Drug-Induced Fulminant Hepatitis in a Child Treated for Latent Multidrug-Resistant Tuberculosis With Dual Therapy Combining Pyrazinamide and Levofloxacin

We report the case of a 10-year-old child treated for latent tuberculosis infection (LTBI) with pyrazinamide (PZA) and levofloxacin after contact with a smear-positive multidrug-resistant tuberculosis adult. Over the course of the treatment, the patient developed a drug-induced fulminant hepatitis attributed to the combination of PZA and levofloxacin. This case highlights the hepatotoxicity of the association of second-line anti-TB treatment in children.
Source: The Pediatric Infectious Disease Journal - Category: Infectious Diseases Tags: Antimicrobial Reports Source Type: research

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Conclusions: The constantly increasing prevalence of NAFLD in the general population can contribute to a growing role of NAFLD/NASH in HCC epidemiology. Moreover, some particular challenges specific for patients with liver steatosis may impede proper HCC diagnosis, treatment and follow-up. PMID: 31631714 [PubMed - as supplied by publisher]
Source: Current Medical Research and Opinion - Category: Research Tags: Curr Med Res Opin Source Type: research
In this study, a mouse model of chronic alcoholic hepatitis was established by eight weeks of Lieber-DeCarli liquid diet feeding; and LGG-s, BMMSCs or a combination of the two were used to explore a new therapeutic method for alcoholic liver disease and to study the mechanism. The results showed that the combined LGG-s and BMMSC treatment might have a synergistic effect and could improve the symptoms of alcoholic hepatitis by regulating inflammation, autophagy and lymphocyte subsets through the PI3k/NF-kB and PI3K/mTOR pathways. With the treatment, the autophagy rate accelerated, and alcohol-induced natural killer B (NKB) ...
Source: American Journal of Translational Research - Category: Research Tags: Am J Transl Res Source Type: research
Tuberculosis (TB), which is estimated to be the deadliest infectious disease worldwide with ~1.6 million deaths yearly [1], is a clinical issue due to the "ancient" diagnostics and drugs currently available. If compared with the management of other highly prevalent infectious diseases, such as HIV/AIDS and hepatitis C virus infection, it is clear that the clinical approach for TB disease requires innovation, being still based on means with limited efficacy (e.g. treatment of multidrug-resistant TB; MDR-TB), and characterised by the denominator "long duration": conventional bacteriological diagnosis, the...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Editorials Source Type: research
Conclusions: Lower educational levels, immunosuppression, previous TB episodes, other complications (depression, hepatitis, drug use, diabetes and HIV co-infection) had been shown to be associated with disease progression and mortality among MDR-TB cases. New strategies need to be implemented for appropriate MDR-TB detection as well as guarantee for a complete adherence to therapy.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Tuberculosis Source Type: research
Abstract: Patients with drug-susceptible tuberculosis (TB) show good tolerance of the medications used and have few side effects. However, medications used to treat multidrug-resistant tuberculosis (MDR-TB) have many known side effects. Here, we studied the occurrence of side effects due to treatment of patients with MDR-TB. We conducted a retrospective and consecutive review of the medical records of 256 patients who received treatment for MDR-TB between January 2006 and December 2011. One or more side effects were observed in 95 (37.1%) of the 256 patients. These side effects led to the suspension of the use of 1 or mo...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Quality Improvement Study Source Type: research
A 93-year-old woman presented with a 2-month history of hoarseness and cough. The patient had never received immunosuppressive treatment, was serologically negative for HIV and hepatitis, and did not have a family history of tuberculosis. Laryngoscopy showed an ulcerated and granular lesion in the ventricular folds, larynx vestibule and bilateral vocal cords (Figure 1A). Histological analysis of the biopsy specimen revealed granulomas with caseating necrotic centers and Langhans giant cells without carcinoma. Ziehl-Neelsen staining of the bronchoalveolar lavage fluid revealed acid-fast bacilli and PCR using the fluid revea...
Source: QJM - Category: Internal Medicine Source Type: research
Discussion HBV reactivation is diagnosed by an increase HBV DNA in chronic carrier with undetectable viral load or rise HBV DNA ≥10-fold increase in HBV DNA compared with baseline. Reactivation of HBV after starting chemotherapy or immunosuppressive medications is well described. Our case report is the first to describe HBV reactivation after starting Ethambutol, levofloxacin and Capreomycin against multidrug resistant mycobacterium tuberculosis. Most studies reported that RIPE (Rifampin, Isoniazid, Pyrazinamide, and Ethambutol) tuberculosis therapy has shown no risk of HBV reactivation. One of the Multidrug resist...
Source: Journal of Investigative Medicine - Category: Research Authors: Tags: Gastroenterology/Clinical Nutrition Source Type: research
Abstract During 2012-2013, at a public hospital in Pune, India, 26 (3.9%) cases of tuberculosis were reported among 662 medical trainees, representing an estimated incidence of 3,279 cases/100,000 person-years. Three of these infections were isoniazid-resistant, 1 was multidrug-resistant, and 1 occurred in a trainee who had fulminant hepatitis after starting treatment for TB. PMID: 26889712 [PubMed - as supplied by publisher]
Source: Emerging Infectious Diseases - Category: Infectious Diseases Authors: Tags: Emerg Infect Dis Source Type: research
ICYMI Health features what we're reading this week. This week, writers answered so many of our longstanding questions. Why do we admire mobsters? (Answer: They're dangerous, but not too dangerous.) And what, exactly, is social anxiety? (Answer: Being afraid of rejection by peers to an extreme degree.)  And on a heavier note, we got answers to questions we didn't even know to ask, including: "What is 'airborne cancer'?" One of our own Healthy Living editors also investigated the hypocrisy in blaming someone for a substance use disorder. We also read about the nature of adult friendships and, ye...
Source: Healthy Living - The Huffington Post - Category: Consumer Health News Source Type: news
CONCLUSIONS: In response to this crisis, the application of global health diplomacy principles represents a possible route of advocacy to ensure that HIV prevention, humane treatment of substance using populations, and improving public health outcomes in the region are pursued among concerned international stakeholders. In order to be effective, global health diplomacy efforts must be coordinated and advocated in all forms of diplomatic engagement, including at the core, multistakeholder and informal levels and through existing channels such as the different human rights bodies of the United Nations as well as amongst othe...
Source: Journal of the International AIDS Society - Category: Infectious Diseases Tags: J Int AIDS Soc Source Type: research
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