trimethoprim--sulfamethoxazole-drug-combination and Muscle-Weakness

Infections caused by Nocardia species are uncommon and have a wide variety of clinical manifestations in immunocompetent and immunocompromised patients. The diagnosis of nocardiosis can easily be missed because there are no characteristic symptoms. We present one case of a Nocardia infection in detail and give a brief description of eight other cases, including a relatively unique type of Nocardia veterana, diagnosed in our hospital during a five-year period. The diversity of clinical manifestations, microbiological identification and general principles of treatment of nocardiosis are reviewed.

Topics: Aged; Anti-Infective Agents; Humans; Leg; Male; Muscle Weakness; Nocardia; Nocardia Infections; Trimethoprim, Sulfamethoxazole Drug Combination

Brucellosis is a zoonotic disease caused by Gram-negative bacteria. It has variable manifestations (gastrointestinal, hepatobiliary, skeletal). Neurobrucellosis may develop at any stage of the disease (acute, subacute, and chronic phases) and affects the central and peripheral nervous systems. Acute peripheral neuropathy mimicking Guillain-Barré syndrome caused by brucellosis is rarely reported: only four cases in children were found in the literature review.. We report a case of a 4-year-old Syrian boy who presented with fever, weakness of lower limbs, backache, and fatigue. The patient lived in a brucellosis endemic area. A physical examination including a neurological examination showed mild paresthesia and muscle weakness. He had a stiff neck with Kernig's sign with an absence of deep tendon reflexes in the lower extremities. Proprioception in the lower extremities was impaired, but he did not have any sensory problems. Abdominal cutaneous reflexes were absent. Brucellosis and Guillain-Barré syndrome were found in laboratory investigations and on electroneurogram (ENG). The patient was treated with sulfamethoxazole + trimethoprim, rifampicin, gentamicin, and dexamethasone, with an improvement.. This case demonstrates a rare case of brucellosis neurologic manifestation. Brucellosis should be kept in mind in all patients with acute paralysis, especially in those who live in endemic areas.

Topics: Brucellosis; Child; Child, Preschool; Guillain-Barre Syndrome; Humans; Male; Muscle Weakness; Paralysis; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Adolescent; Adrenal Cortex Hormones; Anti-Infective Agents; Arthralgia; Cyclophosphamide; Diagnosis, Differential; Fatigue; Female; Fever; Glomerulonephritis; Granulomatosis with Polyangiitis; Humans; Immunosuppressive Agents; Muscle Weakness; Pallor; Renal Dialysis; Stomatitis, Aphthous; Trimethoprim, Sulfamethoxazole Drug Combination