minocycline and Pericarditis

A 23-year-old woman with prolonged fever, rash, and pericarditis associated with high titers of antinuclear, anti-Sm, and anti-RNP antibodies was suspected of having systemic lupus erythematosus (SLE). However, we also considered infectious diseases, particularly Q fever, as the C-reactive protein level was elevated and the patient reported contact with zoo animals around two weeks before the onset. The condition responded rapidly to administration of minocycline; symptoms resolved without using steroids. Thereafter, no recurrence of the illness was observed. Titer of Coxiella burnetii antibody was high and the illness was accordingly diagnosed as acute Q fever rather than SLE.

Topics: Adult; Anti-Bacterial Agents; Antibodies, Bacterial; C-Reactive Protein; Cardiomegaly; Coxiella burnetii; Diagnosis, Differential; Drug Therapy, Combination; Female; Humans; Lupus Erythematosus, Systemic; Meropenem; Minocycline; Pericarditis; Q Fever; Radiography; Thienamycins

Topics: Anti-Bacterial Agents; Authorship; Electrocardiography; Eosinophilia; Humans; Minocycline; Pericarditis

Pericarditis, usually viral in origin, is an infrequent cause of chest pain. Pericarditis due to drug allergy is even less frequent and is thus rarely considered in the differential diagnosis. A case is reported of a woman who presented with severe chest pain, caused by minocycline induced pericarditis. Such allergy may be more common than reported. It is suggested that drug induced pericarditis should be included in the differential diagnosis of acute chest pain.

Topics: Acute Disease; Adult; Anti-Bacterial Agents; Chest Pain; Electrocardiography; Eosinophilia; Female; Humans; Minocycline; Pericarditis

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