trimethoprim--sulfamethoxazole-drug-combination and Headache

Three patients with antibiotic induced meningitis, one following penicillin with seven episodes, are reported on--the first well documented description of penicillin induced meningitis. In this patient episodes of headache and nuchal rigidity appeared with and without CSF pleocytosis. Two patients had a total of five episodes of antibiotic induced meningitis after trimethoprim-sulphamethoxazole (co-trimoxazole) administration. The features common to all three patients were myalgia, confusion and low CSF glucose. CSF analysis was not a reliable method to differentiate antibiotic induced meningitis from partially treated bacterial meningitis.

Topics: Adolescent; Aged; Aged, 80 and over; Cerebrospinal Fluid; Confusion; Diagnosis, Differential; Female; Glucose; Headache; Humans; Male; Meningitis; Muscle Rigidity; Neck Muscles; Penicillins; Recurrence; Trimethoprim, Sulfamethoxazole Drug Combination

This study evaluates the safety and potential pharmacokinetic interaction between indinavir and trimethoprim/sulfamethoxazole (TMP/SMZ). In a randomized, three-period crossover fashion, 12 healthy adults received 1 week of indinavir sulfate 400 mg orally every 6 hours with placebo, TMP 160 mg/SMZ 800 mg orally every 12 hours with placebo, and indinavir sulfate with TMP/SMZ. Plasma indinavir, SMZ, and TMP concentrations were determined after the last dose of each treatment period. Concomitant administration resulted in a 17% decrease in geometric mean trough plasma indinavir concentrations (p = 0.032), an 18% increase in geometric mean AUC0-12 h and Cmax TMP values (p = 0.031 and 0.030, respectively), and a 5% increase in geometric mean AUC0-12 h SMZ values (p = 0.039). None of these effects was considered clinically significant. The combination of indinavir sulfate and TMP/SMZ is generally well tolerated, with no clinically significant pharmacokinetic interaction being noted.

Topics: Abdominal Pain; Administration, Oral; Adolescent; Adult; Anti-Infective Agents; Area Under Curve; Bilirubin; Cross-Over Studies; Diarrhea; Drug Interactions; Female; Headache; HIV Protease Inhibitors; Humans; Indinavir; Male; Middle Aged; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Adult; Amikacin; Anti-Bacterial Agents; Biopsy; Diagnosis, Differential; Diagnostic Imaging; Drug Therapy, Combination; Headache; Humans; Imipenem; Male; Nocardia Infections; Occupational Exposure; Trimethoprim, Sulfamethoxazole Drug Combination

The infection by Nocardia spp is not common in immunocompetent patients. The empirical antimicrobial treatment directed by anatomical regions does not contemplate the particularities of the germ and the microbiological analysis is necessary for the specific treatment.\ We present the case of a previously healthy and immunocompetent patient, without known risk factors for Nocardia spp. infection, with evidence of involvement of the pulmonary parenchyma and the skin and subsequent development of multiple brain abscesses.. La infección por Nocardia spp. no es común en pacientes inmunocompetentes. El tratamiento antimicrobiano empírico dirigido según las regiones anatómicas, no contempla las particularidades del germen y el análisis microbiológico se hace necesario para el tratamiento específico. A continuación, se presenta el caso de una paciente previamente sana, inmunocompetente y sin factores de riesgo conocidos para la infección por Nocardia spp., con evidencia de compromiso en el parénquima pulmonar y la piel, que posteriormente desarrolló varios abscesos cerebrales.

Topics: Anti-Bacterial Agents; Brain Abscess; Ceftriaxone; Drug Therapy, Combination; Female; Headache; Humans; Immunocompetence; Magnetic Resonance Imaging; Middle Aged; Neuroimaging; Nocardia Infections; Pneumonia, Bacterial; Pulmonary Atelectasis; Tomography, X-Ray Computed; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Adult; Anti-Bacterial Agents; Antibiotic Prophylaxis; Biopsy; Brain; Cyclophosphamide; Fever; Headache; Hematopoietic Stem Cell Transplantation; Humans; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Magnetic Resonance Imaging; Male; Myeloablative Agonists; Polymerase Chain Reaction; Toxoplasma; Toxoplasmosis, Cerebral; Transplantation Conditioning; Transplantation, Homologous; Trimethoprim, Sulfamethoxazole Drug Combination; Vomiting

Topics: Aged; Cholestasis; Diagnosis, Differential; Female; Fever; Headache; Humans; Transaminases; Trimethoprim, Sulfamethoxazole Drug Combination

In May 2014, six patients presented in Germany with a Sarcocystis-associated febrile myositis syndrome after returning from Tioman Island, Malaysia. During two earlier waves of infections, in 2011 and 2012, about 100 travellers returning to various European countries from the island were affected. While the first two waves were associated with travel to Tioman Island mostly during the summer months, this current series of infections is associated with travel in early spring, possibly indicating an upcoming new epidemic.

Topics: Adolescent; Anti-Infective Agents; Child; Female; Fever; Germany; Headache; Humans; Infant; Malaysia; Male; Myalgia; Prednisolone; Sarcocystis; Sarcocystosis; Travel; Trimethoprim, Sulfamethoxazole Drug Combination

We report the first known Australian case of probable neurobrucellosis, in a young feral-pig shooter who presented with episodic left-sided visual loss and left-sided numbness and headache. Treatment with intravenous ceftriaxone and oral rifampicin, doxycycline and trimethoprim–sulfamethoxazole resulted in a good clinical response.

