Ceftriaxone-induced leukocytoclastic vasculitis: a case report and literature review of antibiotic-induced leukocytoclastic vasculitis.

Leukocytoclastic vasculitis (hypersensitivity vasculitis) is defined as small blood vessel inflammation with skin or other systemic manifestations due to infections, drugs, or neoplastic disease. This clinical case report highlights an association between ceftriaxone and leukocytoclastic vasculitis in a 49-year-old female patient with a history of penicillin allergy, on mirtazapine for anxiety disorder. Articles concerning antibiotic-induced leukocytoclastic vasculitis are also reviewed. The patient reported a symptom of upper respiratory tract infection and fever 5 days previously for which she received ceftriaxone for 2 days before presenting to the emergency department with a pruritic skin rash in the upper and lower extremities and swollen lips for 1 day. The rash was erythematous, maculopapular, itchy, and non-tender, with no mucus membrane involvement. Laboratory investigations revealed leukocytosis (white blood cells, 22.3 × 109/L) that was mainly eosinophilic (18.4%). The patient was administered prednisolone and antihistamine after stopping ceftriaxone empirically. A skin biopsy confirmed the diagnosis of leukocytoclastic vasculitis. Significant clinical improvement was observed after treatment initiation. Upon follow-up, the skin rash was resolved entirely with no scars; however, there was skin-peeling over the lower extremities. Recognition of antibiotic-induced leukocytoclastic vasculitis is crucial as many classes of antibiotics can contribute to this condition. Continuation of the offending drug may lead to life-threatening complications.

Giant-cell tumors of soft tissue in the head and neck: A review article.

Giant-cell tumor of soft tissue (GCT-ST) is a rare neoplasm that was first described in 1972. Due to its histological and immune-histochemical similarities with GCT of bones, GCT-ST is thought to be its counterpart. This review article aims to recognize the characteristics of this rare tumor along with a favorable way to diagnose and treat. We reviewed 12 cases of GCT-ST in the head and neck. This tumor involves both sexes at any age. Histopathology in many cases revealed the presence of mononuclear cells and spindle cells. Immunohistochemistry was positive in many cases for CD68. Complete excision was the most accepted management technique; however, few cases reported recurrence and metastasis. Post-operative radiology is suggested to prevent local recurrence and in case of incomplete excision of the tumor.