ro13-9904 and Brain-Neoplasms

Legionella species are a common cause of community-acquired pneumonia, infrequently complicated by cavitary disease. We describe Legionella pneumophila pneumonia and abscess formation in an immunosuppressed patient receiving corticosteroid therapy for metastatic breast carcinoma. The predisposing role of corticosteroids is discussed and the management of this complication is reviewed.

Topics: Adult; Anti-Bacterial Agents; Antineoplastic Combined Chemotherapy Protocols; Australia; Azithromycin; Brain Neoplasms; Breast Neoplasms; Ceftriaxone; Combined Modality Therapy; Cranial Irradiation; Dexamethasone; Diagnosis, Differential; Drainage; Female; Humans; Immunocompromised Host; Legionella pneumophila; Legionnaires' Disease; Lung Abscess; Lung Neoplasms; Metronidazole; Roxithromycin; Thoracic Surgery, Video-Assisted; Thoracostomy; Tomography, X-Ray Computed

This paper analysed 525 intracranial neoplastic patients who were hospitalized from July, 1992 to June, 1993. The patients were randomly divided into control and experiment groups. In the experiment group, patients who received one kind of antibiotic during perioperation had a nosocomial infection rate of 6.29% (11/175), while the patients in the control group where antibiotics were routinely used as usual had a rate of 17.43% (61/350). There was a significant difference between the control (8.00%) and experiment group (2.29%) in terms of the intracranial infection incidence. Perioperative antibiotic prophylaxis showed great influence on the expenditure of antibiotics and duration of hospitalization in the patients with intracranial neoplastic tumors.

Topics: Adolescent; Adult; Brain Neoplasms; Ceftriaxone; China; Cross Infection; Female; Humans; Male; Middle Aged; Premedication; Prospective Studies; Surgical Wound Infection

Topics: Antineoplastic Combined Chemotherapy Protocols; Borrelia burgdorferi; Brain Neoplasms; Ceftriaxone; Cyclophosphamide; Doxorubicin; Humans; Lyme Disease; Lymphoma, Large B-Cell, Diffuse; Middle Aged; Prednisolone; Rituximab; Vincristine

Topics: Acyclovir; Adrenal Cortex Hormones; Anti-Bacterial Agents; Antiviral Agents; Brain Neoplasms; Ceftriaxone; Dexamethasone; Diagnosis, Differential; Electroencephalography; Emergency Service, Hospital; Encephalitis, Herpes Simplex; Fever; Humans; Hypnotics and Sedatives; Infarction; Levetiracetam; Male; Massachusetts; Middle Aged; Phenytoin; Piracetam; Propofol; Status Epilepticus; Temporal Lobe; Tomography, X-Ray Computed; Unconsciousness; Vancomycin

Ceftriaxone-induced immune hemolytic anemia (CIHA) is the second most common cause of drug-induced hemolytic anemia. Prompt recognition of this drug reaction is essential because brisk hemolysis can be deadly. The extent to which ceftriaxone antibodies persist after CIHA is unknown; rechallenging patients who have experienced CIHA is not recommended. We report a case of CIHA in a neurooncology patient, which is the first to show anticeftriaxone antibodies with Rh specificity and persisted for 8 months after the drug reaction. These findings have implications for understanding the mechanism of CIHA.

Topics: Anemia, Hemolytic, Autoimmune; Anti-Bacterial Agents; Antibodies; Brain Neoplasms; Ceftriaxone; Child, Preschool; Female; Glioma; Humans

Topics: Abducens Nerve Diseases; Anti-Bacterial Agents; Antibodies, Bacterial; Borrelia burgdorferi; Brain Neoplasms; Ceftriaxone; Child; Diagnosis, Differential; Diplopia; Erythema Chronicum Migrans; France; Humans; Intracranial Hypertension; Lyme Neuroborreliosis; Male; Scotland; Travel

Topics: Aged; Anti-Bacterial Agents; Antineoplastic Combined Chemotherapy Protocols; Brain Neoplasms; Carcinoma, Small Cell; Ceftriaxone; Cisplatin; Combined Modality Therapy; Cranial Irradiation; Etoposide; Fatal Outcome; Female; Humans; Immunocompromised Host; Lung Neoplasms; Opportunistic Infections; Pneumonia, Pneumocystis; Pneumonia, Staphylococcal; Staphylococcus aureus; Trimethoprim, Sulfamethoxazole Drug Combination

