Drug rash with eosinophilia and systemic symptoms (DRESS) probably induced by cefotaxime: a report of two cases.

We report two cases, one of a 52-year-old man and one of a 32-year-old man, who were treated with cefotaxime. On day 23 and day 28 of the treatment, respectively, the patients manifested clinically with fever, pruriginous skin rash, and facial edema. Blood tests showed marked eosinophilia and atypical lymphocytosis for both patients, and hepatic cytolysis only in the second patient. Cefotaxime was discontinued in both patients; the clinico-biological picture improved gradually and completely disappeared approximately 4 weeks later. Six weeks after complete recovery, both patients underwent intradermal testing which was positive to cefotaxime (2 mg/ml) at the 48-hour reading and negative to benzylpenicillin, amoxicillin, and cefazolin at the 20-minute and 48-hour readings. These clinical pictures suggest drug rash with eosinophilia and systemic symptoms (DRESS) induced by cefotaxime. To the best of our knowledge, only one case of cefotaxime-induced DRESS has been reported in the medical literature. Thus, we add two new cases of cefotaxime-induced DRESS and emphasize the usefulness and safety of intradermal testing in establishing the diagnosis.

[H1N1 influenza vaccines in Tunisia: efficiency and safety]. / Les vaccins anti A(H1N1) en Tunisie : efficacité et tolérance.

OBJECTIVE: We carried out this study in order to evaluate the effectiveness and the safety of the two H1N1 vaccines available in Tunisia: Focetria(®) and Panenza(®). METHODS: It's a prospective epidemiological study including 601 vaccinated subjects. The vaccine effectiveness was based on the occurrence of flu clinical symptoms after vaccination. The safety was based on the occurrence of unexpected events after vaccines administration. The vaccines imputability was established according to Begaud et al. method. RESULTS: The number of subjects vaccinated by Focetria(®) is more important than Panenza(®). The efficiency of vaccines would be 93.6%. Neither the medical statue nor the type of the vaccine used influence the occurrence of a flu episode after vaccination. We recorded 406 adverse effects (32.4%) with a high score of imputability (I3). Focetria(®) adverse effects were more frequent than Panenza(®) ones (p = 0.009). Almost all adverse events disappeared within few days. CONCLUSION: The two vaccines used in Tunisia remain enough efficient to face the influenza (H1N1) pandemia and are well tolerated independently of the demographic and pathological statue of the vaccinated person as well as nature of the vaccine used.

[Not Available]. / Les vaccins anti A(H1N1) en Tunisie : efficacité et tolérance.

OBJECTIVE: We carried out this study in order to evaluate the effectiveness and the safety of the two H1N1 vaccines available in Tunisia: Focetria® and Panenza®. METHODS: It's a prospective epidemiological study including 601 vaccinated subjects. The vaccine effectiveness was based on the occurrence of flu clinical symptoms after vaccination. The safety was based on the occurrence of unexpected events after vaccines administration. The vaccines imputability was established according to Begaud et al. RESULTS: The number of subjects vaccinated by Focetria® is more important than Panenza®. The efficiency of vaccines would be 93.6%. Neither the medical statue nor the type of the vaccine used influence the occurrence of a flu episode after vaccination. We recorded 406 adverse effects (32.4%) with a high score of imputability (I3). Focetria® adverse effects were more frequent than Panenza® ones (p=0.009). Almost all adverse events disappeared within few days. CONCLUSION: The two vaccines used in Tunisia remain enough efficient to face the influenza (H1N1) pandemia and are well tolerated independently of the demographic and pathological statue of the vaccinated person as well as nature of the vaccine used.

[Psoas abscesses reviewed]. / Les abces du psoas a pyogenes.

Psoas abscesses are rare. In the absence of specific symptoms and signs, their diagnosis was usually difficult. Medical imaging advances have helped in their diagnosis and treatment. Eleven cases of psoas abscess were reviewed retrospectively. We tried to determine epidemiologic and clinical features and therapeutic alternatives for this entity. Mean aged 27 years. Three of the 11 cases occurred in females. An underlying disease was observed in three cases. Associated clinical features were fever (n = 11), lumbar pain (n = 10), and psoOtis (n = 5). Diagnosis was confirmed by ultrasonography (n = 10) and computed tomography (n = 1). Blood culture was positive in 6 out of 11 cases: Staphylococcus aureus (n = 5) and Klebsiella pneumonia (n = 1) Staphylococcceus aureus was isolated in 6 abscess pus. Antibiotics were prescribed in all cases for a mean length of 61 days, in association with percutaneous drainage in 5 cases, surgical drainage in one case and abscess puncture in one case. Outcome was favourable in all cases.