minocycline and Lymphatic-Diseases

Nocardiosis is a mixed suppurative and granulomatous inflammatory disease caused by infection with Nocardia organisms, a group of aerobic actinomycetes. We recently encountered a 25-year-old woman with posttraumatic nocardiosis of the lower extremities. The clinical symptoms noted during her first visit included erythematous swelling of the right knee accompanied by white maceration of the center of the knee and erosions, shallow ulcers and satellite pustules. In addition, multiple erythematous areas (up to the size of the tip of the thumb) were linearly distributed on the right thigh. These lesions were painful, and right inguinal lymphadenopathy was also noted. No lesion was found in internal organs such as the lungs. Histopathologically, signs of nonspecific granulomatous inflammation were observed, as well as several filamentous branching bacilli positive on Grocott stain. The organisms isolated from culture of pus were acid-fast, Gram-positive long rods. The isolated strain was finally identified as Nocardia brasiliensis. The patient was therefore diagnosed with lymphocutaneous type of primary cutaneous nocardiosis caused by N. brasiliensis. Drip infusion of flomoxef sodium was initially performed to treat her condition. Because of exacerbation of erythematous swelling of the right knee and an increase in number of pustules, treatment was switched to oral minocycline hydrochloride therapy. The disease healed 9 weeks after the start of oral minocycline hydrochloride therapy. Our patient was free of systemic immunosuppression and was neither under 10 nor over 65 years of age. She may therefore be considered a rare case of lymphocutaneous type of nocardiosis. We present this case and discuss reported cases of primary cutaneous nocardiosis due to N. brasiliensis in Japan.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Child; Child, Preschool; Female; Humans; Japan; Lymphatic Diseases; Middle Aged; Minocycline; Nocardia; Nocardia Infections; Skin; Skin Diseases, Bacterial; Wound Infection

A 65-year-old man developed respiratory failure with diffuse interstitial shadow, bilateral pleural effusion, and bilateral hilar lymphadenopathy on chest X-ray and CT, after intravenous administration of minocycline. Corticosteroid therapy was effective. The findings from bronchoalveolar lavage (BAL) and transbronchial lung biopsy were compatible with eosinophilic pneumonia. Provocation test supported this diagnosis, but the lymphocyte stimulation test was negative. A review of the literature and the diagnoses of drug-induced pulmonary diseases are discussed.

Topics: Aged; Drug Hypersensitivity; Humans; In Vitro Techniques; Lymphatic Diseases; Lymphocyte Activation; Male; Minocycline; Pleural Effusion; Prednisolone; Pulmonary Eosinophilia

Lung involvement is rarely observed in the DRESS syndrome (Drug rash with eosinophilia and systemic symptoms). We report here a severe minocycline induced hypersensitivity syndrome with initial respiratory distress.. A 19 year old man was admitted to the intensive care unit for acute respiratory distress with fever (400C), lymph node enlargement, hepatomegaly, splenomegaly and eosinophilia (1640/mm3). Bilateral alveolar opacities were observed on the chest x-ray. Sedation and mechanical ventilation rapidly became necessary because of severe hypoxaemia (47 mm Hg) and the sudden onset of severe aggressive behaviour. The diagnosis of DRESS was immediately suspected as the patient had been treated for acne with minocycline for 28 days, and IV corticosteroids (2 mmg/kg/day) were initiated. Skin lesions were delayed and appeared 3 days later. The outcome was uncertain for the following 6 weeks with serious disturbance of hepatic and renal function. Serology for human herpes virus (HHV6) was initially negative but became positive. One year later, after progressive withdrawal of corticosteroid therapy, the patient had made a complete recovery with no sequelae.. The DRESS syndrome can cause considerable morbidity with multiple, severe visceral functional disturbances. Respiratory physicians should be aware of this syndrome as lung involvement can be serious and may precede cutaneous symptoms.

Topics: Adult; Anti-Bacterial Agents; Drug Eruptions; Eosinophilia; Hepatomegaly; Humans; Hypoxia; Lymphatic Diseases; Male; Minocycline; Respiratory Distress Syndrome; Splenomegaly; Syndrome

