cefotaxime and Pleurisy

The authors report a fatal case of acute bacterial myocarditis in a nonneutropenic child with acute lymphoblastic leukemia. She was admitted to the hospital with a urinary tract infection resulting from and remained persistently febrile despite resolution of the infection. On hospital day 4 signs of acute cardiac failure developed. Despite aggressive resuscitation measures, she died. Pathologic examination revealed the cause of death to be bacterial myocarditis. In addition, she was found to have a generalized decrease in her serum immunoglobulin levels. Acute bacterial myocarditis in patients with malignancy has been rarely reported. The rapid clinical deterioration and death in the patient in this report is particularly interesting.

Topics: Acute Disease; Agammaglobulinemia; Antineoplastic Combined Chemotherapy Protocols; Cefotaxime; Child; Drug Therapy, Combination; Fatal Outcome; Female; Humans; Immunocompromised Host; Klebsiella Infections; Klebsiella pneumoniae; Myocarditis; Oxacillin; Pericarditis; Pleurisy; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Remission Induction; Shoulder Pain; Tobramycin; Trimethoprim, Sulfamethoxazole Drug Combination; Urinary Tract Infections

The paper is concerned with a study in which eosinophilic exudative pleuritis was the first sign of drug allergy (penicillin, streptomycin, claphoran), also manifesting itself in fever, hemorrhagic eruption, eosinophilia in the blood. Fast recovery was achieved after discontinuation of antibacterial therapy and prescription of prednisolone. The problem of differential diagnosis of pleuritis in acute pneumonia is discussed.

Topics: Adult; Anti-Bacterial Agents; Cefotaxime; Drug Hypersensitivity; Eosinophilia; Humans; Male; Pleural Effusion; Pleurisy; Pneumonia

Plasma levels and distribution in pulmonary and bronchial tissues of CTM following injection into the jugular vein were investigated in rabbits with experimental pleuritis or pneumonitis as well as in normal rabbits. The experiments also included the assessment of the effect of concomitant administration of serratiopeptidase (TSP). The pneumonitis + TSP group, pleuritis group and pleuritis + TSP group showed a tendency to delayed dissipation of CTM from the plasma, as compared with controls. The CTM concentrations in tissues from the apical region of upper lobe (L1), lateral region of middle lobe (L2) and diaphragmatic region of lower lobe (L3) 30 minutes after injection did not differ significantly between the control and the TSP group, pleuritis group or pleuritis + TSP group. In the pneumonitis group, the tissue CTM concentrations at all 3 sites (L1, L2, L3) were lower than those in the control group. They were increased by the concomitant administration of TSP, with statistical significance of increase in regions L2 and L3. Thirty minutes after the injection of CTM, the pneumonitis group and pneumonitis + TSP group displayed essentially comparable CTM levels in pleural fluid, whereas the CTM concentrations in the pleural fluid were prone to be increased in the pleuritis + TSP group as comparing with the pleuritis group. CTM levels in the tissues of trachea (B0), right and left main bronchi (B1) and lobar bronchi (B2) 30 minutes after the injection did not show any significant difference between control and TSP-treated normal groups. CTM concentrations tended to be increased, yet not significantly, in all these regions in the rabbits with pleuritis administered TSP, compared to those without TSP.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Animals; Cefotaxime; Cefotiam; Disease Models, Animal; Lung; Male; Peptide Hydrolases; Pleurisy; Pneumonia; Rabbits; Tissue Distribution; Trachea