zithromax and Splenic-Diseases

Topics: Abdominal Abscess; Anti-Bacterial Agents; Azithromycin; Dehydration; Diagnosis, Differential; Epstein-Barr Virus Infections; Fluid Therapy; Humans; Infant; Male; Spleen; Splenic Diseases; Ultrasonography

Patients with cat-scratch disease (CSD), which is caused by Bartonella henselae, typically present with local lymphadenopathy with a brief period of fever and general symptoms. Most cases are self-limiting and usually afflict children and young adults. Although rare, CSD can lead to serious complications, especially in immunocompromised patients. These rare complications often require intensive treatment. We describe the case of a 79-year-old man who presented with general malaise and a high fever. The physical examination findings were unremarkable. Of note, the lymph nodes were not enlarged. An abdominal CT scan with intravenous contrast revealed a solitary splenic abscess and no lymphadenopathy. The initial antibiotic treatment was ineffective and a splenectomy was indicated. A history of contact with cats raised the possibility of CSD, which was confirmed by a positive serology test result for B henselae. Antibiotic treatment with azithromycin successfully treated the splenic abscess and splenectomy was avoided.

Topics: Abscess; Aged; Anti-Bacterial Agents; Azithromycin; Cat-Scratch Disease; Delayed Diagnosis; Diagnosis, Differential; Humans; Male; Splenic Diseases; Treatment Outcome

Babesiosis, an infection caused by the protozoan Babesia microti and transmitted by the Ixodes scapularis tick, is commonly described in the literature with an approximate incidence of 1000 cases per year (Herwaldt et al., 2012). Infections in North America occur most frequently during the spring and summer months in the Northeastern and Midwestern United States. Babesia can cause a wide spectrum of clinical manifestations ranging from a self-limited febrile illness or mild anemia to severe illness causing acute respiratory distress syndrome (ARDS), disseminated intravascular coagulopathy (DIC) and multisystem organ failure. Severe illness most commonly occurs in elderly, immunocompromised, or asplenic patients (Vannier and Krause, 2012). Splenic rupture has been generally described as a complication of severe illness secondary to babesiosis. We describe a case of spontaneous splenic rupture in an otherwise healthy woman that required emergent splenectomy. Recent case reports suggest that splenic rupture occurs in people without known risk factors for severe babesiosis. Physicians should be aware of this acute presentation in otherwise healthy individuals.

Topics: Animals; Azithromycin; Babesia; Babesiosis; Doxycycline; Hematoma; Hemoperitoneum; Humans; Middle Aged; Rupture, Spontaneous; Splenectomy; Splenic Diseases

Topics: Abdominal Pain; Abscess; Animals; Anti-Bacterial Agents; Azithromycin; Bartonella henselae; Bartonella Infections; Cats; Diagnosis, Differential; Female; Fever; Humans; Liver Abscess, Pyogenic; Middle Aged; Splenic Diseases; Treatment Outcome

An 8-year-old boy was admitted because of recurrent fever for 1 month with increased CRP and ESR. Ultrasound reviewed multiple, small, hypo-echoic, rounded and wedge-shaped nodules with diffuse blood flow in spleen and enlarged abdominal lymph nodes. The spleen was enlarged and no echoic space was found in the largest lesion on 5th day. After a positive mycoplasma pneumoniae (MP) IgM was reported on 6th day, azithromycin was used intravenously. The temperature returned to normal and CRP and ESR improved in a short period. The lesions and lymphadenopathy disappeared and MP IgM antibody became negative 6 months later.

Topics: Anti-Bacterial Agents; Azithromycin; Blood Sedimentation; C-Reactive Protein; Child; Focal Nodular Hyperplasia; Humans; Immunoglobulin M; Male; Pneumonia, Mycoplasma; Spleen; Splenic Diseases; Tomography, X-Ray Computed