trimethoprim--sulfamethoxazole-drug-combination and Behcet-Syndrome

The granulomatous vasculitides frequently involve the lung. These syndromes include Wegener's granulomatosis, allergic angiitis and granulomatosis, and the polyangiitis overlap syndrome. Although not a true systemic vasculitis, necrotizing sarcoid granulomatosis also represents a type of pulmonary vasculitis. It is clear that many infectious agents can cause a picture in the lung that can be confused with granulomatous vasculitis and that an infectious process must be ruled out before a diagnosis of pulmonary vasculitis can be established. Pulmonary vasculitis can be associated with the hypersensitivity vasculitides, and pulmonary hemorrhage can be secondary to pulmonary capillaritis. Therapy of the hypersensitivity vasculitides consists of removing the offending antigen and instituting a limited course of corticosteroids. If the vasculitis is secondary to an underlying disease, such as lymphoma, therapy should be directed at the primary disease. Combination therapy with cyclophosphamide and corticosteroids is effective in the systemic vasculitides and the 5-yr survival rate is approximately 90%.

Topics: Adrenal Cortex Hormones; Azathioprine; Behcet Syndrome; Chlorambucil; Connective Tissue Diseases; Cyclophosphamide; Cyclosporins; Drug Combinations; Granuloma; Granulomatosis with Polyangiitis; Hemorrhage; Humans; Lung Diseases; Lymphomatoid Granulomatosis; Respiratory Tract Infections; Sulfamethoxazole; Syndrome; Takayasu Arteritis; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination; Vasculitis; Vasculitis, Leukocytoclastic, Cutaneous

Topics: Adrenal Cortex Hormones; Adult; Anti-Bacterial Agents; Anticoagulants; Arterial Occlusive Diseases; Behcet Syndrome; Diagnostic Errors; Granulomatous Disease, Chronic; Humans; Immunocompromised Host; Lung; Male; Opportunistic Infections; Pneumonia, Pneumocystis; Trimethoprim, Sulfamethoxazole Drug Combination

Little is known about the characteristic features of oral mucosal fixed drug eruption (FDE).. To present the clinical highlights and the differential diagnosis of oral mucosal FDE in a relatively large group of patients from Turkey.. This was a methodological, retrospective, cross-sectional study of 61 patients with oral mucosal FDE. The causative drug was established mainly by oral provocation test.. The age range of 61 patients (38 females, 23 males) was 7 to 62 years. Naproxen and cotrimoxazole were the main inducers. Fourteen patients (23%) had a solitary oral lesion predominantly located on the dorsum of the tongue, or on the hard palate, the former statistically significantly associated with cotrimoxazole. Bullous/erosive (n = 47), aphthous (n = 12), and erythematous (n = 2) morphology were observed. A considerable number of patients were referred with a prior clinical diagnosis of herpes simplex and Behçet's disease; some of them were already receiving long-term treatment with acyclovir and colchicine, respectively.. The main limitation of the present study resides in its retrospective design.. Isolated oral lesions, aphthous lesions, severe bullous/erosive lesions, and the absence of residual pigmentation are the main features that may cause difficulties in the differential diagnosis. It is important to differentiate dysmenorrhea-related monthly attacks of oral FDE in female patients caused by nonsteroidal anti-inflammatory drugs from menstruation-triggered attacks of herpes simplex infection, and isolated orogenital aphthous FDE from Behçet's disease, especially in countries with a high frequency of the disease in order to prevent irrelevant therapies.

Topics: Adolescent; Adult; Age Distribution; Behcet Syndrome; Child; Cross-Sectional Studies; Diagnosis, Differential; Drug Eruptions; Drug-Related Side Effects and Adverse Reactions; Female; Follow-Up Studies; Herpes Simplex; Humans; Incidence; Male; Middle Aged; Mouth Mucosa; Naproxen; Retrospective Studies; Risk Assessment; Severity of Illness Index; Sex Distribution; Stomatitis, Aphthous; Trimethoprim, Sulfamethoxazole Drug Combination; Young Adult

We report a 24-year-old man with a known Behcet's disease who was lost to follow-up for a year. The patient was admitted for the association of scrotal ulceration and inguinal folliculitis, suggesting a Behcet's disease flare-up. Necrotizing course of the folliculitis led to the diagnosis of skin infection caused by a community-acquired methicillin-resistant Staphylococcus aureus strain, carrying Panton-Valentine leukocidin genes. Bacteriological analysis should be mandatory in the absence of specific criteria for the diagnosis of Behcet's disease.

Topics: Anti-Bacterial Agents; Anti-Infective Agents; Anti-Infective Agents, Local; Bacterial Toxins; Behcet Syndrome; Chlorhexidine; Colchicine; Community-Acquired Infections; Diagnosis, Differential; Drug Therapy, Combination; Exotoxins; Folliculitis; Follow-Up Studies; Groin; Humans; Leg Ulcer; Leukocidins; Male; Methicillin-Resistant Staphylococcus aureus; Necrosis; Ofloxacin; Phenindione; Scrotum; Staphylococcal Skin Infections; Stomatitis, Aphthous; Time Factors; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination; Young Adult

Topics: Adult; Anti-Bacterial Agents; Behcet Syndrome; Humans; Male; Skin Diseases, Vesiculobullous; Trimethoprim, Sulfamethoxazole Drug Combination