trimethoprim--sulfamethoxazole-drug-combination and Respiratory-Distress-Syndrome

A 19-year-old, previously healthy man presented with 3 days of cough, high-grade fevers (40 °C), and dyspnea. Apart from a resolved history of seizures not requiring medications, he had no medical or surgical history. He had no known drug allergies. He took montelukast for allergies and trimethoprim-sulfamethoxazole (TMP-SMX) for 2 weeks before admission for acne, but no other medications, including over-the-counter medications and supplements. He had animal exposures to a new puppy and a friend's bird. He had no history of smoking, vaping, or recreational drug use. His paternal grandmother had rheumatoid arthritis.

Topics: Anti-Bacterial Agents; Biopsy; Diagnosis, Differential; Extracorporeal Membrane Oxygenation; Humans; Male; Pneumothorax; Respiratory Distress Syndrome; Tomography, X-Ray Computed; Trimethoprim, Sulfamethoxazole Drug Combination; Young Adult

Stenotrophomonas maltophilia-induced pulmonary haemorrhage is considered a fatal infection among haematological patients. The outcome can be explained by the patients' immunity status and late diagnosis and treatment.. We present the rare case of successful outcome in a 61-year-old female who developed alveolar haemorrhage and acute respiratory distress syndrome 8 days after a chemotherapy session for her acute lymphoblastic leukaemia, in the context of secondary bone marrow aplasia. Stenotrophomonas maltophilia was isolated in sputum culture. The patient benefitted from early empirical treatment with colistin followed by trimethoprim/sulfamethoxazole, according to the antibiogram. Despite a severe initial clinical presentation in need of mechanical ventilation, neuromuscular blocking agents infusion, and ventilation in prone position, the patient had a favourable outcome and was discharged from intensive care after 26 days.. Stenotrophomonas maltophilia severe pneumonia complicated with pulmonary haemorrhage is not always fatal in haematological patients. Empirical treatment of multidrug-resistant Stenotrophomonas maltophilia in an immunocompromised haematological patient presenting with hemoptysis should be taken into consideration.

Topics: Anti-Bacterial Agents; Colistin; Drug-Related Side Effects and Adverse Reactions; Female; Gram-Negative Bacterial Infections; Hemorrhage; Humans; Immunocompromised Host; Middle Aged; Pneumonia, Bacterial; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Pulmonary Alveoli; Respiratory Distress Syndrome; Sputum; Stenotrophomonas maltophilia; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Ambulatory Care; Child; Drug-Related Side Effects and Adverse Reactions; Extracorporeal Membrane Oxygenation; Humans; Patient Safety; Pediatrics; Respiratory Distress Syndrome; Risk Assessment; Tracheostomy; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination; Walking

The case is presented of a 38 year-old patient who was admitted in the Emergency Department due to a severe acute respiratory failure and who was transferred to the Critical Care Unit with a suspected initial diagnosis of community acquired pneumonia caused by an atypical microorganism, which was complicated with an acute respiratory distress syndrome. This was able to be treated with non-invasive mechanical ventilation. At 48 hours after admission, the growth of Gram negative bacilli in the blood culture was reported, which was subsequently identified as Salmonella enteritidis. This information, along with the lymphopenia suffered by the patient, suggested an immunodepressed state, thus serological tests were performed which showed positive for HIV. Antibiotic treatment was started based on the microbiological findings, with a favourable clinical outcome for the patient.

Topics: Adult; AIDS-Related Opportunistic Infections; Anti-Bacterial Agents; Bacteremia; Bronchoalveolar Lavage Fluid; Ceftriaxone; Cocaine-Related Disorders; Community-Acquired Infections; Diagnosis, Differential; Female; Humans; Lymphopenia; Pneumonia, Bacterial; Pneumonia, Pneumocystis; Respiratory Distress Syndrome; Salmonella enteritidis; Salmonella Infections; Trimethoprim, Sulfamethoxazole Drug Combination

Pneumocystis jirovecci is an opportunist fungal agent that usually causes pneumonia in immunocompromised patients, particularly those presenting with AIDS. In rare cases, this fungus can cause pneumonia in immunocompetent patients. The symptomatology in this case is acute and fulminant. We report the case of a Pneumocystis jirovecci pneumonia in a young patient initially admitted for acute respiratory distress. This case is unusual since all the exams performed to screen for immune deficit were negative. The diagnosis was made after identifying Pneumocystis jirovecci cysts in broncho-alveolar lavage.

Topics: Anti-Bacterial Agents; Bronchoalveolar Lavage Fluid; Drug Therapy, Combination; Female; Humans; Immunocompetence; Methylprednisolone; Pneumocystis carinii; Pneumonia, Pneumocystis; Respiratory Distress Syndrome; Trimethoprim, Sulfamethoxazole Drug Combination; Young Adult

We describe a fatal case of haemolytic uraemic syndrome in a young woman with AIDS, and disseminated adenovirus (ADV) and cytomegalovirus (CMV) co-infection. We hypothesize that ADV/CMV co-infection may have a causative role in this clinical picture.

Topics: Acquired Immunodeficiency Syndrome; Acute Kidney Injury; Adenovirus Infections, Human; Colitis; Cytomegalovirus Infections; Enteritis; Fatal Outcome; Female; Foscarnet; Ganciclovir; Hemolytic-Uremic Syndrome; Humans; Respiratory Distress Syndrome; Trimethoprim, Sulfamethoxazole Drug Combination

We present an initial report of Nocardia asteroides implantable cardioverter defibrillator infection. Systemic infection persisted despite pulse generator explant and several years of appropriate antibiotic therapy. Without epicardial lead system removal, chronic pleuropericardial disease developed.

Topics: Aged; Anti-Infective Agents; Coronary Artery Disease; Defibrillators, Implantable; Fatal Outcome; Humans; Male; Nocardia asteroides; Nocardia Infections; Respiratory Distress Syndrome; Trimethoprim, Sulfamethoxazole Drug Combination

A case of a patient receiving chemotherapy because of breast cancer who developed adult respiratory distress caused by Pneumocystis carinii pneumonia is presented. The evolution was good after treatment with 20 mg/kg/day of trimethoprim and 100 mg/kg/day of sulfamethoxazole.

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Breast Neoplasms; Carcinoma, Intraductal, Noninfiltrating; Combined Modality Therapy; Female; Humans; Pneumonia, Pneumocystis; Respiration, Artificial; Respiratory Distress Syndrome; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Aged; Aged, 80 and over; Drug Combinations; Female; Humans; Respiratory Distress Syndrome; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination