Contact urticaria refers to a wheal-and-flare response occurring on the application of chemicals to intact skin. When contact urticaria is accompanied by systemic symptoms, it is known as the urticaria syndrome. Fourteen cases of cefotiam-induced contact urticaria have been reported in the foreign literature, but no such case, as far as we know, has been described in the Korean dermatology literature. We report a case of contact urticaria syndrome occurring in a 23-year-old nurse due to occupational contact exposure to cefotiam. She experienced generalized urticaria, itching of the skin, difficulty in breathing, and abdominal pain, when she was preparing an injection of cefotiam. An open patch test showed positive reactions to cefotiam, cefmetazole, and ceftriaxone. Since avoiding cefotiam, the symptoms disappeared and did not recurred.
Abdominal Pain ; Cefmetazole ; Cefotiam ; Ceftriaxone ; Dermatology ; Humans ; Patch Tests ; Pruritus ; Respiration ; Skin ; Urticaria* ; Young Adult

Several of the newer broad-spectrum, potent antibiotics are currently being used for the treatment of meningitis, ventriculitis and shunt-tract infection. The risk of complications following intrathecal administration of some of this newer antibiotics varies considerably. Possible complications of immediate or delayed seizure, cortical electric depression, radiculopathy, transverse myelopathy, and arachnoiditis after intrathecal or intraventricular administration must be weighed against the potential value of this route. These risks may influence the therapeutic management of a specific clinical situation. The author studied the effect of the first generation of cephalosporins(cepalothin, cefazolin, cepharadine, cephapirin), the second generation of cephalosporins(cefamandole, cefmetazole), and the third generation of cephalosporins(cefotaxime, cetriaxone, cefotetan), on electrocortical activity of cerebral cortex. The results are as follows : 1) The topical application of cephalothin, cefazolin, cephapirin 8mg/ml shows electrocortical spike activity. In higher concentration, each cases show intense electrocortical spike activity. The topical application of cephradine 100mg/ml shows electrocortical spike activity and in higher concentration, electrocortical spike activity continued. 2) The topical application of cefamandole 64mg/ml shows electrocortical spike activity first and that of cefmetazole 100mg/ml shows electrocortical spike activity and in higher concentration of each cases, intense electrocortical spike activity continued. 3) The topical application of cefotaxime 16mg/ml shows electrocortical spike activity and that of ceftriaxon 200mg/ml and cefatetan 100mg/ml shows mild electrocortical spike activity. In higher concentration of each cases, electrocortical spike activity continued. In conclusion, the degrees of epileptogenic effect was most severe in the first generation of cephalosporins and the second generation of cephalosporins and the third generation of cephalosporins on the decreasing order.
Anti-Bacterial Agents ; Arachnoid ; Arachnoiditis ; Cefamandole ; Cefazolin ; Cefmetazole ; Cefotaxime ; Ceftriaxone ; Cephalosporins* ; Cephalothin ; Cephapirin ; Cephradine ; Cerebral Cortex* ; Depression ; Meningitis ; Radiculopathy ; Seizures ; Spinal Cord Diseases

OBJECTIVETo isolate and culture the predominant anaerobes from the periodontal abscesses, and to test the antibiotic susceptibility and drug resistant genes of the strains.

METHODSThe isolated strains were identified by both API20A biochemical method and polymerase chain reaction (PCR) method. The antibiotic susceptibility test was performed by agar dilution method. The resistant genes of the drug-resistant strains obtained were screened by PCR.

RESULTSThe anaerobes were detected in 48% (28/58) of the samples and Prevotella melaninogenica (Pm) was mostly identified in 43% (12/28). API20A biochemical method had 82% (23/28) agreement with the 16SrRNA method in identification rate. Anaerobes were resistant to metronidazole, clindamycin and cefmetazole. The erythromycin-resistant methylase genes F (ermF) gene was detected in three of eight clindamycin resistant strains. None of them was found coded on bacterial plasmids. However, no metronidazole resistant gene was detected on drug resistant strains.

CONCLUSIONSPm was the predominant species dectected in the periodontal abscess of the patients. The antibiotic agents should be used based on the genotypes and general condition of the patients.

Adult ; Anti-Bacterial Agents ; pharmacology ; Bacteria, Anaerobic ; isolation & purification ; Cefmetazole ; pharmacology ; Clindamycin ; pharmacology ; Drug Resistance, Bacterial ; genetics ; Erythromycin ; pharmacology ; Female ; Genes, Bacterial ; Humans ; Male ; Metronidazole ; pharmacology ; Microbial Sensitivity Tests ; Middle Aged ; Periodontal Abscess ; microbiology ; Prevotella ; isolation & purification