Adverse Interaction Between Colchicine and Ketoconazole in a Chinese Shar Pei

2014 ◽  
Vol 50 (6) ◽  
pp. 417-423 ◽  
Author(s):  
Amber McAlister ◽  
Sharon A. Center ◽  
Hannah Bender ◽  
Sean P. McDonough
Keyword(s):  
Mitotic Spindle ◽  
Drug Withdrawal ◽  
Gastrointestinal Toxicity ◽  
Multiple Drug ◽  
Drug Discontinuation ◽  
Loss Of Function ◽  
Metaphase Arrest ◽  
Multiple Drug Resistant ◽  
History Of ◽  
Rule Out

A Chinese shar pei with a 2 yr history of episodic fever, lethargy, and shifting lameness was presumptively diagnosed with familial shar pei fever but had never been treated for the syndrome. After being presented for a superficial pyoderma with possible dermatophyte coinfection, treatment with a cephalosporin and ketoconazole were prescribed. One wk later, colchicine was initiated for familial shar pei fever using cautious dose escalation. Nevertheless, gastrointestinal toxicity, skeletal muscle myopathy, and hepatotoxicity developed within 2 wk. Abrupt resolution of gastrointestinal toxicity and myopathy followed drug withdrawal. However, escalating liver enzyme activity and hyperbilirubinemia led to liver biopsy to rule out an antecedent hepatopathy. Biopsy characterized canalicular cholestasis and colchicine-associated metaphase arrest and ring mitoses reflecting repression of mitotic spindle formation. Signs of illness completely resolved 3 mo after drug discontinuation. Although avoidable adverse interactions between ketoconazole and drugs reliant on cytochrome oxidase biotransformation and/or drug efflux mediated by multiple drug-resistant transporters are well documented in humans, these are rarely reported in veterinary patients. This case exemplifies an important and avoidable ketoconazole/colchicine drug interaction from which the patient completely recovered. The dog tested negative for the canine MDR1 loss of function mutation that also might potentiate colchicine toxicity.

Extreme laryngeal candidiasis: airway obstruction

2021 ◽  
Vol 14 (8) ◽  
pp. e242910
Author(s):  
Susan C Murray ◽  
Christopher SG Thompson ◽  
David L Walker ◽  
Miles Bannister
Keyword(s):  
Multiple Drug ◽  
Chronic Obstructive ◽  
Drug Resistant ◽  
Obstructive Pulmonary Disease ◽  
Accident And Emergency ◽  
Multiple Drug Resistant ◽  
Female Smoker ◽  
History Of ◽  
The Subject ◽  
Accident And Emergency Department

We describe the case of a 33-year-old female smoker who presented to the Accident and Emergency department with a 1-day history of rapidly evolving airway compromise. She had no preceding illness or other objective signs/symptoms on presentation, had a history of Chronic Obstructive Pulmonary Disease (COPD) and a previous opioid addiction. Following failed endotracheal intubation, the airway was secured with an emergency surgical tracheostomy. Subsequent direct laryngoscopy revealed a severely diseased glottis and supraglottic area, from which biopsy samples revealed a multiple drug-resistant strain of Candida albicans requiring specialist microbiology input and antifungal treatment. We describe the presentation, investigation, management and outcome of this rare case, along with a literature review of the subject.

scholarly journals Etiology of Diarrhoea with Reference to Multiple Drug Resistant Enteric Bacterial Pathogens

1970 ◽  
Vol 9 ◽  
pp. 131-138 ◽  
Author(s):  
Sirjana Devi Shrestha ◽  
Sarala Malla ◽  
Shital Raj Basnyat
Keyword(s):  
Nalidixic Acid ◽  
Clinical History ◽  
Multiple Drug ◽  
Enteric Infection ◽  
Drug Resistant ◽  
Salmonella Spp ◽  
Key Words Antibiotics ◽  
Significant Incidence ◽  
Multiple Drug Resistant ◽  
History Of

