zithromax and Headache

In this prospective study, children from 1-month to 12-years, admitted with positive IgM ELISA testing for scrub typhus, were enrolled over 1-year and administered an empirical single dose of azithromycin (10 mg/kg). All 189 (median age 4.84-years) children had fever with median duration of 8 days at admission. Shortness of breath, altered sensorium, headache, lymphadenopathy, hepatosplenomegaly, pallor, oedema and hypotension were the most prominent symptoms/signs. About 46% of children developed complications, among them hepatic, neurological and cardiovascular were most common. Our study showed a remarkable response to azithromycin, with mean defervescence of 32 h and no mortality. The presence of shortness of breath, headache, altered sensorium, hepatosplenomegaly, meningeal signs, severe anemia, leucocytosis, hyponatremia along with/without any of above mentioned three systemic complications were independent predictors for delayed treatment response by multivariate logistic regression analysis. Hepatic, neurological and cardiovascular complications are an emerging trend. Empiric azithromycin based on clinical suspicion of scrub typhus can be lifesaving.

Topics: Anti-Bacterial Agents; Azithromycin; Child; Child, Preschool; Doxycycline; Dyspnea; Headache; Hepatomegaly; Humans; India; Prospective Studies; Scrub Typhus; Splenomegaly; Treatment Outcome

Topics: Acetaminophen; Adult; Ampicillin; Anti-Bacterial Agents; Azithromycin; Cefpodoxime; Ceftizoxime; Ceftriaxone; Dexamethasone; Drug Therapy, Combination; Fatigue; Female; Headache; Humans; Meningitis, Aseptic; Pneumonia; Tomography, X-Ray Computed; Treatment Outcome; Vancomycin; Young Adult

Topics: Acetaminophen; Acetazolamide; Altitude; Altitude Sickness; Analgesics, Non-Narcotic; Anti-Bacterial Agents; Antitrichomonal Agents; Azithromycin; Diarrhea; Diuretics; Fatigue; Hand Disinfection; Hand Sanitizers; Headache; Humans; Nausea; Nepal; Rest; Running; Tinidazole; Vomiting

Clinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) is a clinico-radiological syndrome characterized by transient mild symptoms of encephalopathy and a reversible lesion in the splenium of the corpus callosum on magnetic resonance imaging (MRI). It is often triggered by infection. The common pathogens of MERS are viruses, especially influenza virus. However, Mycoplasma pneumoniae (M.pneumoniae) are relatively rare pathogens for MERS.. Here we report two paediatric cases of M.pneumoniae infection-induced MERS. The diagnosis of M.pneumoniae infection was established based on polymerase chain reaction (PCR) and specific serum antibodies (IgM). Both of the two patients presented with mild encephalopathy manifestations and recovered completely within a few days. The initial MRI showed a lesion in the central portion of the splenium of the corpus callosum, which completely resolved on the seventh and eighth day after admission for case 1 and case 2. Lumbar puncture was performed in both patients, which revealed no pleocytosis. In case 1, the patient had hyponatremia, peripheral facial nerve paralysis, and rash. To the best of our knowledge, it is the first MERS case associated with peripheral nerve damage. In case 2, interleukin-6(IL-6) was moderately increased in the cerebrospinal fluid (CSF). It suggested that IL-6 may play a role in the pathogenesis of M.pneumoniae-induced MERS.. Our study enriches the available information on the pathogens of MERS and provides valuable data for better understanding of this syndrome.

Topics: Anti-Infective Agents; Azithromycin; Child; Corpus Callosum; Diagnosis, Differential; Encephalitis; Headache; Humans; Male; Mycoplasma Infections; Mycoplasma pneumoniae