zithromax and Erythema-Nodosum

The aim of this study was to investigate the effects of azithromycin on mucocutaneous manifestations and ex vivo intracellular cytokine responses in patients with Behçet's disease (BD).. Ten BD patients with active manifestations and nine healthy controls (HCs) were included in the study. Patients were treated with azithromycin (1500 mg/week) for four weeks. Clinical and immunological responses were evaluated in the pre- and post-azithromycin treatment periods. Peripheral blood mononuclear cells (PBMCs) of patients and controls were stimulated by Streptococcus sanguinis, lipopolysaccharide (LPS), lipoteichoic acid (LTA), and heat shock protein-60 (HSP-60) for three hours. Ex vivo intracellular interferon-γ (IFN-γ) and tumor necrosis factor-α (TNF-α) levels were measured.. Follicular lesions and genital ulcers completely healed, and the number of oral ulcers decreased after treatment (P = 0.000). The stimulated intracellular IFN-γ response to S. sanguinis was higher in BD patients (5.75%) than in HCs (3.9%) before treatment (P = 0.05). Likewise, the pretreatment IFN-γ response was significantly higher than the post-treatment response (1.95%). In BD patients, pretreatment stimulated intracellular IFN-γ responses to LTA (5.8%) were also higher than post-treatment responses (3.15%), but the difference did not reach statistical significance (P = 0.07).. Azithromycin treatment decreased the mucocutaneous manifestations in BD patients and suppressed the intracellular IFN-γ responses of PBMCs to S. sanguinis ex vivo, which suggests this treatment has an immunomodulatory effect.

Topics: Adult; Anti-Bacterial Agents; Azithromycin; Behcet Syndrome; Cytokines; Drug Resistance; Erythema Nodosum; Female; Humans; Leukocytes, Mononuclear; Male; Middle Aged; Mucous Membrane; Oral Ulcer; Skin; Skin Ulcer; Treatment Outcome

Herein we report a case of cat scratch disease on account of its atypical presentation.. A 21-year-old woman presented erythema nodosum associated with painful bilateral inguinal adenopathy, odynophagia, joint pain and evening urticaria in a setting of impaired general condition. Initial serological testing for Bartonella henselae was negative. PCR for Bartonella henselae performed on an adenectomy fragment was positive. A favourable outcome was achieved with azithromycin.. This case shows an atypical and severe presentation of cat scratch disease and raises the problem of sensitivity of serotyping.

Topics: Animals; Anti-Bacterial Agents; Arthralgia; Azithromycin; Bartonella henselae; Bartonella Infections; Cats; Erythema Nodosum; Female; Humans; Ketoprofen; Lymph Nodes; Lymphatic Diseases; Pharyngitis; Pristinamycin; Urticaria; Wound Infection; Young Adult