ro13-9904 and Lung-Diseases--Interstitial

A 65-year-old diabetic (requiring insulin during the last year) was admitted as an emergency because of a septic temperature rising to 40 degrees C with rigor, tachycardia (up to 120/min) and dyspnoea. On examination there was local reddening and swelling of the skin over the right thenar eminence and along the lower arm. Two days before admission a bad scratch had been inflicted on his right hand by a cat. He had first noticed the reddening and swelling 10 hours after the incident; 1 1/2 days after the scratch and 9-10 hours before hospitalization the first bouts of fever had occurred.. The chest radiogram showed interstitial pneumonia. The clinical findings, the laboratory tests (white cell count 21 750/microliters, platelets 140,000/microliters, C-reactive protein 35 mg/l and positive blood cultures pointed to early septicaemia. The germ was identified as Pasteurella multocida two days after blood had been taken for culturing. HbA1c was 11.38%.. From the time of hospitalization the patient had been treated with ceftriaxon, 2 g daily intravenously, and also with erythromycin because atypical pneumonia had been the suspected diagnosis at first and acute chlamydia infection had at first not been excluded. The patient's general condition quickly improved and the fever started to go down a few hours after onset of treatment. Blood cultures became negative after the first administration of antibiotics. He was discharged in a good state on optimal insulin dosage.. Pasteurella multocida is present in a high percentage of domestic animals and can be the cause of systemic infections in immunocompromised patients (e. g. poorly controlled diabetes mellitus).

Topics: Aged; Animals; Bites and Stings; Cats; Ceftriaxone; Diabetes Mellitus, Type 2; Drug Therapy, Combination; Emergencies; Erythromycin; Humans; Lung Diseases, Interstitial; Male; Pasteurella Infections; Pasteurella multocida; Pneumonia, Bacterial; Sepsis

Topics: Antibodies, Monoclonal, Humanized; Betacoronavirus; Brugada Syndrome; Ceftriaxone; Clinical Laboratory Techniques; Continuous Positive Airway Pressure; Coronavirus Infections; COVID-19; COVID-19 Drug Treatment; COVID-19 Testing; Humans; Hydroxychloroquine; Lung Diseases, Interstitial; Male; Middle Aged; Nasopharynx; Pandemics; Pneumonia, Viral; Psoriasis; SARS-CoV-2; Treatment Outcome

A 70 year-old woman was prescribed of levofloxacin and ceftriaxone for acute bronchitis. On the seventh day of administration she was hospitalized with a dry cough and a decreased platelet count(2.1 x 10(4)/microliter). However, bleeding tendency was not seen. So, we changed anticoagulants with citric acid and heparin from EDTA, and measured platelet count because we suspected pseudothrombocytopenia(PTCP), then platelet count became elevated (respectively, 12.5 x 10(4)/microliter and 15.0 x 10(4)/microliter). In addition, platelet associated IgG increased to 309.3 ng/10(7) cells. Based on drug lymphocyte stimulation test, she was diagnosed as having antibiotic-induced PTCP, especially as she had no history of thrombocytopenia. PTCP should be considered when thrombocytopenia occurs during antibiotic treatment.

Topics: Aged; Anti-Bacterial Agents; Ceftriaxone; Fatal Outcome; Female; Humans; Levofloxacin; Lung Diseases, Interstitial; Ofloxacin; Thrombocytopenia