A total of 340 stool samples were processed and studied from both sexes including all ages of patients. Association of enteropathogens between male and female was not statistically significant. Incidence of diarrhoea (28.23%) as well as prevalence of enteropathogens (34.31%) was found highest in the age group (20-30) years. The highest prevalence of enteropathogens (44.87%) was found in August. Of the total isolated enteropathogens, Vibrio cholerae O1 was observed in 51.96% followed by Shigella (18.6%) and Salmonella (8.82%) and parasites were also detected from 20.58% samples. All isolated V. cholerae O1 were El Tor, Inaba. Among Shigella, majority of isolates were S. flexneri. Among Salmonella, S. typhi, S. typhimurium and Salmonella spp. (polyvalent A-S positive) were identified. Entamoeba histolytica, Girdia lamblia, Ascaris lumbricoides and Trichuris trichiura were isolated among parasites. All isolated (100%) V. cholerae O1 were resistant to nalidixic acid and cotrimoxazole, whereas 68%; 63%; 53%; 37% and 11% Shigella were resistant to nalidixic acid, ampicillin, cotrimoxazol, mecillinam and ciprofloxacin respectively. Similarly, 55.5%; 44.4% and 11.1% Salmonella were resistant to nalidixic acid; ampicillin and cotrimoxazole respectively. All V. cholerae strains, 10 strains of Shigella and 2 strains of Salmonella were found multi drug resistant (MDR). The clinical history of the positive cases revealed that abdominal pain, fever, vomiting, dehydration and nausea were the symptoms of enteric infection. Key words: antibiotics; isolates; enteropathogen; Inaba DOI: 10.3126/njst.v9i0.3176 Nepal Journal of Science and Technology 9 (2008) 131-138

scholarly journals Bacteriophage therapy: a potential solution for the antibiotic resistance crisis

2014 ◽  
Vol 8 (02) ◽  
pp. 129-136 ◽  
Author(s):  
Zhabiz Golkar ◽  
Omar Bagasra ◽  
Donald Gene Pace
Keyword(s):  
Antimicrobial Agents ◽  
Resistant Bacteria ◽  
Multiple Drug ◽  
Bacterial Disease ◽  
Drug Resistant ◽  
Bacteriophage Therapy ◽  
Advantages And Disadvantages ◽  
Drug Resistant Bacteria ◽  
Multiple Drug Resistant ◽  
History Of

The emergence of multiple drug-resistant bacteria has prompted interest in alternatives to conventional antimicrobials. One of the possible replacement options for antibiotics is the use of bacteriophages as antimicrobial agents. Phage therapy is an important alternative to antibiotics in the current era of drug-resistant pathogens. Bacteriophages have played an important role in the expansion of molecular biology and have been used as antibacterial agents since 1966. In this review, we describe a brief history of bacteriophages and clinical studies on their use in bacterial disease prophylaxis and therapy. We discuss the advantages and disadvantages of bacteriophages as therapeutic agents in this regard.

scholarly journals Aneurysmal fibrous histiocytoma

2019 ◽  
Vol 7 (10) ◽  
pp. 3906
Author(s):  
Istan Irmansyah Irsan ◽  
Thomas Erwin C. J. Huwae ◽  
Satria Pandu Persada Isma ◽  
Agung Riyanto Budi Santoso ◽  
Hanindya Prasojo
Keyword(s):  
Fibrous Histiocytoma ◽  
Excisional Biopsy ◽  
Skin Lesions ◽  
Wide Excision ◽  
Loss Of Function ◽  
Diagnostic Challenge ◽  
Late Treatment ◽  
History Of ◽  
Cd 68 ◽  
Rule Out

Aneurysmal fibrous histiocytoma is rare clinicopathological variant of Cutaneous Fibrous Histiocytoma. The clinical manifestation of Aneurysmal Fibrous Histiocytoma is often confusing to distinguish from other skin lesions. Most of the cases showed rapid increase in size or a history of recurrence, however histologically all are almost similar. Rarity of aneurysmal fibrous histiocytoma and high numbers of recurrence rate poses a big diagnostic challenge. Late treatment will result in a decrease until loss of function of the affected region.  In this article, author reported the case of aneurysmal fibrous histiocytoma of the hand in 7 years old girl with restricted at 2nd-3rd metacarpophalangeal joints. The patient had undergone a series of investigations until finally a wide excision was carried out. Excision tissue was performed CD 68 and CD 34  immunocytochemical smear to establish the diagnosis. It was not simple to make diagnosis aneurysmal fibrous histiocytoma. While it is benign, the lesion can appear malignant, and one should consider an excisional biopsy to rule out malignant conditions. The diagnosis had to be confirmed by histopathological and performed immunocytochemical smear. It was often necessary to take aggressive actions with wide excision and reconstruction.