The purpose of this study was to describe our experience with ultrasound-guided aspiration of postoperative pelvic lymphocysts followed by intracavitary minocycline injection as sclerotherapy.. From 1997 to 2003, patients who developed either symptomatic or persistent lymphocyst after pelvic lymphadenectomy for gynecological malignancy were recruited in this study. All of the lymphocysts were palpable and were further examined by ultrasonography. Percutaneous ultrasound-guided needle aspiration of the lymphocyst was performed and then immediately followed by a single-dose injection of minocycline into the collapsed cavity. Follow-up was conducted every 4 weeks with pelvic examination and ultrasonography.. Nineteen patients with a total of 21 pelvic lymphocysts underwent this procedure. The median size of the lymphocysts was 6 cm in diameter (range, 4-9 cm). Fifteen patients received 1 treatment, 3 received 2, and 1 patient with bilateral lymphocysts received 3 treatments. Complete resolution occurred in 14 patients (74%), and the other 5 patients (26%) had partial resolution with the volume of the lymphocyst decreasing at least 50%. For the 14 patients with complete resolution, the median time from treatment to disappearance of the lymphocyst was 3 months (range, 1-10 months), and none of them developed recurrence during the average follow-up period of 40 months (range, 2-62 months). No significant complication occurred with this procedure except for transient mild to moderate pelvic pain.. Minocycline sclerotherapy seems to be a simple and safe method with a satisfactory success rate in treating lymphocysts which develop after pelvic lymphadenectomy. It can be performed in an outpatient setting and can be repeated if necessary. This procedure may be considered as the initial treatment modality for patients suffering from symptomatic or persistent lymphocysts after radical gynecological surgery.

Topics: Adult; Aged; Cysts; Endometrial Neoplasms; Female; Humans; Lymph Node Excision; Lymphatic Diseases; Middle Aged; Minocycline; Ovarian Neoplasms; Pelvic Pain; Pelvis; Sclerotherapy; Suction; Ultrasonography; Uterine Cervical Neoplasms

Postoperative cervical lymphorrhea is a complication uncommonly encountered following neck dissection for which several treatment modalities have been described in the literature. We managed 8 cases of lymphorrhea after neck dissection by injecting Minocycline through a drainage tube. We attempted this procedure for lymph discharge that had continued despite pressure dressing and systemic management with nutritional modification for about 1 week. This treatment rapidly resolved lymph discharge in 6 of the 8 cases. No patient required surgical intervention. Minocycline sclerotherapy has typically been used to treat pleural effusion, ascites, pneumothorax, and other cystic diseases of the liver, pancreas, and kidney. In many cases, this therapy brings rapid resolution. This inefficiency is due to the acidity and toxicity of Minocycline. No major adverse effects have been reported. We believe that Minocycline sclerotherapy is effective for rapidly resolving lymphorrhea following neck dissection and use of this therapy should be attempted before surgical intervention.

Topics: Humans; Lymphatic Diseases; Male; Middle Aged; Minocycline; Neck; Neck Dissection; Postoperative Complications; Sclerotherapy; Treatment Outcome

Topics: Adult; Anti-Bacterial Agents; Bone Marrow; Female; Fever; Humans; Liver; Lymphatic Diseases; Minocycline; Parotitis; Sezary Syndrome

Topics: Adverse Drug Reaction Reporting Systems; Anti-Bacterial Agents; Canada; Chemical and Drug Induced Liver Injury; Drug Eruptions; Eosinophilia; Fever; Humans; Lymphatic Diseases; Lymphocytosis; Minocycline

Minocycline is a tetracycline agent frequently used for acne therapy. It has a few rare but severe side effects that are not widely known but should be recognized early as drug related. These include acute hepatitis and liver failure; a Löffler-like syndrome with pulmonary infiltrates, wheezing, fever, and eosinophilia; skin eruptions, eosinophilic cellulitis, and pustular folliculitis with eosinophilia; and a lupuslike syndrome. Side effects that are better known and recognized include photosensitization, skin exanthema with pruritus, and pseudotumor cerebri.

Topics: Acne Vulgaris; Adult; Drug Eruptions; Drug Hypersensitivity; Eosinophilia; Female; Fever; Humans; Liver; Lymphatic Diseases; Minocycline; Neutropenia

We managed four cases of lymphorrhea after extraperitoneal pelvic lymphadenectomy by means of minocycline instillation into the cavity around the drainage tube. Two patients had concomitantly undergone cystectomy and one prostatectomy via the extraperitoneal approach. In all four cases, the lymphorrhea markedly subsided, which dramatically shortened the duration of drainage. No side effects occurred. These findings indicate that minocycline instillation is an efficacious treatment for lymphorrhea.

Topics: Administration, Intravesical; Aged; Cystectomy; Humans; Lymph Node Excision; Lymphatic Diseases; Male; Minocycline; Pelvis; Prostatectomy

Topics: Adult; Humans; Hyperplasia; Lymphatic Diseases; Male; Minocycline; Skin Diseases, Infectious; Tularemia