scholarly journals A Rare Complication of Trimethoprim-Sulfamethoxazole: Drug Induced Aseptic Meningitis

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Pinky Jha ◽  
Jeremiah Stromich ◽  
Mallory Cohen ◽  
Jane Njeri Wainaina
Keyword(s):  
Adverse Reaction ◽  
Differential Diagnosis ◽  
Clinical Practice ◽  
Early Diagnosis ◽  
Clinical Improvement ◽  
Aseptic Meningitis ◽  
Rare Complication ◽  
Signs And Symptoms ◽  
Drug Induced ◽  
Inflammatory Drugs

Drug induced aseptic meningitis is a rare but challenging diagnosis, most commonly reported with nonsteroidal anti-inflammatory drugs and antibiotics. Trimethoprim/sulfamethoxazole is a sulfonamide that is widely used in clinical practice for the treatment and prophylaxis of various infections. Drug induced aseptic meningitis, when seen with trimethoprim/sulfamethoxazole, occurs predominantly in patients with some degree of immune compromise and is less commonly seen in immune competent individuals. The patient often exhibits the classic symptoms of meningitis. Early diagnosis is important, since the cessation of the antibiotic leads to rapid clinical improvement. Trimethoprim/sulfamethoxazole induced aseptic meningitis has been underreported to FDA/MED-WATCH program. Here we report two cases of trimethoprim/sulfamethoxazole: an immune competent individual and immune compromised individual, both of which presented with signs of meningitis and a negative infectious workup. Trimethoprim/sulfamethoxazole is an uncommon and mysterious adverse reaction to a commonly used antibiotic. It should be considered in the differential diagnosis of patients presenting with acute signs and symptoms of meningitis especially after infectious causes have been ruled out.

scholarly journals Ibuprofen-Induced Aseptic Meningitis in a Male Adolescent with Intracranial Hypertension and Visual Impairment: A Case Report

2021 ◽  
Vol 13 (1) ◽  
pp. 233-238
Author(s):  
Seyed Mohammad Mousavi Mirzaei ◽  
Zahra Ahmadi
Keyword(s):  
Visual Impairment ◽  
Intracranial Hypertension ◽  
Aseptic Meningitis ◽  
Rare Complication ◽  
Clinical Signs ◽  
Male Adolescent ◽  
Drug Induced ◽  
Blurred Vision ◽  
Inflammatory Drugs

Drug-induced aseptic meningitis (DIAM) is a rare complication of certain drugs, most commonly reported with ibuprofen use. The present study reports on a male adolescent with intracranial hypertension and visual impairment accompanied by DIAM. We present a 16-year-old male patient who after ibuprofen consumption displayed headache, fever, photophobia, and blurred vision following heavy exercises. Examination of cerebrospinal fluid showed a mononuclear pleocytosis and an increase in protein concentration. Other examinations had normal results. The development of common clinical signs following ibuprofen use reflected DIAM. The patient’s vision was found to improve with supportive care and stopping of the drug during follow-up. Given the widespread use of nonsteroidal anti-inflammatory drugs and the fact that these drugs are the most common cause of DIAM, the probability of occurrence of this event should be always kept in mind, and screening for autoimmune diseases in these patients is of great importance.

Pyoderma gangrenosum producing saddle nose deformity

1998 ◽  
Vol 112 (9) ◽  
pp. 870-871 ◽  
Author(s):  
George A. Worley ◽  
Michael J. Wareing ◽  
Robert J. Sergeant
Keyword(s):  
Differential Diagnosis ◽  
Early Diagnosis ◽  
Pyoderma Gangrenosum ◽  
Surgical Intervention ◽  
Rare Complication ◽  
Saddle Nose ◽  
Saddle Nose Deformity ◽  
Minor Surgery ◽  
Diagnostic Confusion ◽  
Nose Deformity

