tetracycline and Thrombocytopenia

Topics: Adolescent; Adult; Blood Cell Count; Blood Coagulation Disorders; Child; Ethiopia; Female; Hemoglobinometry; Humans; Insect Vectors; Kidney; Liver; Male; Middle Aged; Neurologic Manifestations; Phthiraptera; Prognosis; Relapsing Fever; Respiration; Spleen; Tachycardia; Tetracycline; Thrombocytopenia

Although liver involvement is frequently seen in brucellosis, acute hepatitis is a rare clinical entity. In its progress, haematological findings are non-specific and vary in respect to severity. In this paper, we present a case of brucellosis with acute hepatitis and bicytopenia without anaemia. A 19-year-old man presented with a 2-week history of fever, sweating, low back and leg pain, lassitude, loss appetite, nausea and vomiting. He gave a history of raw milk ingestion and animal contact. Physical examination showed signs of icteric skin and sclera, tenderness in the right hypochondriac region and hepatosplenomegaly. On admission to hospital, laboratory tests showed WBC 3500/mmc (polymorphs 63% and lymphocytes 33%), haemoglobin 13.8 g/dL, platelet 89000/mmc, erythrocyte sedimentation rate 19 mm/h, and C-reactive protein 21.7 mg/dL (N<0.8 mg/dL). Biochemical tests were as follows: AST 771 U/L, ALT 471 U/L, ALP 355 U/L, GGT 432 U/L, total bilirubin 2.61 mg/dL, direct bilirubin 1.45 mg/dL and albumin 3.7 g/dL. Viral hepatitis markers were found to be negative (HBsAg, anti-HBc total, anti-HBc IgM, anti-HAV IgM, and anti-HCV). Blood culture grew Brucella melitensis. Leukopenia and thrombocytopenia returned to normal levels at the 7th and 14th day of his admission, respectively. Liver function tests improved at the 28th day. Treatment of the brucellosis was performed with antibiotics (tetracycline 500 mg orally four times daily for 6 weeks and streptomycin 1 g IM once daily for 21 days). Finally, a case of brucellosis with acute hepatitis and bicytopenia was treated with a successful outcome. In conclusion, we suggest that due consideration be taken of bicytopenia/pancytopenia and acute hepatitis in brucellosis cases in Turkey, an endemic region.

Topics: Acute Disease; Adult; Anti-Bacterial Agents; Brucella melitensis; Brucellosis; Drug Therapy, Combination; Hepatitis; Humans; Leukopenia; Male; Streptomycin; Tetracycline; Thrombocytopenia; Treatment Outcome; Turkey

Topics: Animals; Anorexia; Dog Diseases; Dogs; Ehrlichiosis; Female; Imidocarb; Male; Phagocytosis; Spain; Tetracycline; Thrombocytopenia

We evaluated the feasibility of using the two-step polymerase chain reaction (PCR) in determining the withdrawal time of antibiotic treatment for Ehrlichia platys infection. We also present experimental evidence of a dog remaining a carrier after treatment with tetracycline. Canine infectious cyclic thrombocytopenia (CICT) was induced in 3 dogs by intravenous inoculation of blood infected with E. platys. Tetracycline was administered to one of the dogs for 2 weeks when parasitemia appeared. Although the hematologic abnormality of cyclic thrombocytopenia soon disappeared, a few parasitized platelets reappeared after the withdrawal of treatment, and the dog thus remained as a carrier. The other dogs were treated with doxycycline when parasitemic episodes first developed. The durations of antibiotic regimens were determined by the results of two-step PCR in which the 16S rDNA of E. platys was amplified from blood samples. Doxycycline was withdrawn after 8 days of treatment, and the follow-up monitoring continued for 3 weeks. The platelet counts of the 2 dogs remained within the normal range, and the etiologic agent of CICT was not found either by Giemsa staining or by the two-step PCR, indicating complete elimination of the agent.

Topics: Administration, Oral; Animals; Anti-Bacterial Agents; DNA, Bacterial; Dog Diseases; Dogs; Dose-Response Relationship, Drug; Doxycycline; Ehrlichia; Ehrlichiosis; Female; Male; Platelet Count; Polymerase Chain Reaction; Tetracycline; Thrombocytopenia

Topics: Antitubercular Agents; Bone Marrow; Chloramphenicol; Drug Hypersensitivity; Drug Therapy, Combination; Drug-Related Side Effects and Adverse Reactions; Hematopoiesis; Humans; Neutropenia; Nitrofurantoin; Pancytopenia; Penicillins; Phenylbutazone; Phenytoin; Red-Cell Aplasia, Pure; Tetracycline; Thrombocytopenia

Sixty-six cases of serologically documented Rocky Mountain spotted fever (RMSF) from North Carolina are reviewed. Gastrointestinal manifestations were present in 80% of these patients. Because other common expressions of RMSF occasionally do not accompany severe gastrointestinal dysfunction, improper diagnosis and therapy can result. Sixty percent of the patients had hyponatremia and thrombocytopenia. Over 70% of those who had liver or muscle enzyme evaluations had at least one abnormality. RMSF should be strongly considered in the differential diagnosis of patients with a combination of these findings.

