trimethoprim--sulfamethoxazole-drug-combination and Remission--Spontaneous

The aim of our study is to analyze the clinic characteristics and evolution of the primary reflux in infants.. We studied retrospectively 203 infants in our hospital, diagnosed of severe primary renal reflux. Renal ecography and cyclic mictional cystography were practiced in all cases. DMSA was carried out in 181 patients.. Renal reflux was unilateral in the 23% of the patients, and bilateral in the remaining cases; 72% of the renal reflux were grade IV and 28% grade V. The renal injuries affected to male infants and reflux grade V. The renal injury was focal (27%), global (44%) and atrophic (29%). The 79% of the patients had conservative treatment, while 21% had surgical treatment. 100% infants with surgical treatment and 94.2% infants with conservative treatment were recovered (Test of Kaplan-Meier). The 27% of patients developed one or several urinary infections, but progression of old renal injuries or formation of new ones, were exceptional (3 cases): While the time the study lasted none of the patients developed chronic renal failure nor arterial hypertension.. 1) The fetal severe primary reflux of the patients was characterized by the following features: to be bilateral reflux, to affect mainly to male infants and to be associated in 33% of cases with a severe renal injury of congenital origin (renal displasia) most of them unilateral. 2) The natural evolution of the reflux goes to spontaneous recovery, so treatment must be conservative. 3) Some patients underwent urinary infections, but progression or formation of new renal injuries were inusual. None of the patients had terminal renal failure nor hypertension and 4) Risk patients would be male infants with bilateral injuries although these are infrequent.

Topics: Female; Follow-Up Studies; Humans; Infant; Infant, Newborn; Kidney; Kidney Function Tests; Life Tables; Male; Nitrofurantoin; Radiography; Remission, Spontaneous; Retrospective Studies; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination; Ultrasonography; Urinary Tract Infections; Vesico-Ureteral Reflux

A 22-year-old woman was given trimethoprim plus sulphamethoxazole for a urinary infection (160 and 800 mg, respectively, daily), drugs she had not previously taken. After 2 weeks she noticed a rash of small spots on her trunk. In addition she had nausea and vomiting. The rash faded within 2 days of stopping the drug, but progressive jaundice developed.. SGPT and SGOT concentrations rose to maximally 328 and 83 U/l, total bilirubin to maximally 5.9 mg/dl. There was no evidence for viral hepatitis (B or C, cytomegalovirus, Epstein-Barr), autoimmune hepatitis or primary biliary hepatitis. Liver biopsy showed central acinar cholestasis, which suggested drug-induced liver damage.. The patient's symptoms regressed over several weeks without any specific treatment and 8 weeks after onset of the rash the laboratory tests also became normal. The allergic cause of the cholestatic hepatitis was confirmed by a lymphocyte transformation test.. Clinical suspicion of drug allergy as cause of a cholestatic hepatitis can be confirmed reliably and without any risk to the patient with the lymphocyte transformation test.

Topics: Adult; Anti-Infective Agents, Urinary; Chemical and Drug Induced Liver Injury; Cholestasis, Intrahepatic; Diagnosis, Differential; Drug Hypersensitivity; Female; Humans; Lymphocyte Activation; Remission, Spontaneous; Time Factors; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Acyclovir; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Antiviral Agents; Child; Female; Hair Diseases; Humans; Immunosuppressive Agents; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Remission, Spontaneous; Trimethoprim, Sulfamethoxazole Drug Combination

Cervical lymphadenitis and fever are common in patients presenting to the Emergency Department (ED). Kikuchi's disease is a rare, self-limited cause of fever and cervical lymphadenitis often misdiagnosed as lymphoma or lupus and inappropriately treated, potentially causing numerous ED visits for unrelieved symptoms. The case described is that of a 29-year-old with persistent fever and cervical lymphadenitis who presented to the ED with a suspected allergic reaction to an antibiotic. The diagnosis of Kikuchi's disease was made in association with nasopharyngeal carcinoma and partial hydatidiform mole. The case highlights the clinical features, diagnosis, and treatment of Kikuchi's disease.

Topics: Adult; Diagnosis, Differential; Dilatation and Curettage; Drug Hypersensitivity; Emergency Medicine; Female; Fever; Histiocytic Necrotizing Lymphadenitis; Humans; Hydatidiform Mole; Nasopharyngeal Neoplasms; Neck; Pregnancy; Remission, Spontaneous; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination; Ultrasonography

Topics: Anti-Infective Agents; Child; Child, Preschool; Creatinine; Drug Combinations; Female; Humans; Infant; Infant, Newborn; Male; Pyelonephritis; Remission, Spontaneous; Retrospective Studies; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination; Urography; Vesico-Ureteral Reflux