rifampin and Lymphopenia

Topics: Adolescent; Adult; Age Factors; Aged; Drug Administration Schedule; Drug Therapy, Combination; Female; Fever; Humans; Isoniazid; Leukocytosis; Lymphopenia; Male; Middle Aged; Purpura, Thrombocytopenic; Rifampin; Sex Factors; Tuberculosis, Pulmonary

Prospective randomised clinical trial comparing the safety and efficacy of rifampicin- and thiacetazone-containing regimens in human immunodeficiency virus (HIV)-infected adults with pulmonary tuberculosis (TB) at the National Tuberculosis Treatment Centre, Kampala, Uganda.. To assess demographic, clinical and laboratory risk factors associated with toxicity during treatment with streptomycin, thiacetazone and isoniazid (STH) of HIV-1 infected adults with pulmonary TB.. Nested case-control study of all subjects randomized to the STH treatment arm. Baseline demographic, clinical, microbiological, hematological and radiographic characteristics were compared between subjects who developed and those who did not develop adverse drug reactions (ADR).. Of the 90 subjects randomized to STH, 13 developed ADR yielding an incidence rate of 19.6 events per 100 person years of observation (PYO). Eleven of the 13 ADR were cutaneous hypersensitivity reactions, including one fatal case of Stevens-Johnson syndrome. Eight of 13 patients who developed ADR were tuberculin anergic, compared to 12 of 77 patients who did not develop ADR (P < 0.001). An absolute lymphocyte count below 2000 cells/mm3 was also associated with ADR (P = 0.02).. Initial anergy to tuberculin and lymphocytopenia, markers of advanced HIV infection and immunosuppression, were associated with increased risk for adverse drug reactions during STH chemotherapy.

Topics: Adolescent; Adult; AIDS-Related Opportunistic Infections; Antitubercular Agents; Case-Control Studies; Clonal Anergy; Confidence Intervals; Developing Countries; Drug Eruptions; Drug Therapy, Combination; Female; HIV-1; Humans; Incidence; Jaundice; Lymphopenia; Male; Middle Aged; Odds Ratio; Prospective Studies; Rifampin; Risk Factors; Stevens-Johnson Syndrome; Survival Rate; Thioacetazone; Tuberculosis, Pulmonary; Uganda

Children who undergo treatment for malignancies are at high for infection with both typical and opportunistic pathogens. Fever in these children prompts extensive evaluation and empiric treatment with broad-spectrum antimicrobials. In the United States (US), tuberculosis is an infrequently reported cause of fever in the pediatric cancer patient and has not been well described. In this report we describe a case of primary pulmonary tuberculosis (TB) in a boy with precursor B-cell acute lymphoblastic leukemia (ALL) and review the pertinent literature.

Topics: Antineoplastic Combined Chemotherapy Protocols; Antitubercular Agents; Azithromycin; Child, Preschool; Combined Modality Therapy; Contact Tracing; Cyclophosphamide; Cytarabine; Dexamethasone; Doxorubicin; Drug Therapy, Combination; Ethambutol; Fever of Unknown Origin; Humans; Immunocompromised Host; Isoniazid; Lymphopenia; Male; Mycobacterium tuberculosis; Pneumonectomy; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Pyrazinamide; Rifampin; Tuberculosis, Pulmonary; Vincristine

Topics: Adolescent; Adrenal Cortex Hormones; Anemia; Antibodies; BCG Vaccine; Biopsy; Bone Marrow Diseases; Ethambutol; Female; Fever; Hepatomegaly; Humans; Immunity, Cellular; Immunoglobulins; Immunologic Deficiency Syndromes; Iron; Isoniazid; Leukocyte Count; Lymph Nodes; Lymphocytes; Lymphopenia; Mycobacterium bovis; Mycobacterium Infections; Rifampin; Splenic Diseases; Splenomegaly; Tuberculin Test