zithromax and Lymphatic-Diseases

Topics: Adult; Anti-Bacterial Agents; Antibodies, Monoclonal, Humanized; Arthritis, Rheumatoid; Azithromycin; Bartonella henselae; Biopsy; Cat-Scratch Disease; Diagnosis, Differential; Humans; Lymph Nodes; Lymphatic Diseases; Male; Receptors, Interleukin-6; Treatment Outcome

To present a clinicocytopathologic correlation of an atypical case of cat scratch disease (CSD) involving retroperitoneal lymph nodes, with emphasis on communication between service teams for managing lymphadenopathy of unknown origin. We consider clinical and cytologic differential diagnoses and review the literature on atypical cases of CSD, with emphasis on abdominal presentation and cytologic findings.. Clinical services met with the cytology service to review clinical and pathologic features. Literature was reviewed via PubMed search (Harbor-UCLA subscriptions). Immunohistochemistry and Steiner silver stains were performed by Harbor-UCLA Department of Pathology. Enzyme-linked immunosorbent assay IgG and IgM Bartonella henselae titers were carried out by Quest Nichols Institute.. Fine-needle aspirate Diff-Quik and Papanicolaou smears and H&E-stained cell block showed abundant histiocytes, monocytoid B cells, and numerous neutrophils associated with necrosis corresponding to a late stage of CSD infection. Silver stain was positive for clumps of pleomorphic organisms. IgM and IgG antibody titers were elevated.. The cytologic findings of CSD in an atypical abdominal presentation are similar to those of a classic presentation. Laboratory workup for atypical CSD should include at least two other modalities aside from cytomorphologic features. Close clinical and cytologic correlation avoided potentially unnecessary and harmful surgery and enabled timely treatment.

Topics: Anti-Bacterial Agents; Antibodies, Bacterial; Azithromycin; Bartonella henselae; Cat-Scratch Disease; Diagnosis, Differential; Gentamicins; Humans; Immunohistochemistry; Lymph Nodes; Lymphatic Diseases; Male; Treatment Outcome; Young Adult

SENLAT syndrome, also known as TIBOLA/DEBONEL, is an emerging disease in France. The major symptoms are necrotic eschar on the scalp associated with painful cervical lymphadenopathy. It occurs mainly in women and children during the cold seasons after a bite by a Dermacentor tick, responsible for transmitting Rickettsia slovaca or Rickettsia raoultii. Cutaneous swabs are safe, easy and reliable tools that should be used routinely by physicians to confirm diagnosis. In this particular disease, they should be preferred to serology, which is less sensitive. Doxycycline is the antibiotic of choice for this syndrome.

Topics: Animals; Anti-Bacterial Agents; Arachnid Vectors; Azithromycin; Bartonella henselae; Bartonella Infections; Dermacentor; Diagnosis, Differential; Doxycycline; Europe; France; Humans; Josamycin; Lyme Disease; Lymphatic Diseases; Neck; Necrosis; Rickettsia; Rickettsia Infections; Scalp Dermatoses; Species Specificity; Symptom Assessment; Syndrome; Tick Bites; Tick-Borne Diseases; Zoonoses

Cat-scratch disease is an infection caused by Bartonella henselae, a fastidious gram-negative bacillus acquired from exposure to an infected kitten or cat. The most common manifestation of human disease is lymphadenitis. Atypical forms of infection include Parinaud oculoglandular syndrome, stellate neuroretinitis, persistent fever without localizing signs, hepatosplenic infection, encephalopathy, osteomyelitis, and endocarditis. Immunocompromised individuals with B. hensalae infection may develop bacillary angiomatosis, bacillary peliosis, and relapsing bacteremia with fever syndrome. The bacillus is susceptible to several antibacterial agents in vitro, including penicillins, cephalosporins, aminoglycosides, tetracyclines, macrolides, quinolones, trimethoprim and sulfamethoxazole, and rifampin. Greatest clinical efficacy has been observed following treatment with rifampin, ciprofloxacin, gentamicin, trimethoprim and sulfamethoxazole, clarithromycin, and azithromycin. In one placebo-controlled study, azithromycin therapy was associated with more rapid diminution in size of infected lymph nodes. The majority of cases of cat-scratch disease occurring in normal hosts do not require anti-infective therapy for resolution of infection.

