39-year old patient with septicemia treated for pharyngitis with antibiotics since a few days. She wasn't able to swallow her antibiotics anymore because of dysphagia. Radiologic examination revealed pulmonary infiltrates and Vena iugularis interna-thrombosis. These findings and anamnesis led to the diagnosis of Lemierre syndrome inspite of lacking detection of bacteria. After changing the antibiotic therapy and start of anticoagulation further course of illness was favorable. The long duration of hospitalization was indepted to high morbidity typically seen in Lemierre syndrome.

Topics: Adult; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Anticoagulants; Ceftriaxone; Clindamycin; Deglutition Disorders; Diagnosis, Differential; Drug Therapy, Combination; Female; Fever of Unknown Origin; Fusobacterium Infections; Fusobacterium necrophorum; Humans; Jugular Veins; Pneumonia, Bacterial; Sepsis; Syndrome; Thrombosis; Tomography, X-Ray Computed; Tonsillitis; Ultrasonography

Giant cell lichenoid dermatitis is a recently described pathological entity, which can be seen as an unusual lichenoid drug eruption, a manifestation of sarcoidosis or within herpes zoster scars. Histopathological findings include focal vacuolar alteration of the basal layer with cytoid bodies, dermal and intraepidermal multinucleated giant cells and a mixed chronic inflammatory infiltrate with a lichenoid pattern consisting of lymphocytes, histiocytes, eosinophils and plasma cells. Here, we report a giant cell lichenoid dermatitis in a 41-year-old male patient who developed, 3 days after intravenous treatment with amoxicillin-clavulanic acid for erysipelas of the left leg, a clinical picture suggesting a baboon syndrome characterized by an erythematous and pruritic eruption on the axillary, inguinal and popliteal areas and the anterior side of elbows. This is the first reported case of giant cell lichenoid dermatitis in a patient with baboon syndrome.

Topics: Adult; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Drug Eruptions; Erysipelas; Giant Cells; Humans; Lichenoid Eruptions; Male; Syndrome

We report a case of Lemierre syndrome in a healthy infant, initially presenting with otitis media and angina. Lemierre syndrome is a disease that every pediatrician must know. Early diagnosis and treatment with antibiotics are necessary to decrease mortality. A review of the history and the complications of Lemierre syndrome is presented.

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Anti-Infective Agents; Cefotaxime; Child; Drug Therapy, Combination; Female; Follow-Up Studies; Fusobacterium Infections; Fusobacterium necrophorum; Gentamicins; Hospitalization; Humans; Jugular Veins; Length of Stay; Metronidazole; Otitis Media; Pharyngitis; Syndrome; Time Factors; Tomography, X-Ray Computed; Venous Thrombosis

Myocardial injury and acute coronary syndrome have been rarely associated with amoxicillin/clavulanic acid intake. The responsible pathogenetic mechanism is described by an amplified mast cell degranulation inducing coronary artery spasm and/or acute myocardial infarction in susceptible individuals which is called Kounis syndrome. We report here a case of Kounis syndrome presented with acute coronary syndrome due to amoxicillin/clavulanic acid use. All other etiologies, including ischemic reinfarction were appropriately ruled out.

Topics: Acute Coronary Syndrome; Amoxicillin-Potassium Clavulanate Combination; Angina Pectoris; Coronary Angiography; Electrocardiography; Humans; Male; Middle Aged; Syndrome

Topics: Adult; Amoxicillin-Potassium Clavulanate Combination; Benzoyl Peroxide; Carcinoma, Basal Cell; Cryosurgery; Dermatologic Agents; Drug Therapy, Combination; Humans; Male; Nevus, Pigmented; Skin Neoplasms; Syndrome; Toes; Tretinoin

Lemierre's syndrome is a rare fulminant condition caused by an acute oropharyngeal infection, with secondary septic thrombophlebitis of the internal jugular vein complicated by multiple metastatic infections. Herein we report 2 patients with internal jugular vein thrombosis secondary to oropharyngeal infection, whose clinical course was indolent, and who were asymptomatic shortly after antibiotic therapy was begun. Careful examination of the neck in patients presenting with sore throat could help identify the typical 'cord sign'. In such cases, intravenous antibiotic treatment should be started as soon as possible to prevent development of metastatic infections and septicaemia characterizing Lemierre's syndrome.

Topics: Adult; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Clindamycin; Drug Therapy, Combination; Humans; Jugular Veins; Male; Pharyngitis; Syndrome; Thrombophlebitis; Tonsillitis

We treated a 5-year-old girl and a 6-year-old boy with acquired Brown's syndrome associated with pansinusitis. In both patients, the diagnosis was established roentgenographically, and the patients were treated with oral antibiotics. Systemic corticosteroids were used in one case, although their clinical value was uncertain. Patients presenting with acute-onset Brown's syndrome of undetermined cause should undergo computed imaging of the orbits and paranasal sinuses.

Topics: Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Child; Child, Preschool; Clavulanic Acids; Diplopia; Drug Therapy, Combination; Eye Diseases; Female; Humans; Male; Oculomotor Muscles; Prednisone; Sinusitis; Syndrome; Tomography, X-Ray Computed

Topics: Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Clavulanic Acids; Humans; Lactobacillus; Syndrome; Urethral Diseases