rifampin and Pleurisy

In the report, 4 patients with similar Hexheimer's reaction during initial chemotherapy for pulmonary tuberculosis were presented. The literatures on clinical manifestations, predisposing factors, pathogenic mechanism, pathological changes, diagnosis and management of Hexheimer's reaction are reviewed.

Topics: Adult; Antibiotics, Antitubercular; Antitubercular Agents; Child, Preschool; Female; Humans; Isoniazid; Lymphadenitis; Male; Pleurisy; Rifampin; Tuberculosis, Pulmonary

Nontuberculous mycobacteria (NTM)-associated pleuritis is a very rare disease. Here, we describe 2 cases of life-threatening Mycobacterium intracellulare-associated pleuritis in immunocompetent hosts.. A 78-year-old man with sudden onset-onset dyspnea (case 1) and an 80-year-old man with cough, sputum and fever (case 2) presented to our emergency room.. Both the patients were diagnosed with Mycobacterium intracellulare-associated pleuritis.. In case 1, the patient underwent intubation with mechanical ventilation due to hypoxemic respiratory failure. Daily azithromycin, rifampin and ethambutol, and intravenous amikacin 3 times a week was administered. In case 2, the patient received daily azithromycin, rifampin and ethambutol, and intravenous amikacin 3 times a week.. In case 1, after receiving NTM treatment for 14 months, NTM-associated pleuritis was cured, with radiologic improvement. In case 2, however, bronchopleural fistula was developed. Despite tube drainage, air leak continued. The patient refused surgical management and eventually died of respiratory failure.. Pleural effusion arising from NTM lung disease located in the subpleural area should be considered a possible cause of NTM-associated pleuritis. Drainage and a multidrug regimen are required to treat NTM, and surgical treatment should be considered when complications occur.

Topics: Aged; Aged, 80 and over; Amikacin; Anti-Bacterial Agents; Anti-Infective Agents; Antitubercular Agents; Azithromycin; Ethambutol; Humans; Immunocompromised Host; Male; Mycobacterium avium Complex; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Pleurisy; Rifampin; Tomography, X-Ray Computed

Anti-interferon-gamma (IFN-γ) autoantibodies has been recognised as an adult-onset immunodeficiency in the past decade in people who originate from Southeast Asia. These patients are susceptible to particular opportunistic infections, especially non-tuberculous mycobacteria (NTM). We present the case of a woman whom originally came from Thailand with disseminated

Topics: Adult; Anti-Bacterial Agents; Asian People; Autoantibodies; Azithromycin; Bacteremia; Disease Progression; Ethambutol; Female; Humans; Immunologic Deficiency Syndromes; Immunologic Factors; Interferon-gamma; Mycobacterium avium Complex; Mycobacterium avium-intracellulare Infection; Pericarditis; Pleurisy; Pneumonia, Bacterial; Recurrence; Rifampin; Rituximab; Thailand

The author reports a case of pleuritis associated with a large homolateral Buruli thorax ulcer in a nine-year old female patient, in the Democratic Republic of Congo. Smears on Ziehl-Neelsen revealed acid-alcohol-resistant bacilli. The pathological histology confirmed a Mycobacterium ulcerans infection (Buruli ulcer). The treatment was surgical (excision-dressing-grafting) associated to antibiotic therapy (Rifater, Pyrazynamide, and Myambutol). After six years of follow up, no relapse was observed.

Topics: Anti-Bacterial Agents; Buruli Ulcer; Child; Chloramines; Combined Modality Therapy; Drug Combinations; Drug Therapy, Combination; Ethambutol; Female; Follow-Up Studies; Humans; Isoniazid; Mastectomy; Metronidazole; Mycobacterium ulcerans; Nitrofurantoin; Pleurisy; Prednisolone; Pyrazinamide; Recurrence; Rifampin; Skin Transplantation

Infections of Rhodococcus equi, a well-known pathogen in animals which causes cavitated pneumonia similar to that caused by mycobacteria, were studied in three HIV-infected patients. This microorganism was isolated in the bronchoalveolar washings of two patients and in the sputum of the third. In two patients, Rh. equi represented the first clinical opportunistic manifestation of HIV disease. One patient died of concomitant Pneumocystis infection. The eradication of the microorganism occurred in two out of three patients. It was found that no isolates were resistant to erythromycin, claritromycin, rifampin, vancomycin, teicoplanin, imipenem, gentamycin or azithromycin (MIC values < or = 0.1 microgram/ml). Moreover, the quinolones (ciprofloxacin and ofloxacin) were found to be less effective, whereas neither the beta-lactam antibiotics nor chloramphenicol were effective therapy for this microrganism. At least two antimicrobial agents should be given contemporaneously to treat these infections for a period of up to several months. Our results suggest that the combinations erythromycin + rifampin or imipenem + teicoplanin are the most effective treatments in Rh. equi infections.

Topics: Actinomycetales Infections; Adult; AIDS-Related Opportunistic Infections; Anti-Bacterial Agents; Azithromycin; Bacteremia; Bronchoalveolar Lavage Fluid; Clarithromycin; Drug Resistance, Microbial; Drug Synergism; Drug Therapy, Combination; Erythromycin; Female; Gentamicins; HIV Infections; Humans; Imipenem; Male; Pleurisy; Pneumonia, Bacterial; Rhodococcus equi; Rifampin; Sputum; Teicoplanin; Vancomycin

A patient is presented who developed a granulomatous hepatitis and pleuritis approximately 7 months after an ileal bypass procedure for morbid obesity. Although the etiological agent was presumed to be Mycobacterium tuberculosis no pathogenic organism was grown from the liver, pleura, bone marrow, sputum, or gastric aspirate. The possibly increased susceptibility of these patients to mycobacterial infections is discussed. The value of obtaining serum levels of ethambutol, isoniazid, and rifampin, in patients with malabsorption is stressed. Although this patient seemed to respond to antituberculous therapy, other possible causes for the granulomatous process are explored.

Topics: Ethambutol; Female; Hepatitis; Humans; Ileum; Intestinal Absorption; Isoniazid; Jejunum; Middle Aged; Obesity; Phagocyte Bactericidal Dysfunction; Pleurisy; Rifampin

Topics: Adrenal Cortex Hormones; Ethambutol; Humans; Isoniazid; Long-Term Care; Models, Biological; Pleurisy; Rifampin; Tuberculosis, Pleural

Topics: Adolescent; Adult; Aged; Bronchitis; Bronchopneumonia; Enterobacteriaceae; Feeding and Eating Disorders; Female; Haemophilus influenzae; Humans; Leukemia, Myeloid, Acute; Male; Middle Aged; Nausea; Neoplasm Metastasis; Pleural Neoplasms; Pleurisy; Pleuropneumonia; Pneumonia, Pneumococcal; Pulmonary Emphysema; Rifampin; Sputum; Staphylococcus