AbstractPyoderma gangrenosum affecting the nose is rare and this may lead to diagnostic confusion because of the large differential diagnosis. As diagnosis is made, largely, on the basis of exclusion the treatment of pyoderma gangrenosum may be unduly delayed. The condition is often disfiguring, particularly following inappropriate surgical intervention, and early diagnosis is therefore important.We present a case of pyoderma gangrenosum managed initially in the community with minor surgery and resulting in the rare complication of saddle nose deformity.

scholarly journals Histopathology of the muscle in rheumatic diseases

Reumatismo ◽  
2018 ◽  
pp. 133-145 ◽  
Author(s):  
S. Barsotti ◽  
A. Tripoli ◽  
L.E. Pollina ◽  
M. Mosca ◽  
R. Neri
Keyword(s):  
Differential Diagnosis ◽  
Clinical Practice ◽  
Connective Tissue ◽  
Rheumatic Diseases ◽  
Critical Analysis ◽  
Medical Literature ◽  
Connective Tissue Diseases ◽  
Current Medical ◽  
Pathology Report ◽  
Drug Induced

The presence of muscular symptoms is common in rheumatological clinical practice, but often the differential diagnosis between muscular involvement in connective tissue diseases, vasculitis and drug-induced myopathy may be difficult. In addition to clinical assessment, laboratory analysis and instrumental examinations, muscle biopsy may help to clarify the diagnosis in patients with muscular involvement. The purpose of this review is to provide a critical analysis of the current medical literature on muscular histopathology, to help clinicians to identify when to perform muscular biopsy and to provide a practical guide to a better understanding of the pathology report. Moreover, we provide an overview of the muscular involvement and the most common histopathological findings in rheumatic diseases.

Non-steroidal anti-inflammatory drug effects on renal and cardiovascular function: from physiology to clinical practice

2019 ◽  
Vol 27 (8) ◽  
pp. 850-867 ◽  
Author(s):  
Aderville Cabassi ◽  
Stefano Tedeschi ◽  
Stefano Perlini ◽  
Ignazio Verzicco ◽  
Riccardo Volpi ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Drug Effects ◽  
Daily Practice ◽  
The Elderly ◽  
Drug Induced ◽  
Inflammatory Drug ◽  
Inappropriate Use ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Cyclooxygenase 2 Inhibitors

Excessive or inappropriate use of non-steroidal anti-inflammatory drugs can affect cardiovascular and renal function. Non-steroidal anti-inflammatory drugs, both non-selective and selective cyclooxygenase 2 inhibitors, are among the most widely used drugs, especially in the elderly, with multiple comorbidities. Exposition to a polypharmacy burden represents a favourable substrate for the onset of non-steroidal anti-inflammatory drug-induced deleterious effects. Cardiovascular and renal issues concerning the occurrence of myocardial infarction, atrial fibrillation, heart failure and arterial hypertension, as well as acute or chronic kidney damage, become critical for clinicians in their daily practice. We discuss current available knowledge regarding prostanoid physiology in vascular, cardiac and renal systems, pointing out potential negative non-steroidal anti-inflammatory drug-related issues in clinical practice.

Acetazolamide-Induced Aseptic Meningitis in a Female Adolescent with Idiopathic Intracranial Hypertension: A Case Report

2019 ◽  
Vol 18 (04) ◽  
pp. 198-200
Author(s):  
Rekha Gupta ◽  
Chris Barton ◽  
Vinay Puri
Keyword(s):  
Intracranial Hypertension ◽  
Aseptic Meningitis ◽  
Idiopathic Intracranial Hypertension ◽  
Female Adolescent ◽  
Drug Induced ◽  
History Of ◽  
Cerebrospinal Fluid Culture ◽  
Inflammatory Drugs ◽  
Management Challenge ◽  
Fluid Culture

