minocycline and Pericardial-Effusion

The patient was a 56-year-old woman who had undergone the Patey operation for left breast cancer when she was 45 years old. She had complained of dyspnea and shortness of breath at the time of exercise. Bilateral accumulation of pleural effusion and pericardial fluid was observed on chest radiographs and computed tomography(CT)scans. Under the diagnosis of cardiac tamponade, the patient was treated with pericardial drainage and local chemotherapy(intra-pericardial dosage of paclitaxel 45 mg and minocycline 100 mg)with the aim of preventing the accumulation of pericardial effusion. Subsequently, the pericardial effusion continued to disappear. The patient was treated with systemic chemotherapy. At the age of 58 years, she died of breast cancer. After treatment with pericardial drainage and local chemotherapy, she did not experience pericardial reaccumulation or cardiac tamponade. Thus, the method of local chemotherapy(intra-pericardial dosage of paclitaxel 45 mg and minocycline 100 mg)was considered effective.

Topics: Antineoplastic Combined Chemotherapy Protocols; Breast Neoplasms; Cardiac Tamponade; Combined Modality Therapy; Female; Humans; Middle Aged; Minocycline; Paclitaxel; Pericardial Effusion

Topics: Adult; Anti-Bacterial Agents; Humans; Male; Minocycline; Pericardial Effusion; Pleural Effusion; Pulmonary Eosinophilia; Tomography, X-Ray Computed; Treatment Outcome

This case report describes Nocardia pericarditis in a newly diagnosed human immunodeficiency virus (HIV) patient as an initial manifestation. Previously, two cases of Nocardia pericarditis were reported in patients with established HIV infection. To our knowledge this is the first case of Nocardia pericarditis as an initial manifestation of HIV infection. This case substantiates and emphasizes the importance of identifying Nocardia as an infectious cause of pericarditis in patients with acquired immunodeficiency. Long-term survival may be achieved with a combined medical and surgical approach.

Topics: Adult; AIDS-Related Opportunistic Infections; Anti-Bacterial Agents; Ceftriaxone; Cephalosporins; Chest Pain; Combined Modality Therapy; Cough; Drug Therapy, Combination; Dyspnea; Humans; Male; Minocycline; Nocardia asteroides; Nocardia Infections; Pericardial Effusion; Pericardial Window Techniques; Pericarditis

Topics: Humans; Minocycline; Pericardial Effusion; Sclerosing Solutions

To evaluate the effectiveness and safety of minocycline hydrochloride (minocycline) intrapericardially in patients with malignant pericardial effusion.. Consecutive patients admitted to the hospital during a 32-month period received intrapericardial minocycline.. A 900-bed university hospital.. Fourteen consecutive patients with malignant pericardial effusion.. Following percutaneous insertion of a pericardial drain, minocycline was administered at a dosage of 10 mg/kg every 48 h until fluid drainage stopped or until further therapy was deemed necessary.. Complications associated with therapy, total minocycline requirements, immediate and late failure of therapy, and clinical and echocardiographic follow-up of at least 6 months.. Mean amount of minocycline administered was 1.9 +/- 1.0g given in 2.4 divided doses. Total drainage time was 5.4 +/- 2.5 days. Recurrence of malignant pericardial effusion was seen in only 1 of 14 patients. Death occurred in 10 patients due to severe metastatic disease in all. Minocycline instillation was associated with severe chest pain in seven patients, and with ECG changes suggesting pericardial or subepicardial injury in two patients.. (1) Intrapericardial minocycline instillation is very effective in preventing recurrence of malignant pericardial effusion. (2) Minocycline is irritative to the pericardium and may cause severe chest pain with transient ECG changes, suggesting pericardial or subepicardial injury.

Topics: Adult; Aged; Female; Humans; Male; Middle Aged; Minocycline; Pericardial Effusion; Recurrence; Sclerosing Solutions; Sclerotherapy; Thoracic Neoplasms