Animals ; Anticonvulsants ; adverse effects ; Cattle ; Drug Hypersensitivity ; complications ; diagnosis ; etiology ; Female ; Humans ; Lupus Erythematosus, Systemic ; complications ; Middle Aged ; Sepsis ; diagnosis ; Syndrome ; Triazines ; adverse effects ; Zoonoses ; etiology

Non-acetylated salicylates have been recommended for use as alternatives to nonsteroidal anti-inflammatory drugs (NSAIDs) in aspirin and/or tartrazine-sensitive patients. We experienced a case of an aspirin-sensitive asthmatic patient who developed a broncho-obstructive reaction after taking 100 mg of sodium salicylate. The result of this study suggests that sodium salicylate may cross-react with aspirin in aspirin-and tartrazine-sensitive patients.
Aspirin/*adverse effects/immunology ; Asthma/*complications/diagnosis/etiology ; Bronchial Provocation Tests ; Cross Reactions ; Drug Hypersensitivity/*complications/diagnosis/etiology ; Female ; Humans ; Middle Aged ; Sodium Salicylate/*adverse effects/immunology ; Tartrazine/adverse effects

Trimethoprim-sulfamethoxazole (TMP-SMZ) is a commonly used antibiotic that has been associated with drug rash with eosinophilia and systemic symptoms (DRESS) syndrome. DRESS syndrome is characterised by fever, rash, lymphadenopathy, eosinophilia and one or more major organ involvement. Although rare, TMP-SMZ is a recognised cause of fulminant hepatic failure. We report a 17-year-old Chinese male adolescent who presented with fever, myalgia, generalised maculopapular rash and lymphadenopathy after taking TMP-SMZ for acne vulgaris. He subsequently developed hepatic encephalopathy and was worked up for urgent liver transplantation. He responded well to extracorporeal liver dialysis (originally intended as a bridging therapy) and subsequently recovered without the need for liver transplantation. This case report highlights the importance of early recognition of TMP-SMZ-induced DRESS syndrome and the need for early discontinuation of the drug in the affected patient. Extracorporeal liver dialysis and transplantation should be considered in the management of TMP-SMZ-induced fulminant hepatic failure.
Acne Vulgaris ; complications ; drug therapy ; Adolescent ; Anti-Infective Agents ; adverse effects ; Biopsy ; Drug Eruptions ; etiology ; Drug Hypersensitivity Syndrome ; diagnosis ; etiology ; Fever ; etiology ; Humans ; Liver Failure, Acute ; etiology ; therapy ; Lymphatic Diseases ; etiology ; Male ; Myalgia ; etiology ; Renal Dialysis ; methods ; Skin ; pathology ; Treatment Outcome ; Trimethoprim, Sulfamethoxazole Drug Combination ; adverse effects

Lamotrigine is an anticonvulsant drug used to treat partial and generalized seizure disorders. Hypersensitivity to lamotrigine usually causes mild symptoms such as fever, rash, and slight invasion of internal organs. However, a 33-year-old male patient who was admitted with Stevens-Johnson syndrome after taking lamotrigine for 15 days experienced hepatic failure and died 5 days after admission. This case demonstrates the importance of realizing that lamotrigine can lead to fatal hepatic failure, and that tests for the normal liver function should be performed when administering lamotrigine.
Adult ; Alanine Transaminase/blood ; Anticonvulsants/*adverse effects/therapeutic use ; Aspartate Aminotransferases/blood ; Drug Hypersensitivity/complications/*diagnosis ; Humans ; Liver/enzymology/metabolism ; Liver Failure/*etiology ; Male ; Stevens-Johnson Syndrome/diagnosis/drug therapy ; Triazines/*adverse effects/therapeutic use

INTRODUCTIONA 22-year-old Malay soldier developed dapsone hypersensitivity syndrome 12 weeks after taking maloprim (dapsone 100 mg/pyrimethamine 12.5 mg) for anti-malarial prophylaxis.

CLINICAL PICTUREHe presented with fever, rash, lymphadenopathy and multiple-organ involvement including serositis, hepatitis and thyroiditis. Subsequently, he developed congestive heart failure with a reduction in ejection fraction on echocardiogram, and serum cardiac enzyme elevation consistent with a hypersensitivity myocarditis.

TREATMENTMaloprim was discontinued and he was treated with steroids, diuretics and an angiotensin-converting-enzyme inhibitor.

OUTCOMEHe has made a complete recovery with resolution of thyroiditis and a return to normal ejection fraction 10 months after admission.

CONCLUSIONIn summary, we report a case of dapsone hypersensitivity syndrome with classical symptoms of fever, rash and multi-organ involvement including a rare manifestation of myocarditis. To our knowledge, this is the first case of dapsone-related hypersensitivity myocarditis not diagnosed in a post-mortem setting. As maloprim is widely used for malaria prophylaxis, clinicians need to be aware of this unusual but potentially serious association.

Abdominal Pain ; drug therapy ; Adult ; Anti-Inflammatory Agents, Non-Steroidal ; adverse effects ; therapeutic use ; Biopsy ; Dapsone ; adverse effects ; therapeutic use ; Diagnosis, Differential ; Drug Hypersensitivity ; complications ; pathology ; Echocardiography ; Electrocardiography, Ambulatory ; Fever ; drug therapy ; Follow-Up Studies ; Humans ; Male ; Myocarditis ; diagnosis ; etiology ; Radiography, Thoracic ; Skin ; pathology ; Thyrotoxicosis ; diagnosis ; etiology

Plastic bronchitis is an uncommon disorder characterized by the formation of bronchial casts. It is associated with congenital heart disease or pulmonary disease. In children with underlying conditions such as allergy or asthma, influenza can cause severe plastic bronchitis resulting in respiratory failure. A review of the literature showed nine cases of plastic bronchitis with H1N1 including this case. We report a case of a child with recurrent plastic bronchitis with eosinophilic cast associated with influenza B infection, who had recovered from plastic bronchitis associated with an influenza A (H1N1) virus infection 5 months previously. To the best of our knowledge, this is the first case of recurrent plastic bronchitis related to influenza viral infection. If patients with influenza virus infection manifest acute respiratory distress with total lung atelectasis, clinicians should consider plastic bronchitis and early bronchoscopy should be intervened. In addition, management for underlying disease may prevent from recurrence of plastic bronchitis.
Administration, Inhalation ; Adrenal Cortex Hormones/therapeutic use ; Antiviral Agents/therapeutic use ; Bronchitis/complications/*diagnosis/drug therapy ; Bronchoscopy ; Child ; DNA, Viral/analysis ; Dyspnea/etiology ; Humans ; Hypersensitivity/pathology ; Influenza A Virus, H1N1 Subtype/*genetics/isolation & purification ; Influenza B virus/genetics/isolation & purification ; Influenza, Human/complications/*diagnosis/drug therapy ; Male ; Oseltamivir/therapeutic use ; Pulmonary Atelectasis/drug therapy/radiography ; Real-Time Polymerase Chain Reaction ; Tachypnea/etiology ; Tomography, X-Ray Computed