AbstractDrug-induced aseptic meningitis (DIAM) has been documented for many years and is considered a diagnostic and patient management challenge. Associated medications include nonsteroidal anti-inflammatory drugs, antibiotics, and monoclonal antibodies, but no cases associated with acetazolamide have been reported. We briefly review a case of a 15-year-old female patient with history of idiopathic intracranial hypertension whose symptoms of aseptic meningitis associated with the use and increase of acetazolamide. DIAM should be considered a possibility in any patient with meningeal symptoms, pleocytosis, and negative cerebrospinal fluid culture. This is the first known case linking acetazolamide to DIAM.

scholarly journals POSTINTUBATION TRACHEAL STENOSIS – A RARE CAUSE OF DYSPNEA

2021 ◽  
Vol 68 (2) ◽  
pp. 297-300
Author(s):  
Irina Cuciureanu ◽  
◽  
Ioana Băjenaru ◽  
Anamaria-Georgiana Avram ◽  
Ion Alexandru ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Tracheal Intubation ◽  
Airway Obstruction ◽  
Tracheal Stenosis ◽  
Rare Complication ◽  
Signs And Symptoms ◽  
Final Diagnosis ◽  
Post Intubation

Tracheal stenosis is a rare complication of tracheal intubation, which usually becomes symptomatic after some time after detubation, with typical superior airway obstruction signs and symptoms. This is a case of a 62-yearold female with post intubation tracheal stenosis, with interesting problems of differential diagnosis until the final diagnostic was found. Clinical and imagistic investigations led us to our final diagnosis of iatrogenic post intubation tracheal stenosis.

scholarly journals Cholestatic Hepatitis with Small Duct Injury Associated with Celecoxib

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Suresh Kumar Nayudu ◽  
Shanti Badipatla ◽  
Masooma Niazi ◽  
Bhavna Balar
Keyword(s):  
Liver Diseases ◽  
Sclerosing Cholangitis ◽  
Rare Complication ◽  
Imaging Studies ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Inflammatory Bowel ◽  
Inflammatory Drugs ◽  
Cyclooxygenase 2 Inhibitors ◽  
Metabolic Liver Diseases

Drug-induced liver injury (DILI) is a common clinical entity but is underreported due to various reasons. Cyclooxygenase-2 inhibitors like Celecoxib have been proven to be associated with lesser incidence of adverse drug reactions compared to other nonsteroidal anti-inflammatory drugs (NSAID). However, Celecoxib has been rarely reported to be associated with cholestasis and hepatitis. We present a young Hispanic female presented with cholestatic liver chemistries who has been taking Celecoxib for 3 weeks. Extensive workup did not support diagnosis of viral, autoimmune, or metabolic liver diseases. Liver biopsy revealed findings suggestive of secondary sclerosing cholangitis. Imaging studies were negative for large duct involvement, and endoscopy ruled out inflammatory bowel disease. Liver chemistries normalized after cessation of medication. We recommend that physician should be aware of this rare complication when prescribing Celecoxib.

scholarly journals Lung Injury Induced by Antitumor Drugs: Diagnosis, Features of the Clinical Course, Risk Factors, Differential Diagnosis, Treatment, and Prevention. Part 1

2021 ◽  
Vol 99 (7) ◽  
pp. 55-62
Author(s):  
N. V. Orlovа ◽  
O. D. Ostroumovа ◽  
E. V. Shikh ◽  
S. V. Smerdin ◽  
E. V. Rebrovа ◽  
...  
Keyword(s):  
Risk Factors ◽  
Differential Diagnosis ◽  
Early Diagnosis ◽  
Lung Injury ◽  
Tobacco Smoking ◽  
Clinical Course ◽  
Antitumor Drugs ◽  
Drug Induced ◽  
Duration Of Therapy ◽  
Treatment And Prevention

