zithromax and Liver-Neoplasms

A report of acute azithromycin-induced hepatocellular injury is described.. An 83-year-old male was admitted with possible community-acquired pneumonia and received azithromycin and ceftriaxone. After 2 doses of azithromycin, the patient's aspartate aminotransferase and alanine aminotransferase were greater than 3 times the upper limit of normal and continued to rise with subsequent doses. A diagnostic abdominal ultrasound revealed hepatomegaly. Total bilirubin remained within normal limits during the course. Rosuvastatin and fenofibrate were held on admission and were not resumed in the setting of elevated liver enzymes. Rivaroxaban was held in the setting of worsening renal function. Hepatitis serologies were negative. Liver enzymes, international normalized ratio (INR), and activated partial thromboplastin time (aPTT) continued to climb until hospital day 5 when azithromycin was discontinued in response. Liver enzymes, INR, aPTT, and lactate dehydrogenase all decreased from hospital days 6 through 8.. A potentially serious liver injury occurred with the initiation of azithromycin and began to resolve quickly after its discontinuation. While cholestatic injury with azithromycin is well described, this is only the third reported case of direct hepatocellular injury.

Topics: Aged, 80 and over; Azithromycin; Carcinoma, Hepatocellular; Chemical and Drug Induced Liver Injury; Humans; International Normalized Ratio; Liver Neoplasms; Male

Mycoplasma infection has been reported to be associated with cancer migration, invasion, epithelial-mesenchymal transition as well as the resistance to nucleoside analogues chemotherapeutic drugs. In this study, we found that the sensitivity of hepatocarcinoma cells to Cisplatin, Gemcitabine and Mitoxantrone was increased by mycoplasma elimination. Similar to the effect of anti-mycoplasma agent, interrupting the interaction between Mycoplasma hyorhinis membrane protein P37 and Annexin A2 of host cells using the N-terminal of ANXA2 polypeptide enhanced the sensitivity of HCC97L cells to Gemcitabine and Mitoxantrone. Meanwhile, we did not observe any changes in expression or distribution of multidrug resistance associated transporters, ATP-Binding Cassette protein B1, C1 and G2, on the removal of mycoplasma. These results suggest that mycoplasma induces a resistance to multiple drugs in hepatocarcinoma cells which required the interaction of P37 and Annexin A2. The pathway downstream this interaction needs to be explored.

Topics: Adaptor Proteins, Signal Transducing; Annexin A2; Anti-Bacterial Agents; Antineoplastic Agents; Azithromycin; Carcinoma, Hepatocellular; Cell Line, Tumor; Deoxycytidine; Drug Resistance, Multiple; Drug Resistance, Neoplasm; Fluoroquinolones; Gemcitabine; Humans; Liver Neoplasms; Mitoxantrone; Moxifloxacin; Mycoplasma hyorhinis; Protein Binding; Real-Time Polymerase Chain Reaction

Bartonella henselae is the causative agent of cat-scratch disease and other disorders, including hepatosplenic granulomatosis. This infection has only rarely been reported after solid organ transplantation, where it can mimic the more common post-transplant lymphoproliferative disease. Here we present a case of asymptomatic B. henselae hepatic and lymph nodal granulomatosis in a pediatric patient who had received orthotopic liver transplant 2 months before; we hypothesize that the causative agent was transmitted from the donor. This infection developed early in the post-transplant period; the disease involved only the graft liver and the regional lymph nodes, and the patient did not have a cat or any history of contact, scratches, or bites by a cat. In our patient this infection resolved successfully with a combination of 2 associated antibiotics and reduction of immunosuppressive therapy.

Topics: Amikacin; Anti-Infective Agents; Antibodies, Bacterial; Azithromycin; Bartonella henselae; Cat-Scratch Disease; Child; Humans; Immunosuppressive Agents; Liver; Liver Neoplasms; Liver Transplantation; Lymph Nodes; Lymphomatoid Granulomatosis; Male; Postoperative Complications; RNA, Bacterial; RNA, Ribosomal, 16S; RNA, Ribosomal, 23S; Tacrolimus; Tissue Donors; Transplants; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination; Ultrasonography