rifampin and Arthralgia

This study aims to analyze the clinical characteristics and treatment outcomes of 590 patients with brucellosis in Xinjiang, China.. The clinical characteristics, laboratory findings, complications and prognosis of 590 patients infected with brucellosis were retrospectively analyzed. These patients had a mean age of 44.24 ± 15.83 years with 60.5% having a history of close contacting with cattle and sheep. Of them, 53.6% (316 /590) were in acute phase and 21.5% were in chronic phase. Agglutination test showed 98.5% positive with 34% blood culture positive of Brucella. The major symptoms were fatigue (91%), hyperhidrosis(88.1%), fever(86.9%), and joint pain(81%) with 29.8% having enlarged liver, 26.1% having enlarged spleen and 23.2% having osteoarticular complications. Combination of doxycycline plus rifampicin for 12 weeks was an effective regimen for patients without complications. The 3-drug regimen (doxycycline+rifampicin+levofloxacin) for 12 weeks was recommended for these with complications. There were 6 patients died (1.02%) with overall relapse rate of 5.98%.. Brucellosis is mostly associated with contacting with domestic animal production in Xinjiang, China. Clinical symptoms include fever, fatigue, hyperhidrosis, and joint pain with common complication of osteoarticular involvement. Three-drug-regimen of doxycycline+rifampicin+levofloxacin for 12 weeks was effective for these patients with complications.

Topics: Adolescent; Adult; Aged; Animals; Animals, Domestic; Anti-Bacterial Agents; Arthralgia; Brucella; Brucellosis; Child; Child, Preschool; China; Doxycycline; Drug Therapy, Combination; Female; Fever; Hepatomegaly; Humans; Levofloxacin; Male; Middle Aged; Retrospective Studies; Rifampin; Splenomegaly; Treatment Outcome; Young Adult

Topics: Administration, Oral; Arteries; Arthralgia; Bacteremia; Brucella melitensis; Brucellosis; Child; Diagnosis, Differential; Doxycycline; Drug Therapy, Combination; Femoral Fractures; Fractures, Open; Gentamicins; Germany; Hip; Humans; Infusions, Intravenous; Knee; Male; Postoperative Complications; Refugees; Rifampin; Syria; Thigh; Ultrasonography; Veins

Streptococcus agalactiae is not only a well-known cause of severe infections in the first 3 months of life but also an unusual organism to be isolated in case of septic arthritis, especially in children. We report a case of a monoarticular arthritis in a 6-month-old girl.

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Arthralgia; Arthritis, Infectious; Ceftriaxone; Female; Humans; Infant; Knee Joint; Rifampin; Streptococcal Infections; Streptococcus agalactiae; Ultrasonography

Non-tuberculous mycobacteria (NTM) are an unusual cause of osteomyelitis in immunocompetent children. Diagnosis is often difficult due to the paucity of clinical symptoms and a subtle course of the disease. NTM comprise a group of about 91 identified species of environmental mycobacteria that cause infections most frequently in immunocompromised individuals or in patients with predisposing factors. Cervical lymphadenitis is the most common presentation of NTM infection in children. Invasive and recurrent infections with these organisms have been associated with a genetic defect of the interferon gamma-receptor. We report a 3-year-old immunocompetent girl who presented a NTM osteomyelitis of the left femur. Four months before she had been treated with medical and surgical therapy for a mycobacterium avium complex cervical lymphadenitis. Polymerase chain reaction assay on bone aspirate specimens confirmed the diagnosis of mycobacterium avium osteomyelitis. The patient was treated successfully with clarithromycin and rifampicin for 6 months.

Topics: Anti-Bacterial Agents; Arthralgia; Child, Preschool; Clarithromycin; Drug Therapy, Combination; Female; Humans; Immunocompetence; Mycobacterium avium Complex; Mycobacterium avium-intracellulare Infection; Osteomyelitis; Rifampin; Treatment Outcome

In the Netherlands, brucellosis is uncommon. Diagnosis is difficult and frequently delayed. We present three patients with back pain and/or arthralgia caused by brucellosis. We emphasise the importance of considering brucellosis in patients returning from a stay in a rural area of an endemic country, who present with osteoarticular symptoms and signs of chronic inflammation. Clues to the diagnosis come from a thorough medical history.

Topics: Adult; Aged; Arthralgia; Back Pain; Brucellosis; Ciprofloxacin; Diagnosis, Differential; Doxycycline; Drug Therapy, Combination; Dyspnea; Female; Humans; India; Male; Middle Aged; Netherlands; Rifampin; Turkey

Topics: Anti-Bacterial Agents; Arthralgia; Arthritis; Arthritis, Infectious; Arthroplasty, Replacement, Knee; Atorvastatin; Combined Modality Therapy; Debridement; Diagnosis, Differential; Doxycycline; Drug Interactions; Female; Heptanoic Acids; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Hyperlipoproteinemia Type II; Levofloxacin; Middle Aged; Ofloxacin; Postoperative Complications; Prosthesis-Related Infections; Pyrroles; Recurrence; Reoperation; Rifampin; Thyroiditis, Autoimmune; Thyroxine; Trimethoprim, Sulfamethoxazole Drug Combination

The incidence of acute rheumatic fever has seen a dramatic decline over the last 15 to 20 years in most developed countries and treatment of this disease has changed little since. The ease of travel and immigration and the cosmopolitan nature of many cities mean that occasionally the disease will come to the attention of clinicians not familiar with its presentation, resulting in delayed diagnosis and treatment. We present a case of recurrent acute rheumatic fever in a patient who was initially thought to be suffering from acute bacterial endocarditis on her previously diseased rheumatic aortic valve. This culminated in her undergoing urgent aortic valve replacement during a phase of the illness that should have been treated with high dose anti-inflammatory medication. Therefore, clinicians should be aware of this condition and include it in their differential diagnosis of the febrile patient with a previous history of rheumatic fever. We briefly discuss the diagnostic dilemma of patients suffering from this condition and in differentiating it from acute endocarditis.

Topics: Acute Disease; Adult; Amoxicillin; Anti-Inflammatory Agents; Aortic Valve; Aortic Valve Insufficiency; Arthralgia; Bangladesh; Clarithromycin; Diagnosis, Differential; Diagnostic Errors; Drug Therapy, Combination; Emigration and Immigration; Endocarditis, Bacterial; England; Female; Fever; Gentamicins; Heart Failure; Heart Valve Prosthesis Implantation; Humans; Penicillin G; Penicillin V; Pericarditis; Pharyngitis; Prednisone; Recurrence; Rheumatic Fever; Rheumatic Heart Disease; Rifampin; Unnecessary Procedures; Vancomycin

For many years, Rifampicin has been used empirically for the treatment of hemophilic chronic synovitis with encouraging results. A study was performed in which Rifampicin was shown to reduce the inflammation of joints affected by hemophilic synovitis. A clinical study was performed on 48 hemophilic patients (48 joints). Seventeen elbows, eight knees, and 23 ankles were treated. The mean age of the patients was 6 years (range, 4-23 years) and the mean followup was 29 months (range, 24-53 months). Overall, 40 excellent results and eight good results were obtained. The average number of weekly injections of Rifampicin was 3.06 (range, 1-10 injections). Eight patients experienced pain on the first injection, which subsided gradually with the subsequent procedures. Synoviorthesis with Rifampicin seems to be a good method for the treatment of hemophilic synovitis, especially in small joints (elbows and ankles) and in younger children.

Topics: Adolescent; Adult; Age Factors; Animals; Ankle Joint; Anti-Bacterial Agents; Arthralgia; Child; Child, Preschool; Chronic Disease; Disease Models, Animal; Elbow Joint; Follow-Up Studies; Forecasting; Hemarthrosis; Hemophilia A; Hemophilia B; Humans; Injections, Intra-Articular; Knee Joint; Logistic Models; Male; Rabbits; Rifampin; Synovitis; Treatment Outcome

The aim of this study was to determine the current incidence of side-effects severe enough to cause intolerance of standard antituberculosis therapy with isoniazid, rifampin and pyrazinamide in patients hospitalized as a result of pulmonary tuberculosis. Five hundred and nineteen patients with proven pulmonary tuberculosis, who initially received standard antituberculosis therapy, were retrospectively studied in the department of infectious diseases in a teaching chest hospital. The incidence of severe side-effects related to the therapy, which led to the definitive termination of one of the three standard drugs, was measured and the risk factors for intolerance were analysed. Final termination of either isoniazid, rifampin or pyrazinamide because of severe side-effects was necessary in 121 of the 519 patients (23%). The most severe side-effects leading to final termination of one drug were hepatotoxicity (11%), exanthema (6%), and arthralgia (2%). Pyrazinamide showed more severe side-effects (15%) than isoniazid (7%) and rifampin (1.5%). Significant risk factors for intolerance of the standard therapy following a multivariate analysis were a history of hepatitis (odds ratio (OR) 3.4; 95% confidence interval (95% CI) 1.6-7.6; p = 0.0026) and an age > or = 60 yrs (OR 1.9; 95% CI 1.2-3.2; p = 0.017). Both of these risk factors were also significantly associated with the intolerance of pyrazinamide (history of hepatitis: OR 2.5; 95% CI 1.4-4.3; p = 0.0045; age > or = 60 yrs: OR 2.1, 95% CI 1.3-3.5; p = 0.0029) but not of isoniazid and rifampin. The side-effects of standard antituberculosis therapy are frequent in hospitalized patients aged > or = 60 yrs or with a history of previous hepatitis, and are probably due to pyrazinamide rather than to isoniazid or rifampin.

Topics: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Antitubercular Agents; Arthralgia; Child; Child, Preschool; Exanthema; Female; Hepatitis; Hospitalization; Humans; Incidence; Infant; Isoniazid; Liver; Logistic Models; Male; Middle Aged; Multivariate Analysis; Pyrazinamide; Retrospective Studies; Rifampin; Risk Factors; Treatment Outcome; Tuberculosis, Pulmonary