rifampin and Sarcoidosis

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and mainly affects the lungs. Sarcoidosis is an autoinflammatory disease characterized by the diffusion of granulomas in the lungs and other organs. Here, we discuss how the two diseases might involve some common mechanistic cellular pathways around the regulation of autophagy.

Topics: Angiotensin-Converting Enzyme Inhibitors; Autophagy; Azithromycin; Betacoronavirus; Chloroquine; Coronavirus Infections; COVID-19; Host-Pathogen Interactions; Humans; Isoniazid; Lung; Pandemics; Pneumonia, Viral; Pulmonary Edema; Rifampin; Sarcoidosis; SARS-CoV-2; Severe Acute Respiratory Syndrome; Severity of Illness Index

We report the first Italian case of Mycobacterium chimaera disseminated infection in a patient with a history of cardiac surgery. The patient was initially diagnosed with sarcoidosis and started on immunosuppressive therapy. Ten months later she developed a vertebral osteomyelitis: M. chimaera was isolated from bone specimen. A review of the literature shows that M. chimaera infection occurs specifically in this population of patients, due to contamination of heater-cooler units used during cardiosurgery. Devices responsible for the transmission were produced by Sorin Group Deutschland. Mycobacterium chimaera infection should be included in the differential diagnosis for patients undergoing cardiac surgery.

Topics: Acinetobacter Infections; Aged; Bacteremia; Diagnostic Errors; Drug Therapy, Combination; Equipment Contamination; Female; Heart Valve Prosthesis Implantation; Heating; Humans; Linezolid; Lumbar Vertebrae; Mycobacterium avium Complex; Mycobacterium avium-intracellulare Infection; Osteomyelitis; Postoperative Complications; Prednisone; Rifampin; Sarcoidosis; Spondylitis; Vertebroplasty; Water Microbiology

The association sarcoidosis-lung abscess due to emerging microorganisms-mycetoma has prompted the authors to report the above clinical case which is interesting in view of the rarity of the disease and of its infective complications. The authors also review the literature on the subject.

Topics: Bronchoalveolar Lavage Fluid; Ceftazidime; Fluconazole; Humans; Lung Abscess; Male; Middle Aged; Mycetoma; Radiography, Thoracic; Rifampin; Sarcoidosis; Tomography, X-Ray Computed

Sarcoidosis is a chronic granulomatous disease for which there are limited therapeutic options. This is the first randomized, placebo-controlled study to demonstrate that antimycobacterial therapy reduces lesion diameter and disease severity among patients with chronic cutaneous sarcoidosis.. To evaluate the safety and efficacy of once-daily antimycobacterial therapy on the resolution of chronic cutaneous sarcoidosis lesions.. A randomized, placebo-controlled, single-masked trial on 30 patients with symptomatic chronic cutaneous sarcoidosis lesions deemed to require therapeutic intervention.. A tertiary referral dermatology center in Nashville, Tennessee.. Participants were randomized to receive either the oral concomitant levofloxacin, ethambutol, azithromycin, and rifampin (CLEAR) regimen or a comparative placebo regimen for 8 weeks with a 180-day follow-up.. Participants were monitored for absolute change in lesion diameter and decrease in granuloma burden, if present, on completion of therapy.. In the intention-to-treat analysis, the CLEAR-treated group had a mean (SD) decrease in lesion diameter of -8.4 (14.0) mm compared with an increase of 0.07 (3.2) mm in the placebo-treated group (P = .05). The CLEAR group had a significant reduction in granuloma burden and experienced a mean (SD) decline of -2.9 (2.5) mm in lesion severity compared with a decline of -0.6 (2.1) mm in the placebo group (P = .02).. Antimycobacterial therapy may result in significant reductions in chronic cutaneous sarcoidosis lesion diameter compared with placebo. These observed reductions, associated with a clinically significant improvement in symptoms, were present at the 180-day follow-up period. Transcriptome analysis of sarcoidosis CD4+ T cells revealed reversal of pathways associated with disease severity and enhanced T-cell function following T-cell receptor stimulation.. clinicaltrials.gov Identifier: NCT01074554.