Topics: Adult; Agglutination Tests; Agricultural Workers' Diseases; Animals; Anti-Bacterial Agents; Antibodies, Bacterial; Australia; Brucella; Brucellosis; Ceftriaxone; Central Nervous System Bacterial Infections; Doxycycline; Drug Therapy, Combination; Headache; Humans; Hypesthesia; Male; Rifampin; Trimethoprim, Sulfamethoxazole Drug Combination; Vision Disorders

Isolated Whipple disease of the central nervous system is a rare occurrence. Migratory arthralgias and gastrointestinal problems, including malabsorption, abdominal pain, diarrhea, and weight loss, are common presenting symptoms.. For those patients with systemic signs and symptoms of Whipple disease, 6% to 43% will have clinically manifested CNS involvement that may include alterations in personality, ataxia, and dementia. We report our experience with a patient, who was successfully treated for Whipple disease 12 years prior to presentation and had a magnetic resonance image of the brain that revealed two solitary lesions resembling a tumor upon presentation.

Topics: Anti-Infective Agents; Brain Neoplasms; Chronic Disease; Consciousness Disorders; Diagnosis, Differential; Diagnostic Errors; Encephalitis; Headache; Humans; Hypothalamus; Magnetic Resonance Imaging; Male; Middle Aged; Neurosurgical Procedures; Temporal Lobe; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination; Tropheryma; Whipple Disease

Topics: Adult; Anorexia; Anti-Bacterial Agents; Brain Abscess; Combined Modality Therapy; Diagnosis, Differential; Female; Fever; Headache; Humans; Immunocompromised Host; Liver Abscess; Lupus Erythematosus, Systemic; Nocardia asteroides; Nocardia Infections; Opportunistic Infections; Pleural Effusion; Trimethoprim, Sulfamethoxazole Drug Combination

Polysensitivity in fixed drug eruption is a rare finding that occurs because of chemically unrelated drugs. In cases of polysensitivity, the lesions may occur on identical or separate sites, the latter indicating the role of antigen-specific mechanisms in the site-specificity of fixed drug eruption. I herein report a patient with separate site involvement induced by trimethoprim-sulfamethoxazole and tenoxicam, a drug combination that has not been reported before. Reactivation of old trimethoprim-sulfamethoxazole-specific lesions after a long resting period was another striking feature.

Topics: Buttocks; Drug Eruptions; Drug Therapy, Combination; Female; Foot; Hand; Headache; Humans; Middle Aged; Piroxicam; Skin Tests; Trimethoprim, Sulfamethoxazole Drug Combination

We treated a patient with an atypical presentation of Wegener's granulomatosis (WG) with dural involvement as the initial clinical manifestation. A 37-year-old man had a dural lesion without lower respiratory tract or renal manifestations in the initial clinical course. His only initial symptom was headache, and at disease onset computed tomography (CT) and magnetic resonance imaging (MRI) of the head revealed bilateral abnormal subdural masses. The diagnosis of WG was made based on the results of needle biopsy of the nasal polyps and the finding of positive circulating antineutrophil cytoplasmic antibodies (c-ANCA). He achieved remission on daily prednisone and cyclophosphamide with the later addition of sulfamethoxazole-trimethoprim.

Topics: Adult; Antibodies, Antineutrophil Cytoplasmic; Autoimmune Diseases; Biopsy; Cyclophosphamide; Dura Mater; Granulomatosis with Polyangiitis; Headache; Hematoma, Subdural; Humans; Immunosuppressive Agents; Magnetic Resonance Imaging; Male; Nasal Polyps; Prednisone; Tomography, X-Ray Computed; Trimethoprim, Sulfamethoxazole Drug Combination

A case of adverse side effects of co-trimoxazole (Biseptol) was observed, with predominance of neurological changes in the clinical picture. Attention is called to the infrequent occurrence of such side effects of this drug and to the necessity of prompt diagnostic and therapeutic management of such cases.

Topics: Acute Disease; Adult; Bronchitis; Combined Modality Therapy; Disorders of Excessive Somnolence; Drug Hypersensitivity; Headache; Humans; Male; Trimethoprim, Sulfamethoxazole Drug Combination

In 8 of 18 homosexual men with the acquired immunodeficiency syndrome (AIDS) and Pneumocystis carinii pneumonia (PCP) treated with intravenous co-trimoxazole (trimethoprim-sulphamethoxazole) apparent drug-related complications developed during the course of acute therapy. A symptom complex of fevers and increasing malaise, often with nausea and headaches, developed usually after 9 days of therapy at a daily dosage of 20 mg/kg of trimethoprim and 100 mg/kg of sulphamethoxazole. These symptoms were associated with a diffuse erythematous maculopapular eruption and peripheral cytopenias. A similar picture was noted in two children with suspected AIDS-associated PCP. The high frequency of adverse reactions to co-trimoxazole therapy for PCP seems to be characteristic of AIDS patients.

Topics: Acquired Immunodeficiency Syndrome; Adult; Drug Combinations; Fever; Headache; Homosexuality; Humans; Male; Middle Aged; Pancytopenia; Pneumonia, Pneumocystis; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination