rifampin and Atrophy

Topics: Aged; Atrophy; Biopsy; Chronic Disease; Clofazimine; Dapsone; Drug Therapy, Combination; Eye Infections, Bacterial; Humans; Iris; Leprostatic Agents; Leprosy, Lepromatous; Macular Edema; Male; Mycobacterium leprae; Rifampin; Skin; Tomography, Optical Coherence; Uveitis, Anterior

The case is presented of a 29-year-old woman who complained of headache over a period of several days, with loss of visual acuity and pain in her left eye. She had a 3-year history of type 1 diabetes mellitus, and was an immigrant from Ecuador. The funduscopic examination revealed a papilledema. The polymerase chain reaction (PCR) study of the cerebrospinal fluid was positive for Mycobacterium tuberculosis (MTB). She showed a marked improvement after treatment with anti-TB drugs.. About a third of the world's population has a latent infection of MTB, comorbidity between diabetes mellitus and tuberculosis has been reported, particularly in undeveloped countries.

Topics: Adult; Antitubercular Agents; Atrophy; Cerebrospinal Fluid; Developing Countries; Diabetes Mellitus, Type 1; Drug Therapy, Combination; Ecuador; False Negative Reactions; Female; Humans; Immunocompromised Host; Isoniazid; Latent Tuberculosis; Mycobacterium tuberculosis; Ophthalmoscopy; Optic Nerve; Papilledema; Rifampin; Spinal Puncture; Tuberculin Test; Tuberculosis, Meningeal

Histoid leprosy is a rare but well-defined entity with specific clinical, histopathologic, and bacteriologic features. We present a case of histoid leprosy in an 84-year-old Egyptian male in view of the rarity of this condition. The patient presented with erythematous itchy discrete and coalescent papules that were distributed bilaterally and symmetrically on the front and back of the trunk. Before approaching us, he was initially misdiagnosed as a case of pityriasis rosea. There was no mucosal or facial affection and the patient's general examination was normal. Routine hematologic investigations, urine analysis, liver and renal function tests were all normal. Slit skin smear revealed acid-fast bacilli of BI - 6+ and MI - 50-60%. Histopathologic examination of hematoxylin and eosin-stained section revealed atrophic epidermis with flattened rete ridges and dermal infiltration by nodular granulomata formed of spindle shaped histiocytes with pyknotic nuclei oriented in a storiform pattern. Fite's stain for lepra bacilli showed plenty of acid fast bacilli. So, the diagnosis of histoid leprosy was made. Therefore, ROM therapy (rifampicin 600 mg, ofloxacin 400 mg, minocycline 200 mg) was started and followed by multi-drug therapy for 2 years.

Topics: Aged; Atrophy; Dermis; Epidermis; Humans; Leprostatic Agents; Leprosy; Male; Minocycline; Ofloxacin; Rifampin

Urinary tuberculosis is a rare disease in children. It poses major diagnostic problems because of clinical symptoms, which are often atypical and misleading. It causes serious lesions which are often multifocal and extensive, requiring complex surgical excision and urinary tract reconstruction. Prevention of this disease is based on generalized vaccination with BCG and adequate treatment of pulmonary tuberculosis. The authors report a case of urinary tuberculosis in a fourteen-year-old child who presented episodes of cystitis and hematuria refractory to treatment. The diagnosis, confirmed by the positive test for AFB in the urine was established late, at the stage of silent kidney and scleroatrophic bladder. The patient was treated with antituberculous chemotherapy (Isoniazid; Rifampicin, PZA) and nephro-ureterectomy with augmentation enterocystoplasty.

Topics: Adolescent; Antitubercular Agents; Atrophy; Bacteriuria; BCG Vaccine; Child; Cystitis; Hematuria; Humans; Isoniazid; Male; Mycobacterium tuberculosis; Nephrectomy; Pyrazinamide; Rifampin; Sclerosis; Tuberculosis, Pulmonary; Tuberculosis, Renal; Tuberculosis, Urogenital; Ureter; Urinary Bladder; Urinary Bladder Diseases

Adrenal computed tomographic (CT) scanning was conducted in twelve patients with Addison's disease during the clinical course. In tuberculous Addison's disease (n = 8), three of four patients examined during the first two years after disease onset had bilaterally enlarged adrenals, while one of four had a unilaterally enlarged one. At least one adrenal gland was enlarged after onset in all six patients examined during the first four years. Thereafter, the adrenal glands may atrophy bilaterally, in contrast to adrenal glands in idiopathic Addison's disease, which atrophy bilaterally from disease onset (n = 2). Adrenal calcification was a less sensitive clue in tracing pathogenesis, i.e., adrenal calcification was observed in five of eight patients with tuberculous Addison's disease, but not in idiopathic patients. Thus, adrenal CT scanning could show the etiology of Addison's disease (infection or autoimmunity) and the phase of Addison's disease secondary to tuberculosis, which may be clinically important for initiating antituberculous treatment.

Topics: Addison Disease; Adrenal Glands; Adult; Aged; Atrophy; Female; Humans; Hydrocortisone; Isoniazid; Male; Middle Aged; Rifampin; Streptomycin; Tomography, X-Ray Computed; Tuberculosis, Pulmonary

Topics: Acute Disease; Adolescent; Adult; Aged; Atrophy; Chemical and Drug Induced Liver Injury; Female; Hepatitis A; Humans; Jaundice; Liver; Male; Rifampin; Transaminases; Tuberculosis, Pulmonary

Topics: Acute Disease; Administration, Oral; Animals; Atrophy; Body Weight; Chronic Disease; Female; Injections, Intraperitoneal; Injections, Subcutaneous; Male; Mice; Organ Size; Piperidines; Rats; Rifampin; Sex Factors; Testis