[Successful desensitization of efavirenz in an 8 year old HIV-positive child]

Background and Aims: Allergic reaction is a common side effect of Efavirenz and drug replacement may not be an option to physicians. Here, a successful drug desensitization experiment on an 8-year-old female child over a period of 9 days is reported

Case presentation: The patient was an 8-year old female child with HIV in Kerman, Iran who had been received oral efavirenz together with lamivudine and zidovudine. The patient had showed allergic reaction in the form of skin rashes and itchy skin right one hour after the use of the medication. Since replacing efavirenz with other medications was not an option, in this case, we developed a 9- day drug desensitization strategy in which on the first day, 300 mg of efavirenz was dissolved in 10 ml water and was given to the patient. The medication was doubled every day since after. After 9 days of drug administration, the patient was successfully desensitized toward the medication. The patient was monitored for 3 months and had no problem while using efavirenz together with lamivudine and zidovudine

Conclusion: This drug desensitization protocol for efavirenz can be recommended to physicians when medication replacement may not be an option due to the lack of drug availability

Evaluation of producing extended spectrum p-lactamase among isolated escherchia coli from patients suffering from urinary tract infections: [short report]

Despite the widespread availability of antibiotics, antibiotic resistance in uropathogens is increasing. The most common mechanism in the antibiotic resistance is production of extended spectrum B-lactamase [ESBL]. In this study, the presence of producing ESBL among isolated Escherchia Coli from patients suffering from urinary tract infections in Ali-Ebne Abitaleb hospital [Rafsanjan, Iran] as well as their sensitivity to newer antibiotics were evaluated. In this descriptive study, 146 Escherchia Coli were collected from 1634 urine samples of suspected patients with urinary tract infection in a five month tim period. Isolated organisms were identified by standard biochemical and microbial tests. Antibiotic susceptibility test was done by disc diffusion method. Isolated E coli that were resistant to third generation cephalosporines were tested for ESBL phenotype by double disc synergy test method. Their susceptibility to imipenem, meropenem and cefepime were also determined. Totally, 19.86% of the isolated E coli showed resistance to third generation cephalosporines and 10.27% of them were ESBL producer. Also, ESBLs E Coli showed co-resistance to other antibiotics. Susceptibility to imipenem, meropenem were 100%, and cefepime 26.66%. ESBL producer isolated Escherchia Coli had resistance to many different antibiotics, but it showed high susceptibility to imipenem and meropenem. So in order to prevent any resistance, we should use these antibiotics correctly

[ case report of kikuchi's disease]

Kikuchi's disease is a necrotizing lymphadenitis that is prevalent in Japan and is being increasingly recognized in other areas of the world. It usually occurs in women in their late 20s or early 30s and manifests as a posterior cervical adenopathy. It resolves spontaneously, usually over a period of several weeks to 6 months. Its initial clinical appearance is commonly similar to that of a lymphoma, and it can be pathologically misdiagnosed as such. We report a case of Kikuchi's disease that occurred in a 51-year-old Iranian woman. We discuss the clinical features, differential diagnosis, and pathology of this case in an effort to assist otolaryngologists in diagnosing this benign and uncommon entity