RESUMO
A 34-year-old man with 22q11.2 deletion syndrome (DiGeorge syndrome) concurrently suffered from myopathy and eosinophilic pneumonia shortly after receiving daptomycin (DAP) for right-sided infective endocarditis. The simultaneous occurrence of these phenomena in relation to DAP therapy has not been previously well described. An allergic reaction was suspected as a possible etiology of these DAP-related complications. This case highlights the need for close observation in order to detect both musculoskeletal and respiratory disorders from the start of DAP therapy. Physicians should pay more attention to this new drug, which is expected to be frequently used in various clinical settings.
Assuntos
Antibacterianos/administração & dosagem , Daptomicina/administração & dosagem , Doenças Musculares/induzido quimicamente , Eosinofilia Pulmonar/induzido quimicamente , Adulto , Antibacterianos/uso terapêutico , Daptomicina/uso terapêutico , Síndrome de DiGeorge , Endocardite Bacteriana/tratamento farmacológico , Humanos , MasculinoAssuntos
Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Endocardite Bacteriana/diagnóstico por imagem , Imagem Multimodal/métodos , Tomografia por Emissão de Pósitrons/métodos , Obstrução do Fluxo Ventricular Externo/diagnóstico por imagem , Adulto , Antibacterianos/uso terapêutico , Procedimentos Cirúrgicos Cardíacos/métodos , Ecocardiografia , Ecocardiografia Transesofagiana/métodos , Endocardite Bacteriana/tratamento farmacológico , Endocardite Bacteriana/microbiologia , Fluordesoxiglucose F18 , Seguimentos , Cardiopatias Congênitas/diagnóstico , Cardiopatias Congênitas/cirurgia , Humanos , Masculino , Reoperação/estatística & dados numéricos , Medição de Risco , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Obstrução do Fluxo Ventricular Externo/cirurgiaAssuntos
Antibacterianos/efeitos adversos , Bile/efeitos dos fármacos , Ceftriaxona/efeitos adversos , Colecistite/induzido quimicamente , Diabetes Mellitus/sangue , Infecções Pneumocócicas/tratamento farmacológico , Idoso , Antibacterianos/uso terapêutico , Ceftriaxona/uso terapêutico , Precipitação Química , Colecistite/diagnóstico , Humanos , Masculino , Infecções Pneumocócicas/complicaçõesRESUMO
We herein report a case of persistent methicillin-resistant Staphylococcus aureus (MRSA) bacteremia that was successfully treated with combination therapy consisting of high-dose daptomycin (DAP, 10 mg/kg) and rifampicin. The patient's condition was complicated with multiple infectious foci, including an iliopsoas abscess and epidural abscess, as well as discitis and spondylitis at the cervical, thoracic and lumbar levels. Monotherapy treatments with vancomycin, linezolid and usual-dose DAP were all ineffective. It has been shown that usual-dose DAP administration may result in the emergence of a resistant strain and treatment failure. We would like to emphasize the importance of high-dose DAP therapy for MRSA bacteremia, a condition with a potentially high mortality rate.
Assuntos
Bacteriemia/tratamento farmacológico , Daptomicina/administração & dosagem , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Rifampina/administração & dosagem , Infecções Estafilocócicas/tratamento farmacológico , Idoso , Antibacterianos/administração & dosagem , Antibióticos Antituberculose/administração & dosagem , Bacteriemia/microbiologia , Relação Dose-Resposta a Droga , Quimioterapia Combinada , Humanos , Masculino , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Infecções Estafilocócicas/microbiologiaRESUMO
We herein describe a case of Wuchereria bancrofti infection in a previously healthy 37-year-old Nepalese man. The patient presented with a history of milky urine with subsequent acute urinary retention lasting for a few days. The presence of microfilariae was confirmed on both peripheral blood and urine smears obtained at midnight. He was conservatively treated with diethylcarbamazine combined with doxycycline. Filariasis was previously endemic in southern parts of Japan, although it has been eradicated. Clinicians should remember filariasis as a potential etiology of urinary retention, especially in cases that may be associated with imported infectious disease.
