rifampin and Emergencies

Topics: Adult; Bacteremia; Drug Therapy, Combination; Emergencies; Female; Humans; Levofloxacin; Magnetic Resonance Imaging; Pregnancy; Psoas Abscess; Puerperal Disorders; Rifampin; Sacroiliitis; Staphylococcal Infections

We describe 3 previously healthy Costa Rican children who had Listeria monocytogenes meningitis, an uncommon cause of bacterial meningitis beyond the newborn period in normal subjects. Two of them had initial normal brain computed tomography, but all 3 developed acute hydrocephalus at days 7, 3, and 5, respectively. All required immediate ventriculostomy placement and only 1 of 3 survived. L. monocytogenes should be considered among the etiologies of bacterial meningitis in children who do not respond initially to conventional antimicrobial treatment or who deteriorate rapidly.

Topics: Acute Disease; Amikacin; Cefotaxime; Child; Child, Preschool; Combined Modality Therapy; Costa Rica; Dexamethasone; Drug Resistance; Drug Therapy, Combination; Emergencies; Fatal Outcome; Female; Humans; Hydrocephalus; Male; Meningitis, Listeria; Meropenem; Rifampin; Thienamycins; Tomography, X-Ray Computed; Vancomycin; Ventriculostomy

Topics: Acute Disease; Angioplasty, Balloon, Coronary; Anti-Bacterial Agents; Coronary Restenosis; Drainage; Drug Therapy, Combination; Emergencies; Humans; Male; Middle Aged; Myocardial Infarction; Pericardial Effusion; Pericarditis; Prosthesis-Related Infections; Rifampin; Staphylococcal Infections; Stents; Teicoplanin

Mycotic thoracic aortic aneurysms are a life-threatening diagnosis and carry a high risk of morbidity and mortality in the perioperative setting. Traditional open repair consists of debridement, drainage, and either in situ or extra-anatomic bypass. Acute rupture portends a dismal prognosis; however, emergent endovascular repair of ruptured mycotic aneurysms has been described in the literature and we present a case of successful endovascular treatment of a ruptured mycotic descending thoracic aortic aneurysm.. We report the case of a 42-year-old male with hypertension and active intravenous drug use who presented with 3 weeks of chest pain, dyspnea, and hemoptysis, and on computed tomography scan was found to have a contained 4.1-cm ruptured mycotic thoracic aortic aneurysm. Blood cultures were positive for methicillin-resistant Staphylococcus aureus. Emergent repair was recommended because of likelihood of further rupture and death. Thoracic endovascular aortic repair (TEVAR) was performed using a rifampin-soaked stent graft without complication. At 2-year follow-up, the patient was asymptomatic and imaging demonstrated the stent graft in excellent position, without endoleak, and complete resolution of the aneurysm sac.. TEVAR can be safely employed to treat a ruptured mycotic thoracic aneurysm when open repair is not possible because of patient's comorbidity or complex rupture, as these patients face imminent death. Long-term follow-up is necessary for detection of endoleak, recurrence, or propagation of the aneurysm, and persistent bacterial infections.

Topics: Adult; Aneurysm, Infected; Anti-Bacterial Agents; Aortic Aneurysm, Thoracic; Aortography; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation; Coated Materials, Biocompatible; Emergencies; Endovascular Procedures; Humans; Male; Methicillin-Resistant Staphylococcus aureus; Prosthesis Design; Rifampin; Staphylococcal Infections; Stents; Time Factors; Tomography, X-Ray Computed; Treatment Outcome

Topics: Aged, 80 and over; Antitubercular Agents; Drug Therapy, Combination; Dyspnea; Emergencies; Fatal Outcome; Female; Humans; Isoniazid; Pyrazinamide; Rifampin; Tomography, X-Ray Computed; Tuberculosis, Pulmonary

Topics: Adult; Antigens, CD; Antigens, Differentiation, Myelomonocytic; B-Lymphocytes; CD3 Complex; Clofazimine; Dapsone; Drug Therapy, Combination; Emergencies; Face; Facial Dermatoses; Humans; Leprostatic Agents; Leprosy, Borderline; Leprosy, Tuberculoid; Male; Prednisone; Receptors, Cell Surface; Rifampin; T-Lymphocytes; Treatment Outcome

To present a case of successful emergency endovascular repair of a ruptured, probably mycotic, thoracoabdominal aortic aneurysm (TAAA) with a stent-graft deliberately covering the celiac axis.. A 79-year-old woman with significant pulmonary comorbidity presented with a ruptured mycotic TAAA extending to the celiac axis. The aneurysm was excluded with a stent-graft soaked in rifampicin and deployed to deliberately occlude the celiac axis for effective distal sealing and fixation. The patient recovered well and was prescribed antibiotic treatment for up to 6 months.. Endovascular repair of a ruptured TAAA may be a life-saving option. In emergency situations when poor distal anatomy is present, covering the celiac artery with the stent-graft should be considered.

