Ciprofloxacin-Induced Anaphylactic Reaction Followed by Negative Provocation Test in Response to Levofloxacin: A Case Report.

Fluoroquinolones are a commonly prescribed class of antibiotics due to their broad spectrum of antimicrobial activity, favorable pharmacokinetic properties, ability to switch from parenteral to oral administration, and global availability. After beta-lactams, they are the second most common antibiotic class associated with drug allergies. The mechanism of fluoroquinolone-induced hypersensitivity reactions has not yet been fully understood, so the true incidence of hypersensitivity reactions remains unknown. Cross-reactivity between fluoroquinolones has been the subject of conflicting and limited clinical research. Due to their similar chemical structure, some argue for close cross-reactivity within the group. However, recent studies have produced contradictory results. We present the case of a young patient who had an anaphylactic reaction to ciprofloxacin but was tolerant to levofloxacin, as determined via a skin prick test followed by a drug provocation test. Our findings support the notion that there is little cross-reactivity between fluoroquinolones. Consequently, exposure to another fluoroquinolone in a hospital setting may be beneficial, particularly for patients who lack adequate antibiotic alternatives. However, additional research on this subject is required.

Klatskin-Mimicking Lesions.

Altemeier-Klatskin tumor is a perihilar cholangiocarcinoma that occurs within 2 cm of the confluence of the right and left hepatic duct at the hepatic hilum and accounts for 50-70% of all cholangiocarcinomas cases. Although imaging techniques have come very far today, this entity can still be very challenging to diagnose as there are many lesions that can mimic Klatskin tumor. In this review, we will present the most common Klatskin-mimicking lesions.

The Role of Anxiolytics in Hypertensive Urgency Management.

Current guidelines do not cover hypertensive urgency management in out-of-hospital setting. Main goal of this study was to evaluate the value of anxiolytic therapy in hypertensive urgencies. We analyzed data gathered by out-of-hospital unit set up during one year. Arterial hypertension was the primary diagnosis in 178 (6.11%) patients, of whom 144 had hypertensive urgency with mean SBP reduction 19.5±7.2%; control group 10.1±6.9%. Anxiolytic therapy was administered in 60% of patients in hypertensive urgency group, and they had a statistically significant greater SBP reduction (p=0.03) than patients who did not receive anxiolytic therapy. There is a place for anxiolytic therapy in hypertensive urgency management.