rifampin and Leg-Ulcer

Bacillus cereus is a ubiquitous telluric organism. B. cereus endocarditis is a rare condition seen mostly in prosthetic heart valves and among intravenous drug users. We report a new case of a patient without risk factors and with a good clinical outcome not requiring valve replacement.. In October 2014, a 50-year-old woman was referred to the dermatology department of Lille University Hospital for lower-limb wounds developing 6 months earlier. She presented fever without clinical signs of infection, except for the lower-limbs wounds. Blood cultures revealed the presence of B. cereus. Transesophageal echocardiography was performed and revealed two foci of aortic valve vegetation with a diameter of 5mm. After bacterial sensitivity testing, rifampicin and levofloxacin treatment was given for six weeks, with complete remission. A skin graft was performed and good improvement was seen.. Nineteen cases of B. cereus endocarditis have been described previously, only one of which was without risk factors. We described a case of complete remission after a 6-week course of antibiotics. Our case demonstrates that BC should not be considered as a blood culture contamination, and that treatment may be complex due to antibiotic resistance.

Topics: Anti-Bacterial Agents; Bacillus cereus; Drug Therapy, Combination; Endocarditis; Female; Humans; Leg Ulcer; Levofloxacin; Middle Aged; Rifampin; Risk Factors; Time Factors; Treatment Outcome

Topics: Administration, Oral; Adult; Anti-Bacterial Agents; Buruli Ulcer; Clarithromycin; Drug Therapy, Combination; France; Humans; Leg Ulcer; Male; Mali; Mycobacterium ulcerans; Pain; Rifampin; Travel; Treatment Outcome

At one time it was believed that granuloma annulare was associated with or even caused by tuberculosis. In the past 50 years, that idea has seemed to be of little more than historic importance. A case is reported of chronic, inadequately treated tuberculosis with erythema induratum in which clinical and histologic lesions compatible with granuloma annulare occurred. Specific antituberculosis therapy caused clearing of the skin lesions. The previous reported cases of granuloma annulare and tuberculosis are summarized. Other systemic diseases reportedly associated with granuloma annulare are noted to emphasize the many possible etiologic relationships. Granuloma annulare may be viewed not as a disease sui generis but as a phenotypic macrophage-granulomatous response to multiple etiologic disease patterns.

Topics: Antitubercular Agents; Back; Diagnosis, Differential; Erythema; Female; Granuloma Annulare; Humans; Leg Ulcer; Middle Aged; Phenotype; Radiography; Rifampin; Tuberculosis, Pulmonary

A chronic, painless sore developed over a 2-month period on the left calf of a Canadian man traveling for 8 months in Africa. A presumptive diagnosis of a Mycobacterium spp. infection was made despite initially negative biopsy and culture results, after failure of several courses of anti-bacterial antibiotics. Mycobacterium ulcerans was eventually isolated and the lesion progressed despite treatment with multiple anti-mycobacterial agents. The lesion finally responded to wide and repeated excision, aggressive treatment with anti-mycobacterial antibiotics, and split-thickness skin grafting. The isolation and treatment of this unusual organism are discussed.

Topics: Adult; Africa; Anti-Bacterial Agents; Antibiotics, Antitubercular; Antitubercular Agents; Ciprofloxacin; Clarithromycin; Cloxacillin; Ethambutol; Humans; Leg Ulcer; Male; Metronidazole; Mycobacterium Infections, Nontuberculous; Mycobacterium ulcerans; Penicillins; Rifampin; Skin Diseases, Bacterial; Skin Transplantation; Travel; Trimethoprim, Sulfamethoxazole Drug Combination; Virulence

Topics: Aged; Ascorbic Acid; Diabetic Angiopathies; Female; Humans; Hyaluronic Acid; Leg Ulcer; Male; Middle Aged; Ointments; Rifampin; Vascular Diseases

Topics: Adult; Aged; Female; Heparinoids; Humans; Leg Ulcer; Male; Middle Aged; Povidone; Rifampin

Topics: Female; Humans; Leg Ulcer; Male; Placental Extracts; Rifampin; Thrombosis; Varicose Veins