Topics: Abdominal Pain; Aged; Aneurysm, Infected; Angiography; Angioplasty, Balloon; Anti-Bacterial Agents; Antibiotics, Antitubercular; Aortic Aneurysm, Abdominal; Aortic Aneurysm, Thoracic; Aortic Rupture; Blood Vessel Prosthesis Implantation; Celiac Artery; Diarrhea; Emergencies; Fatigue; Female; Fever; Humans; Patient Selection; Prosthesis Design; Rifampin; Stents; Tomography, X-Ray Computed; Treatment Outcome

Topics: Antibiotics, Antitubercular; Emergencies; Female; Humans; Infant, Newborn; Male; Pregnancy; Pregnancy Complications, Infectious; Rifampin; Shock, Hemorrhagic; Tuberculosis, Pleural

To report our therapeutic experience with tuberculosis of the lower cervical spine with neurological complications in 9 adults in Gabon.. A retrospective study of these 9 adults treated for progressive Pott's tetraplegia or paraplegia from 1982 to 1998 was conducted. The medical treatment consisted of the early administration in the first 3 patients of rifampin, isoniazid and ethambutol for 18 months; and, in the remaining 6 patients, of rifampin, isoniazid, ethambutol and pyrazinamide for 6 months. This medical treatment was systematically started 3 weeks before surgery in 7 patients, once the disease had been diagnosed radiologically. Two patients with an acute onset of paraplegia underwent surgery on an emergency basis. The standard anterior approach was used: debridement was done in 3 cases, to establish the diagnosis; 6 patients underwent radical surgery for severe neurological deficit and spinal instability. Average follow-up time was 40.6 months.. Three patients were found to be functionally and neurologically normal at follow-up examinations. Eight of the nine patients recovered sufficiently to walk unaided. One patient was able to get about on crutches. After 3-4 months, a satisfactory consolidation was already observed, with reduction of kyphosis in 4 cases. All patients were considered medically cured by the Antituberculous Center.. Early radical surgery, as primary procedure, in conjunction with a six-month chemotherapeutic regimen (four drugs) seems to be adequate for the management of tuberculosis of the lower cervical spine with neurological complications and spinal instability, in our setting.

Topics: Adult; Antitubercular Agents; Cervical Vertebrae; Combined Modality Therapy; Debridement; Emergencies; Ethambutol; Follow-Up Studies; Gabon; Humans; Isoniazid; Kyphosis; Paraplegia; Physical Therapy Modalities; Pyrazinamide; Quadriplegia; Retrospective Studies; Rifampin; Treatment Outcome; Tuberculosis, Spinal

The aim of this prospective study was to evaluate the incidence of allergic reactions to drugs compared to other kinds of medical emergencies admitted to the main Hospital in Milan during a 6 months period. At the same time we drew a list of drugs most frequently involved in allergic reactions, and a list of the most frequent symptoms. Using special forms, the medical staff collected patients' data: age, history of atopy, identification of the drug causing the reaction, and any previous reactions. Among 11,407 cases of medical emergencies, we found 163 (1.43%) patients showing drug reactions: the mean age was 27.3; 58.90% were female; atopy was present in 16.56%. The drugs most frequently involved were: pyrazon group (22%); ASA (20.86%); penicillin and derivatives (9.20%); sulfa drugs (6.14%); group B vitamins (4.30%); tetanus toxoid (4.30%); hyposensitizing extracts (3.68%); propionic acid derivatives (2.46%); paracetamol (1.84%); indomethacin (1.23%); rifampicin (1.23%); erythromycin (1.23%); glafenine (1.23%); others (17.80%). Urticaria and/or angioedema were the most frequent symptoms (86.51%), then anaphylactic shock (9.81%) and asthma (3.68%) with regard to anaphylactic shock only 6.20% of the patients had had a previous reaction to the same drug. From these data we can see that the incidence of drug reactions is very low compared to other medical emergencies; penicillin evidenced fewer reactions than expected, while the pyrazon group and ASA confirmed the data from literature.

Topics: Acetaminophen; Adult; Anaphylaxis; Angioedema; Aspirin; Asthma; Drug Hypersensitivity; Emergencies; Erythromycin; Female; Glafenine; Humans; Indomethacin; Italy; Male; Penicillins; Propionates; Prospective Studies; Pyridazines; Rifampin; Urticaria; Vitamin B Complex

Topics: Acute Disease; Bladder Exstrophy; Burns; Carcinoid Tumor; Cholelithiasis; Coronary Angiography; Coronary Artery Bypass; Coronary Disease; Emergencies; Esophageal and Gastric Varices; General Surgery; Methods; Necrosis; Pancreatitis; Rifampin; Transportation of Patients; Tuberculosis, Lymph Node; Tuberculosis, Osteoarticular; Vascular Surgical Procedures; Wounds and Injuries

Topics: Adult; Drug Resistance, Microbial; Emergencies; Emergency Service, Hospital; Female; Germany, West; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Pneumonia, Staphylococcal; Rifampin