Alexander disease is a rare, untreatable and usually fatal neurodegenerative disorder caused by heterozygous mutations of the glial fibrillary acidic protein (GFAP) gene which ultimately lead to formation of aggregates, containing also alphaB-Crystallin, HSP27, ubiquitin and proteasome components. Recent findings indicate that up-regulation of alphaB-Crystallin in mice carrying GFAP mutations may temper the pathogenesis of the disease. Neuroprotective effects of ceftriaxone have been reported in various animal models and, noteworthy, we have recently shown that the chronic use of ceftriaxone in a patient affected by an adult form of Alexander disease could halt its progression and ameliorate some of the symptoms. Here we show that ceftriaxone is able to reduce the intracytoplasmic aggregates of mutant GFAP in a cellular model of Alexander disease. Underlying mechanisms include mutant GFAP elimination, concurrent with up-regulation of HSP27 and alphaB-Crystallin, polyubiquitination and autophagy. Ceftriaxone has also been shown to modulate the proteasome system, thus decreasing NF-kappaB activation and GFAP promoter transcriptional regulation, which further accounts for the down-modulation of GFAP protein levels. These mechanisms provide previously unknown neuroprotective targets of ceftriaxone and confirm its potential therapeutic role in patients with Alexander disease and other neurodegenerative disorders with astrocyte involvement.

Topics: alpha-Crystallin B Chain; Anti-Bacterial Agents; Astrocytoma; Autophagy; Blotting, Western; Brain Neoplasms; Ceftriaxone; Cell Proliferation; Fluorescent Antibody Technique; Gene Expression Regulation; Glial Fibrillary Acidic Protein; HSP27 Heat-Shock Proteins; Humans; In Vitro Techniques; Luciferases; Mutant Proteins; Promoter Regions, Genetic; Proteasome Endopeptidase Complex; Protein Multimerization; Reverse Transcriptase Polymerase Chain Reaction; RNA, Messenger; Tumor Cells, Cultured; Ubiquitin

Topics: Aged; Brain Diseases; Brain Neoplasms; Brain Stem; Ceftriaxone; Dexamethasone; Diagnosis, Differential; Doxycycline; Gadolinium; Humans; Magnetic Resonance Imaging; Male; Neurosyphilis; Penicillins; Radiographic Image Enhancement; Tomography, X-Ray Computed

The cerebral penetration of ceftriaxone in patients who underwent surgery for cerebral tumours was investigated. Seventeen patients received 2 g of ceftriaxone given intravenously 2 to 13 h before blood and brain samples were taken. Antibiotic levels were determined by an agar-well diffusion method. Cerebral ceftriaxone concentrations ranged from 0.3 to 12 micrograms/g, with a mean value of 1.63 micrograms/g. These values were less than 2% of corresponding serum concentrations, but enough to inhibit 75% of bacterial strains recently isolated from brain abscesses in our unit.

Topics: Adult; Aged; Biological Assay; Brain; Brain Neoplasms; Ceftriaxone; Female; Humans; Male; Middle Aged

Study of the penetration of ceftriaxone into the brain of patients who underwent surgery for cerebral tumors. Seventeen patients received 2 g of ceftriaxone intravenously 2 h to 13 h before blood and brain samples were taken. Ceftriaxone levels in serum and in non tumoral cerebral tissue were determined by the agar well diffusion technique. Hemoglobin concentration was measured in cerebral samples in order to subtract ceftriaxone due to blood contamination. True ceftriaxone levels in cerebral tissue ranged from 0.3 to 12 mcg/g, mean 1.63 mcg/g. The ceftriaxone level ratio in brain and serum was low, mean about 2%, but cerebral ceftriaxone concentrations would be sufficient to inhibit more than 75% of bacteria isolated in recent cerebral abscesses. These results allow to do further therapeutic studies of ceftriaxone in cerebral abscesses due to identified and susceptible bacteria or in random treatment in association with antibiotics directed on anaerobic organisms and resistant hospital strains.

Topics: Adult; Aged; Biological Transport; Brain Abscess; Brain Neoplasms; Ceftriaxone; Female; Humans; Male; Middle Aged