Topics: Adolescent; Adult; Child; Child, Preschool; Diagnosis, Differential; Female; Gastrointestinal Diseases; Humans; Hyponatremia; Infant; Infant, Newborn; Male; Middle Aged; Rocky Mountain Spotted Fever; Tetracycline; Thrombocytopenia

Sixteen cases of chronic Q fever are described. In eight there was a history of exposure to infection from farms or farm products. All had valvular heart disease, involving the mitral valve in nine and the aortic valve in seven. Infection occurred on a prosthetic valve in two patients. Arterial embolism was common. Venous thrombosis occured in three patients, and pulmonary embolism occurred in three other patients. Complement fixing antibodies to phase 1 antigen were found in a titre of 1:200 or greater in all except two patients. In one of these post-mortem examination revealed rickettsial bodies in mitral valve vegetations, and in the other Coxiella burneti was isolated from heart valve tissue. The majority presented with infective endocarditis but two presented primarily with liver disease. All patients had evidence of liver involvement and in one this led to death from cirrhosis. Abnormal tests of liver function, particularly hyperglobulinaemia, raised alkaline phsophatase and abnormal bromsulphthalein retention were found in all patients. Hepatic histology was abnormal in all eight patients in whom it was studied. The commonest features were mononuclear cell infiltration of the portal tracts and prominence of the sinusoidal Kupffer cells. Patchy focal necrosis of parenchymal cells, granulomata, fatty change, and eosinophilia of the sinusoidal walls were also noted in several patients and cirrhosis developed in one. Six patients had a purpuric rash, and in 12 there was thrombocytopenia. It is suggested that the presence of hepatomegaly and liver involvement and thrombocytopenia may help to differentiate Q fever endocarditis from bacterial endocarditis. Raised serum IgM and IgA levels occured frequently, but with only a moderate dominance of IgM. Sheep cell agglutination and latex fixation tests for rheumatoid factor were occasionally positive. Several features of the disease suggest the possibility that immune-complex mechanisms may play a role in chronic Q fever. Treatment was with prolonged courses of tetracycline usually combined with lincomycin. Seven patients underwent valve replacement surgery for haemodynamic reasons. Five patients died; two from heart failure, one from cirrhosis, one seven days after valve replacement and one from intraperitoneal haemorrhage following percutaneous liver biopsy. Three patients have survived for more than five years, and another six for more than three and a half years after diagnosis. Of these nine patients, th

Topics: Adult; Chronic Disease; Endocarditis; Female; Heart Valve Diseases; Hematologic Diseases; Humans; Hypergammaglobulinemia; Lincomycin; Liver Diseases; Male; Middle Aged; Q Fever; Tetracycline; Thrombocytopenia

A report on a 17-year-old patient with sarcoidosis who was admitted to hospital because of acute generalized tendency to hemorrhage in very severe thrombopenia. This type of thrombopenia has a high primary mortality rate unless steroids are administered in high doses in good time. If the patient survives this crisis, the prognosis for him and the sarcoidosis is good.

Topics: Adolescent; Adrenal Cortex Hormones; Blood Platelets; Hemoglobins; Humans; Lymph Nodes; Lymphadenitis; Male; Prognosis; Sarcoidosis; Tetracycline; Thrombocytopenia

Topics: Agranulocytosis; Amphotericin B; Anemia, Aplastic; Anemia, Hemolytic; Anti-Bacterial Agents; Ataxia; Bacitracin; Cardiovascular Diseases; Chemical and Drug Induced Liver Injury; Chloramphenicol; Deafness; Gastrointestinal Diseases; Gentamicins; Humans; Kanamycin; Kidney Diseases; Leukopenia; Lung Diseases; Neomycin; Neuromuscular Diseases; Nitrofurantoin; Optic Neuritis; Peripheral Nervous System Diseases; Skin Diseases; Streptomycin; Sulfonamides; Tetracycline; Thrombocytopenia; Vertigo

Topics: Adult; Aged; Agranulocytosis; Aminopyrine; Antineoplastic Agents; Candidiasis, Oral; Dentin; Drug Hypersensitivity; Female; Gingival Hyperplasia; Humans; Hydantoins; Mouth; Mouth Diseases; Mouth Mucosa; Necrosis; Palate; Penicillins; Phenylbutazone; Tetracycline; Thrombocytopenia

Topics: Autopsy; Blood Coagulation Tests; Disseminated Intravascular Coagulation; Ecchymosis; Epistaxis; Fibrinogen; Fibrinolysis; Hematuria; Hemorrhage; Humans; Purpura; Relapsing Fever; Retinal Hemorrhage; Tetracycline; Thrombocytopenia

Topics: Administration, Oral; Animals; Blood Platelets; Bone Marrow Diseases; Depression, Chemical; Megakaryocytes; Rabbits; Tetracycline; Thrombocytopenia

Topics: Adult; Age Factors; Animals; Child; Child, Preschool; Chloramphenicol; Complement Fixation Tests; Diagnosis, Differential; Dogs; Female; Fluorescent Antibody Technique; Hemagglutination Tests; Humans; Insect Bites and Stings; Leukocyte Count; Male; Massachusetts; Measles; Occupations; Rocky Mountain Spotted Fever; Seasons; Tetracycline; Thrombocytopenia; Ticks; Zoonoses

Topics: Adrenal Cortex Hormones; Agranulocytosis; Anti-Bacterial Agents; Oxytetracycline; Penicillins; Schizophrenia; Streptomycin; Tetracycline; Thioridazine; Thrombocytopenia; Toxicology