57 publications on pneumotoxicity of antitumor drugs were analyzed. It was found that the development of pneumotoxic effects could be influenced by risk factors such as gender, age, tobacco smoking, comorbidities, and duration of therapy. Symptoms of lung injury induced by antitumor drugs are nonspecific thus it is difficult to diagnose them promptly. For prevention, early diagnosis and timely management of drug-induced lung injury during antineoplastic therapy, it is necessary to raise awareness of such a condition in practitioners of different specialties, primarily general practitioners, pulmonologists, phthisiologists, and oncologists.

scholarly journals Aseptic meningitis, hepatitis and cholestasis induced by trimethoprim/sulfamethoxazole: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
J. A. A. van Asperdt ◽  
R. A. De Moor
Keyword(s):  
Case Report ◽  
Side Effects ◽  
Liver Injury ◽  
Aseptic Meningitis ◽  
Cholestatic Hepatitis ◽  
Diagnostic Challenge ◽  
Drug Induced ◽  
Case Presentation ◽  
Drug Induced Liver Injury ◽  
Inflammatory Drugs

Abstract Background Drug-induced aseptic meningitis is a rare, but challenging diagnosis, most commonly reported with nonsteoroidal anti-inflammatory drugs (NSAIDs) and antibiotics. Trimethoprim/sulfamethoxazole (TMP/SMX) is a sulfonamide that is widely used in clinical practice for the treatment and prophylaxis of various infections. The most common side effects associated with TMP/SMX are generally mild and self-limited, but serious side effects have been reported, including liver injury and aseptic meningitis. Case presentation We report a 2,5 year old Dutch girl with both drug-induced aseptic meningitis and drug-induced liver injury while using TMP/SMX prophylaxis. Ursodeoxycholic acid was started because of cholestatic injury. After cessation of TMP/SMX, full convalescence was reached within weeks. Conclusions This is the first report of a young patient with both aseptic meningitis and drug-induced liver injury caused by TMP/SMX. Drug-induced aseptic meningitis and cholestatic hepatitis constitute a considerable diagnostic challenge to clinicians. In addition to a thorough evaluation for infectious causes, clinicians should be aware of drug-induced aseptic meningitis and cholestatic hepatitis.

scholarly journals IBUPROFEN-INDUCED ASEPTIC MENINGITIS: A CASE REPORT

2019 ◽  
Vol 37 (3) ◽  
pp. 382-385 ◽  
Author(s):  
Sofia Alexandra Pereira Pires ◽  
Ana Pereira Lemos ◽  
Ester Preciosa Maio Nunes Pereira ◽  
Paulo Alexandre da Silva Vilar Maia ◽  
João Patrício de Sousa e Alvim Bismarck do Agro
Keyword(s):  
Aseptic Meningitis ◽  
Early Recognition ◽  
Conjunctival Hyperemia ◽  
Cerebrospinal Fluid Analysis ◽  
Drug Induced ◽  
Blurred Vision ◽  
Neck Stiffness ◽  
Fluid Analysis ◽  
Causative Agents ◽  
Inflammatory Drugs

ABSTRACT Objective: To report a case of a male adolescent with the diagnosis of ibuprofen-induced meningitis. We discuss themain causes of drug-induced aseptic meningitis (DIAM) and highlight the importance of early recognition of DIAM, sothat the offending drug can be withdrawn, and recurrences prevented. Only few DIAM cases have been reported in pediatric age. Case description: A healthy 15-year-old boy presented to the emergency department with headache, nausea, dizziness, fever, conjunctival hyperemia and blurred vision 30 minutes after ibuprofen-intake. During his stay, he developed emesis and neck stiffness. Cerebrospinal fluid analysis excluded infectious causes, and DIAM was considered. He totally recovered after drug withdrawal. Comments: DIAM is a rare entity, that should be considered in the differential diagnosis of an aseptic meningitis. The major causative agents are nonsteroidal anti-inflammatory drugs, particularly ibuprofen. Suspicion is made by the chronologic link between drug intake and the beginning of symptoms, but infectious causes should always be ruled out.

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