ro13-9904 and Remission--Spontaneous

Ceftriaxone is a widely used third-generation cephalosporin. In this prospective study, we used sonography to investigate the incidence and outcome of biliary complications in children receiving ceftriaxone therapy.. Ceftriaxone was administered intravenously at a dosage of 100 mg/kg/day for 1-3 weeks to 118 children hospitalized for severe infection. Serial gallbladder sonograms were obtained on days 1, 5-7, and 10-14 of therapy and the day after therapy ended if it had lasted more than 2 weeks. When sonographic abnormalities were found, additional sonograms were obtained every 3 days until the abnormalities had completely resolved.. Twenty patients (17%), all asymptomatic, demonstrated sonographic abnormalities: 8 had gallbladder sludge, defined as echogenic material without associated acoustic shadowing, and 12 had pseudolithiasis, defined as echogenic material with acoustic shadowing. These abnormalities spontaneously resolved within 2 weeks of stopping the ceftriaxone (mean time to disappearance, 8.2 +/- 3.4 days). No significant differences were found between patients with normal versus abnormal sonographic findings in sex, age, duration of treatment, or other risk factors for drug precipitation.. Ceftriaxone-associated biliary pseudolithiasis is usually asymptomatic and was rapidly reversible after cessation of therapy in this group of Turkish children.

Topics: Adolescent; Ceftriaxone; Chemical Precipitation; Child; Child, Preschool; Cholelithiasis; Female; Gallbladder; Humans; Incidence; Infant; Male; Prospective Studies; Remission, Spontaneous; Ultrasonography

It is well known that ceftriaxone leads to pseudolithiasis in some patients. Clinical and experimental studies also suggest that situations causing gallbladder dysfunction, such as fasting, may have a role for the development of pseudolithiasis. In this study, we prospectively evaluated the incidence and clinical importance of pseudolithiasis in paediatric surgical patients receiving ceftriaxone treatment, who often had to fast in the post-operative period. Fifty children who were given ceftriaxone were evaluated by serial abdominal sonograms. Of those, 13 (26%) developed biliary pathology. Comparison of the patients with or without pseudolithiasis revealed no significant difference with respect to age, sex, duration of the treatment and starvation variables. After cessation of the treatment, pseudolithiasis resolved spontaneously within a short period. The incidence of pseudolithiasis is not affected by fasting.

Topics: Adolescent; Age Factors; Ceftriaxone; Child; Child, Preschool; Cholelithiasis; Fasting; Female; Humans; Incidence; Male; Postoperative Complications; Remission, Spontaneous; Sex Factors; Time Factors; Ultrasonography

Neurological impairment during pregnancy is also commonly found in otorhinolaryngology. Cranial nerve palsy, e.g. of the facial nerve or changes in signal processing of the hearing system, are described. Apart from changes in electrolyte balance, these neurological alterations are attributed to hormone fluctuations. The spontaneous remission of the neurological problems after delivery is frequently reported. This case report presents a 34 year pregnant patient suffering from binaural sensorineural hearing loss and tinnitus in the third trimester. Three weeks after delivery there was a spontaneous remission and a measurable improvement of the audiological findings. Although treatment with cortisone and antibiotics remained without effect, a pharmacological treatment during pregnancy has to be carefully and individually coordinated. An interdisciplinary approach in diagnostic and therapeutic measures together with gynaecologists appears obligatory.

Topics: Adult; Ceftriaxone; Dose-Response Relationship, Drug; Drug Administration Schedule; Drug Therapy, Combination; Female; Follow-Up Studies; Hearing Loss, Bilateral; Hearing Loss, Sensorineural; Humans; Infant, Newborn; Infusions, Intravenous; Prednisolone; Pregnancy; Pregnancy Complications; Pregnancy Trimester, Third; Puerperal Disorders; Remission, Spontaneous; Tinnitus

The authors report the case of a nine-year-old girl admitted to hospital with signs of meningeal irritation during the course of hyperpyretic phlogosis of the upper airways who presented, after 6 days' treatment with CFTX, at a dose of 50 mg/kg/day (1.5 g/day), therefore at the maximum recommended dose for the antibiotic in question, symptomatic cholecystic "pseudolithiasis" which resolved two weeks after the suspension of the drug. This case appears to concord with recent reports of "pseudolithiasis" in childhood that appeared with doses not regarded as being at risk, and it draws attention to the etiopathogenetic importance of other factors, including familial recurrence. The authors recommend a reasonable use of CFTX and the need to be "vigilant" both in relation to the onset and evolution of the clinical condition described above.

Topics: Ceftriaxone; Child; Female; Gallstones; Humans; Pharyngitis; Remission, Spontaneous; Ultrasonography

Topics: Adult; Ceftriaxone; Cholelithiasis; Female; Follow-Up Studies; Humans; Lyme Disease; Remission, Spontaneous; Ultrasonography

Infected pancreatic necrosis was diagnosed clinically and radiologically in a patient admitted for acute pancreatitis. As free gas in the pancreatic area was recognized, antibiotic therapy (ceftriaxone) was empirically introduced, while surgical drainage was being planned. After the second week, the patient rapidly started to improve, to the point that he could be discharged home without operation. Control CT-scans and general laboratory tests, at this phase and later on, confirmed a still enlarged gland but free of infection or ongoing inflammation. Cholelithiasis, which had been identified in an early ultrasound scan, was electively treated by cholecystectomy 2 mo after the onset of pancreatitis, in the absence of sepsis, and with uneventful recovery. This case illustrates the rare possibility of spontaneous regression of infected necrotic pancreatitis, without any type of operation or nonoperative drainage.

Topics: Acute Disease; Aged; Bacterial Infections; Ceftriaxone; Humans; Male; Necrosis; Pancreas; Pancreatitis; Remission, Spontaneous; Tomography, X-Ray Computed

Topics: Adult; Ceftriaxone; Cholelithiasis; Female; Humans; Lyme Disease; Male; Remission, Spontaneous