Topics: Administration, Oral; Adult; Aged; Anti-Bacterial Agents; Azithromycin; CD4-Positive T-Lymphocytes; Chronic Disease; Drug Therapy, Combination; Ethambutol; Female; Follow-Up Studies; Humans; Levofloxacin; Male; Middle Aged; Ofloxacin; Rifampin; Sarcoidosis; Severity of Illness Index; Single-Blind Method; Skin Diseases; Transcriptome; Treatment Outcome; Young Adult

Topics: Antitubercular Agents; Bronchitis; Bronchoalveolar Lavage Fluid; Bronchoscopy; CD4-CD8 Ratio; Diagnosis, Differential; Diagnostic Errors; Drug Therapy, Combination; Ethambutol; Facial Dermatoses; Female; Humans; Isoniazid; Middle Aged; Mycobacterium tuberculosis; Pyrazinamide; Rifampin; Sarcoidosis; Sputum; Tuberculosis, Cutaneous; Tuberculosis, Pulmonary

Topics: Adult; Clofazimine; Dapsone; Diagnostic Errors; Drug Therapy, Combination; Female; Humans; Leprostatic Agents; Leprosy, Borderline; Rifampin; Sarcoidosis; Skin Diseases, Bacterial

We report a rare case of concomitant Hansen's disease (HD) and sarcoidosis. Reticulin staining may be a helpful diagnostic tool in establishing the diagnosis of sarcoidosis in skin lesions. The diagnosis of HD can be established despite negative polymerase chain reaction results for the detection of Mycobacterium leprae DNA. Finally, a well-established diagnosis of sarcoidosis does not preclude the development of another granulomatous disorder. Hence, when new lesions developed in a patient with sarcoidosis despite appropriate therapy, other concurrent diagnoses should be pursued.

Topics: Anti-Inflammatory Agents; Biopsy; Clofazimine; Dapsone; Dermatologic Agents; Electromyography; Female; Humans; Hydroxychloroquine; Leprostatic Agents; Leprosy, Tuberculoid; Lymphadenitis; Middle Aged; Mycobacterium leprae; Peptidyl-Dipeptidase A; Polymerase Chain Reaction; Prednisone; Reticulin; Rifampin; Sarcoidosis; Skin; Triamcinolone

Topics: Abscess; Adrenal Gland Diseases; Amphotericin B; Aspergillosis; Aspergillus fumigatus; Diagnosis, Differential; Drainage; Drug Therapy, Combination; Humans; Ketoconazole; Male; Middle Aged; Opportunistic Infections; Rifampin; Sarcoidosis

Sarcoidosis is a multisystem disease of unknown etiology characterized by non-caseating granulomatous inflammation of various organs, but most frequently involving the lungs of young adults. Sarcoidosis is rare in the pediatric age group, however numerous extensive reviews have been published. The most commonly seen initial manifestations in childhood are non-specific constitutional symptoms such as lethargy, fatigue and malaise, followed by cough, dyspnea, fever, weight loss, and lymphadenopathy in order of decreasing frequency. The diagnosis is one of exclusion and is established when clinical and radiological findings are supported by histological evidence of widespread non-caseating epithelial cell granulomas in more than one organ, or a positive Kveim test. Laryngeal involvement is usually part of the systemic disease, but isolated laryngeal sarcoidosis has been reported in adults. We report here a case of isolated laryngeal sarcoidosis in a 13 year old girl. The differential diagnosis and management are discussed.

Topics: Adolescent; Diagnosis, Differential; Epiglottis; Female; Humans; Isoniazid; Laryngeal Diseases; Laryngeal Mucosa; Prednisone; Rifampin; Sarcoidosis; Tuberculosis

Topics: Adrenal Cortex Hormones; Alanine Transaminase; Aspartate Aminotransferases; Bilirubin; Blood Cell Count; Blood Sedimentation; Cholesterol; Contraceptive Agents; Drug Interactions; Female; Humans; Liver; Male; Rifampin; Sarcoidosis

Topics: Biopsy; Diagnosis, Differential; Ethambutol; Female; Humans; Isoniazid; Mandibular Diseases; Middle Aged; Rifampin; Sarcoidosis; Tuberculosis, Osteoarticular

Topics: Adrenal Cortex Hormones; Arthritis, Rheumatoid; Azathioprine; Cephalosporins; Humans; Liver Abscess, Amebic; Metronidazole; Purpura, Thrombocytopenic; Respiratory Tract Infections; Rifampin; Sarcoidosis; Urinary Tract Infections