ro13-9904 and Myositis

Topics: Anti-Bacterial Agents; Arthritis; Ceftriaxone; Endocarditis; Endophthalmitis; Epididymitis; Humans; Male; Middle Aged; Myositis; Orchitis; Whipple Disease

Topics: Adult; Anti-Bacterial Agents; Ceftriaxone; Clindamycin; Combined Modality Therapy; Dental Prophylaxis; Diagnosis, Differential; Fasciotomy; Fever; Humans; Levofloxacin; Male; Mobility Limitation; Mouth; Muscle, Skeletal; Myalgia; Myositis; Rhabdomyolysis; Running; Streptococcus sanguis

Deep face and neck infections are potentially life threatening if they are not diagnosed in time and then treated quickly. This report describes a case of face and deep neck infection, associated with a semi-impacted and decayed wisdom tooth in a cardiopathic, immunosuppressed patient suffering from, diabetes, hypothyroidism, osteoporosis, breathlessness, chronic bronchitis, with oral, cutaneous and vaginal erythematous lichen, Cushing's Syndrome, penicillin allergy, subjected to past hypophysectomy. The swelling was, first of all, treated in urgency, with an intravenous antibiotic therapy and, immediately afterwards, the phlegmonous infiltration linked to the avulsion of the lower third molar was surgically drained. The patient was then treated with intravenous multiple antibiotics, with the aim of eradicating the predominating bacteria that was encountered in the microbiological culture test. A complete remission of the pathological picture was obtained .

Topics: Aged; Airway Obstruction; Anti-Bacterial Agents; Ceftriaxone; Cellulitis; Combined Modality Therapy; Comorbidity; Emergencies; Face; Female; Humans; Immunocompromised Host; Mediastinitis; Molar, Third; Myositis; Neck; Periodontal Abscess; Streptococcal Infections; Tooth Extraction; Tooth, Impacted

Myositis has been reported as a rare manifestation of Lyme disease, and Lyme myositis can be an important consideration in the differential diagnosis of unusual cases, especially in patients who live in or travel to endemic areas. We report the case of a 43-year-old man who presented with focal myositis of the proximal lower extremity and was subsequently diagnosed as having Lyme myositis. The patient had previously experienced a febrile illness and rash, but had no ongoing symptoms of Lyme disease. Myositis was confirmed by magnetic resonance imaging and muscle biopsy; Borrelia burgdorferi infection was confirmed by Lyme serology and polymerase chain reaction testing of synovial fluid and biopsy material. The current case is reviewed in the context of findings from previous case descriptions.

Topics: Adult; Anti-Bacterial Agents; Antibodies, Bacterial; Borrelia burgdorferi; Ceftriaxone; DNA, Bacterial; Humans; Lower Extremity; Lyme Disease; Magnetic Resonance Imaging; Male; Myositis; Reference Values; Treatment Outcome

Our aim was to determine the influence of antibiotic treatment using ceftriaxone on [18F]-fluorodeoxyglucose (FDG) uptake in experimental soft tissue infections. PET scans were performed in two groups (treated n=4; non-treated n=4) at days 3, 5, and 6 after inoculation of the infection. Additional autoradiography was performed in four animals at day 7 and in three animals at day 11. The difference of FDG uptake on day 5 (after three days of antibiotic treatment) between both groups proved to be significant (df=6; T=2.52; p=0.045). FDG uptake determined at the other days did not reveal significant difference between the two groups. It seems to be possible that the effect of antibiotic treatment on FDG uptake is less evident than reported for therapy monitoring of cancer treatment. The change of FDG uptake over time in treated and untreated infections is complex and further in vivo experiments have to be initiated to investigate the potential value of clinical FDG PET in therapy monitoring of infection.

Topics: Animals; Anti-Bacterial Agents; Ceftriaxone; Fluorodeoxyglucose F18; Male; Metabolic Clearance Rate; Myositis; Positron-Emission Tomography; Prognosis; Radiopharmaceuticals; Rats; Rats, Sprague-Dawley; Reproducibility of Results; Sensitivity and Specificity; Soft Tissue Infections; Staphylococcal Infections; Treatment Outcome

Myositis is a rare manifestation of Lyme disease of unknown pathogenesis. This study describes the course of disease in eight patients with Lyme disease, aged 37-70 years, all of whom were suffering from histologically proven myositis. The clinical, electrophysiological, and myopathological findings are reported. One patient showed signs and symptoms of myositis of all limbs. In six patients myositis was localized in the vicinity of skin lesions, arthritis or neuropathy caused by Borrelia burgdorferi. In another patient suffering from pronounced muscle weakness of the legs and cardiac arrest, inflammation of the myocardium, the conducting system and skeletal muscles was revealed at autopsy. Muscle biopsy revealed lymphoplasmocellular infiltrates combined with few fibre degenerations in three patients. The lymphoplasmocellular infiltrates were found predominantly in the vicinity of small vessels. Several spirochetes were stained in six of seven muscle biopsy samples by means of the immunogold-silver technique. Culturing of B. Burgdorferi from the muscle biopsy samples was, however, unsuccessful. Antibiotic treatment succeeded in curing the myositis in four of six patients. In one patients signs and symptoms improved. One patient died from cardiac arrest caused by myocarditis and Guillain-Barré syndrome. The outcome is unknown in one patient. Clinical and myopathological findings indicate that Lyme myositis can be caused either by local spreading of B. burgdorferi or an unknown antigen or toxin from adjacent tissues or haematogenously.

Topics: Adult; Aged; Borrelia burgdorferi Group; Cefotaxime; Ceftriaxone; Creatine Kinase; Doxycycline; Drug Therapy, Combination; Female; Heart Arrest; Humans; Immunologic Tests; Isoenzymes; Lyme Disease; Male; Middle Aged; Muscles; Myositis; Penicillin G; Treatment Outcome