rifampin and Ulcer

Tuberculosis (TB) continues to be a prevalent disease worldwide; an estimated one third of the world's population is infected and 2015 data from the World Health Organization show 10 million people had an active infection. Although TB often is cited as a disease that most commonly occurs in underdeveloped countries, the evolution of drug-resistant forms of TB and infection sensitivity of immunocompromised individuals have made this disease a focal point for indus- trialized countries as well. When TB is spread, it commonly affects the lungs, but it can infect any organ of the body. An uncommon version - cutaneous TB - affects < 2% of all individuals with an active form of TB. This study describes a 34-year-old man with multiple comorbidities, including peripheral vascular disease and a remote history of travel to Latin America who presented to a wound care clinic with a 2-year history of painful shallow necrotic ulcers on his right lower limb and previous treatments that included a positive response to antibiotics. Once TB was con rmed via 2 posi- tive Quantiferon Gold tests, the patient received therapy (directly observed by the state health department) that included pyrazinamide, rifampin, ethambutol, isoniazid, and undocumented vitamin B6. Treatment for the TB-related lesions, con- comitant cellulitis, and a Stage 2 pressure injury under his rst right metatarsal head was initiated as well. The patient received local wound care for 40 days that included sharp debridement, of oading for the pressure injury, and pain relief before treatment at the wound care clinic and daily as prescribed by his primary care provider. All wounds were securely covered with collagen dressings followed by silicone-bordered bandages. Local wound care was provided for 40 days, with biweekly follow-up for an additional 30 days. The wounds resolved and the patient was discharged from the wound care clinic but remained on the caseload for 30 days in the event his pain increased or the wounds recurred. Cutaneous TB, uncommon and challenging, should be a consideration in patients with an increased likelihood of occurrence.

Topics: Adult; Anti-Bacterial Agents; Humans; Male; Pain; Peripheral Arterial Disease; Rifampin; Tuberculosis, Cutaneous; Ulcer; Wound Healing

Brucellosis is the most common bacterial zoonosis, and causes a considerable burden of disease in endemic countries. Cardiovascular involvement is the main cause of mortality due to infection with Brucella spp, and most commonly manifests as endocarditis, peripheral and cerebrovascular aneurysms, or arterial and venous thromboses. We report a case of brucellosis presenting as bacteraemia and aortic endarteritis 18 years after the last known exposure to risk factors for brucella infection. The patient was treated with doxycycline, rifampicin, and gentamicin, and underwent surgical repair of a penetrating aortic ulcer, with a good clinical recovery. We review the signs and symptoms, diagnostic approach, prognosis, and treatment of brucella arteritis. We draw attention to the absence of consensus about the optimum therapy for vascular brucellosis, and the urgent need for additional studies and renewed scientific interest in this major pathogen.

Topics: Abattoirs; Aged; Animals; Anti-Bacterial Agents; Aortic Diseases; Bacteremia; Blood Vessel Prosthesis; Brucella abortus; Brucellosis; Doxycycline; Ecuador; Endarteritis; Endocarditis, Bacterial; Gentamicins; Humans; Male; Occupational Exposure; Prognosis; Rifampin; Ulcer

Tuberculosis can cause genital ulcers, although this clinical manifestation was more frequent at the beginning of the 20th century as it was related to the rite of circumcision. We report the case of a patient with this disease, presumably acquired through sexual intercourse.

Topics: Adult; Antitubercular Agents; Extramarital Relations; Humans; Isoniazid; Male; Penis; Pyrazinamide; Rifampin; Treatment Outcome; Tuberculosis, Cutaneous; Ulcer

Topics: Adult; Antitubercular Agents; Drug Therapy, Combination; Humans; Isoniazid; Laryngitis; Male; Pyrazinamide; Rifampin; Tongue; Tuberculosis, Pulmonary; Ulcer

A 26 year-old female was seeking treatment for a painless ulcerated lesion of the tongue developing 30 days before. No history of a sef biting in that area was told by the patient. Following a provisional diagnosis of tuberculous ulcer or a neoplasm, under local anesthesia, a segment of the lesion was excised and sent to histological diagnosis, which confirmed the existence of a tuberculous ulcer. Additionally, a chest roentgenogram disclosed the presence of an undiagnosed pulmonar tuberculous lesion. The patient underwent a successful treatment with rifampicin, isoniazide and pirazinamide, and two month after the initial diagnosis the oral lesion was almost absent, although the pulmonar lesion was still detected on the roentgenogram. Finally, a total disappearance of the pulmonar lesion was detected six month following drug treatment.

Topics: Adult; Female; Humans; Isoniazid; Pyrazinamide; Rifampin; Tongue Diseases; Tuberculosis; Tuberculosis, Oral; Tuberculosis, Pulmonary; Ulcer

Topics: Bacteria, Anaerobic; Bacterial Infections; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Penile Diseases; Rifampin; Ulcer

Topics: Adult; Anti-Bacterial Agents; Clindamycin; Doxycycline; Esophageal Diseases; Female; Humans; Male; Rifampin; Ulcer

Topics: Humans; Male; Middle Aged; Rifampin; Streptomycin; Tongue Diseases; Tuberculosis, Pulmonary; Ulcer