Phage therapy is an important replacement for the antibiotic resistance

2021 ◽  
Vol 15 (5) ◽  
pp. 1236-1240
Author(s):  
P. Farmehr
Keyword(s):  
Antibiotic Resistance ◽  
Phage Therapy ◽  
Resistant Bacteria ◽  
Multiple Drug ◽  
Bacterial Disease ◽  
Advantages And Disadvantages ◽  
Drug Resistant Bacteria ◽  
Multiple Drug Resistant ◽  
History Of ◽  
Alternative Antibiotic

Antibiotic resistance has become a significant and growing threat to public and environmental health. The emergence of multiple drug-resistant bacteria has prompted interest in alternatives to conventional antimicrobial. One of the possible replacement options for antibiotics is the use of bacteriophages as antimicrobial. We were forced to look for a new approach in treatment. Phage therapy is an important alternative antibiotic in the current of drug-resistance pathogens. In this way, poisoning bacteria bacteriophage bacteria infect and replicate in bacteria, in this therapy, identify the type of virus per person and can be targeted manipulation of harmful bacteria and then returned the person and invented phage therapy. We discuss the advantages and disadvantages of bacteriophages as therapeutic agents in this regard. And so describe a brief history of bacteriophages and clinical studies on their use in bacterial disease. Much hope is placed in genetic modifications of bacteriophages prevents the development of phage-resistant bacteria. Keywords: antibiotic resistance‚ bacteriophage, phage therapy

Natural History of Sigmoid Sinus Thrombosis

2003 ◽  
Vol 112 (2) ◽  
pp. 191-194 ◽  
Author(s):  
Anurag Agarwal ◽  
Patricia Lowry ◽  
Glenn Isaacson
Keyword(s):  
Natural History ◽  
Prospective Observational Study ◽  
Sinus Thrombosis ◽  
Venous Occlusion ◽  
Sigmoid Sinus ◽  
Multiple Drug ◽  
Collateral Flow ◽  
Venous Flow ◽  
Multiple Drug Resistant ◽  
History Of

To demonstrate the evolution of sigmoid sinus thrombosis, we performed a prospective observational study on a 6-year-old girl who presented with mastoiditis, epidural abscess, and occipital osteomyelitis from multiple drug–resistant Streptococcus pneumoniae. She underwent mastoidectomy and partial occipital craniectomy. This procedure produced a window in the occipital bone that allowed serial ultrasonography of the sigmoid sinus during medical treatment. Computed tomography was performed, followed by weekly Doppler ultrasonography used to monitor resolution of sigmoid sinus thrombosis. The natural history of a treated episode of sigmoid sinus thrombosis was illustrated. Venous occlusion resolved over a 4- to 6-week period without surgical drainage or venous anticoagulants. Collateral flow, reversal of normal venous flow, and ultimate return to normal venous transport characterized the period of resolution. We conclude that an occluded sigmoid sinus from mastoiditis can naturally recanalize. Aberrant venous flow can be demonstrated during the period of resolution. This case supports a conservative approach to management of the occluded sinus and suggests that 4 to 6 weeks of antibiotic therapy after removal of perisinus infection is sufficient for cure.

Case Exercise: Toxic Exposure-Related Illness: Causation, Diagnosis, and Permanent Impairment

2007 ◽  
Vol 12 (2) ◽  
pp. 4-8
Author(s):  
Frederick Fung
Keyword(s):  
Concentration Level ◽  
Treatment Plan ◽  
Toxic Exposure ◽  
Dose Response Relationship ◽  
Specialty Board ◽  
History Of ◽  
Subjective Complaints ◽  
Based Medicine ◽  
Illness Causation ◽  
Rule Out

Abstract A diagnosis of toxic-related injury/illness requires a consideration of the illness related to the toxic exposure, including diagnosis, causation, and permanent impairment; these are best performed by a physician who is certified by a specialty board certified by the American Board of Preventive Medicine. The patient must have a history of symptoms consistent with the exposure and disease at issue. In order to diagnose the presence of a specific disease, the examiner must find subjective complaints that are consistent with the objective findings, and both the subjective complaints and objective findings must be consistent with the disease that is postulated. Exposure to a specific potentially causative agent at a defined concentration level must be documented and must be sufficient to induce a particular pathology in order to establish a diagnosis. Differential diagnoses must be entertained in order to rule out other potential causes, including psychological etiology. Furthermore, the identified exposure at the defined concentration level must be capable of causing the diagnosis being postulated before the examiner can conclude that there has been a cause-and-effect relationship between the exposure and the disease (dose-response relationship). The evaluator's opinion should make biological and epidemiological sense. The treatment plan and prognosis should be consistent with evidence-based medicine, and the rating of impairment must be based on objective findings in involved systems.

Sign in / Sign up

Export Citation Format

Share Document