Reactions 1680, p312 - 2 Dec 2017 Skin rash: case report A 30-year-old man developed skin rash during therapy with sulfadiazine [route and dosage not stated]. The man was hospitalised to a neurologic unit for a 5-year history of monthly frontal headache which worsened in frequency and intensity over the last month. Short-lasting episodes of sudden fall had also occurred in the past. Physical examination showed severe obesity without fever or lymphadenopathy. Brain CT scan showed multiple calcifications while MRI showed multiple cystic lesions surrounded by oedema. Toxoplasmosis serology on blood revealed a chronic infection. Total body CT showed mild splenomegaly and lymphadenopathy in the left groin. He was discharged but episodes of falling continued. Later, because of severe headache and occurrence of secondary generalised seizures, he was admitted again. Brain CT and MRI revealed a marked size increase of cystic lesions with ring enhancement; diffuse perilesional oedema with midline shift was evident. Emergency brain surgery with removal of 2 large cysts was performed. Brain tissue examination confirmed the presence of T. gondii DNA. Subsequently, antiparasitic treatment with sulfadiazine along with dexamethasone was initiated. However, after 8 days, he developed skin rash. The man’s sulfadiazine was replaced with clindamycin [outcome not stated]. Author comment: "After 8 days, sulfadiazine was replaced with clindamycin due to skin rash." Pustorino G, et al. Cerebral toxoplasmosis diagnosed by brain tissue PCR analysis in an immunocompetent patient. Neurology: Clinical Practice 7: 436-438, No. 5, Oct 2017. Available from: URL: http://doi.org/10.1212/CPJ.0000000000000364 - Italy 803285202 0114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved Reactions 2 Dec 2017 No. 1680
Reactions Weekly – Springer Journals
Published: Dec 2, 2017
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