Topics: Animals; Anti-Bacterial Agents; Azithromycin; Bartonella henselae; Cat-Scratch Disease; Cats; Disease Reservoirs; Humans; Immunocompromised Host; Lymphatic Diseases

Enteric fever (typhoid and paratyphoid) remains a threat to British troops overseas and causes significant morbidity and mortality. We report the case of a soldier who developed typhoid despite appropriate vaccination and field hygiene measures, which began 23 days after returning from a deployment in Sierra Leone. The incubation period was longer than average, symptoms started 2 days after stopping doxycycline for malaria chemoprophylaxis and initial blood cultures were negative. The Salmonella enterica serovar Typhi eventually isolated was resistant to amoxicillin, co-amoxiclav, co-trimoxazole and nalidixic acid and had reduced susceptibility to ciprofloxacin. He was successfully treated with ceftriaxone followed by azithromycin, but 1 month later he remained fatigued and unable to work. The clinical and laboratory features of enteric fever are non-specific and the diagnosis should be considered in troops returning from an endemic area with a febrile illness. Multiple blood cultures and referral to a specialist unit may be required.

Topics: Adult; Anti-Bacterial Agents; Azithromycin; Cecum; Ceftriaxone; Humans; Lymphatic Diseases; Male; Mesentery; Military Personnel; Sierra Leone; Tomography, X-Ray Computed; Treatment Failure; Typhoid Fever; Typhoid-Paratyphoid Vaccines; United Kingdom

A 46-year-old woman presented with right upper abdominal pain and fever. At imaging, enlarged peripancreatic and hilar lymph nodes, as well as hypodense liver lesions, were detected, suggestive of malignant disease. At endoscopy, the mass adjacent to the duodenum was seen as a protruding lesion through the duodenal wall. A biopsy of this lesion, taken through the duodenal wall, showed a histiocytic granulomatous inflammation with necrosis. Serology for Bartonella henselae IgM was highly elevated a few weeks after presentation, consistent with the diagnosis of cat scratch disease. Clinical symptoms subsided spontaneously and, after treatment with azithromycin, the lymphatic masses, liver lesions and duodenal ulceration disappeared completely.

Topics: Animals; Anti-Bacterial Agents; Azithromycin; Bartonella henselae; Cat-Scratch Disease; Cats; Duodenal Diseases; Duodenum; Female; Humans; Immunoglobulin M; Liver; Liver Diseases; Lymph Nodes; Lymphatic Diseases; Middle Aged

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

Idiopathic intussusception is a leading cause of intestinal obstruction in young children. Although the etiology remains obscure, lymphoid hyperplasia is found in a majority of cases. Antibiotics, the most frequently prescribed medication class in the pediatric population, have been recently associated with intussusception. The authors sought to determine whether enteral antibiotic exposure influences the development of mesenteric adenopathy, bowel dilation or intussusception in an animal model.. The authors conducted a randomized, controlled animal trial using a previously described intussusception model. Mice were gavaged with normal saline, amoxicillin-clavulanate or azithromycin twice daily for 5 days to assess the influence of enteral antibiotic exposure on intussusception, mesenteric adenopathy and bowel dilation. One pediatric surgeon performed all laparotomies and was blinded to group designation. Chi2 and Fisher exact tests were used to evaluate differences between antibiotic exposed and control groups.. Mesenteric adenopathy was identified in 4.1% of the normal saline controls compared with 54.1% (P < 0.01) and 38.9% (P < 0.01) of the amoxicillin-clavulanate and azithromycin exposed animals, respectively. A total of four intussusceptions were observed in the antibiotic-exposed groups combined whereas no intussusception cases were identified in the control group (P = 0.30).. This is the first study to describe a significant association between antibiotic use and mesenteric adenopathy in any animal species.

Topics: Amoxicillin-Potassium Clavulanate Combination; Animals; Anti-Bacterial Agents; Azithromycin; Disease Models, Animal; Female; Intestine, Small; Intussusception; Lymphatic Diseases; Male; Mesentery; Mice; Mice, Inbred BALB C; Peritoneal Diseases; Random Allocation

DEBONEL/TIBOLA is a tick-borne acute/sub-acute infection transmitted in our environment by Dermacentor marginatus and mainly caused by Rickettsia slovaca. The aim of our study was to know the effect of starting early treatment in the course of the DEBONEL/TIBOLA.

Topics: Adult; Animals; Anti-Bacterial Agents; Azithromycin; Boutonneuse Fever; Child; Dermacentor; Doxycycline; Humans; Lymphatic Diseases; Tick-Borne Diseases

Topics: Anti-Bacterial Agents; Azithromycin; Calymmatobacterium; Granuloma Inguinale; Humans; Infant; Infectious Disease Transmission, Vertical; Lymphatic Diseases; Male; Neck

We report the case of an apparently immunocompetent woman whose symptoms and signs have persisted for 8 years following a serologically and histologically confirmed diagnosis of toxoplasmosis. During this period she had two successful pregnancies despite persistently increased anti-toxoplasma IgM antibodies. Neither child is infected.

Topics: Adult; Azithromycin; Chronic Disease; Enzyme-Linked Immunosorbent Assay; Female; Humans; Immunocompetence; Immunoglobulin M; Lymphatic Diseases; Pyrimethamine; Sulfadiazine; Toxoplasmosis