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Rajan AK, Kashyap A, Chhabra M, Rashid M. Linezolid Induced Skin Reactions in a Multi Drug Resistant Infective Endocarditis Patient: A Rare Case. Curr Drug Saf 2021; 15:222-226. [PMID: 32416699 DOI: 10.2174/1574886315666200516175053] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 04/25/2020] [Accepted: 04/27/2020] [Indexed: 11/22/2022]
Abstract
RATIONALE Linezolid (LNZ) induced Cutaneous Adverse Drug Reactions (CADRs) have rare atypical presentation. Till date, there are very few published case reports on LNZ induced CADRs among the multidrug-resistant patients suffering from Infective Endocarditis (MDR IE). Here, we present a rare case report of LNZ induced CARs in a MDR IE patient. CASE REPORT A 24-year-old female patient was admitted to the hospital with chief complaints of fever (101°C) associated with rigors, chills, and shortness of breath (grade IV) for the past 4 days. She was diagnosed with MDR IE, having a prior history of rheumatic heart disease. She was prescribed LNZ 600mg IV BD for MDR IE, against Staphylococcus coagulase-negative. The patient experienced flares of cutaneous reactions with multiple hyper-pigmented maculopapular lesions all over the body after one week of LNZ therapy. Upon causality assessment, she was found to be suffering from LNZ induced CADRs. LNZ dose was tapered gradually and discontinued. The patient was prescribed corticosteroids along with other supportive care. Her reactions completely subsided and infection got controlled following 1 month of therapy. CONCLUSION Healthcare professionals should be vigilant for rare CADRs, while monitoring the patients on LNZ therapy especially in MDR patients as they are exposed to multiple drugs. Moreover, strengthened spontaneous reporting is required for better quantification.
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Affiliation(s)
- Asha K Rajan
- Department of Pharmacy Practice, Jaya College of Pharmacy, Thiruninravur, Chennai, Tamil Nadu 602024, India
| | - Ananth Kashyap
- Department of Pharmacy Practice, Sarada Vilas College of Pharmacy, Mysuru, Karnataka 570004, India
| | - Manik Chhabra
- Department of Pharmacy Practice, ISF College of Pharmacy, Moga, Punjab 142001, India
| | - Muhammed Rashid
- Department of Pharmacy Practice, Sri Adichunchanagiri College of Pharmacy, Adichunchanagiri University, BG Nagara, Nagamangala 571448, Karnataka, India
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Salem M, Friedrich C, Saad M, Frank D, Salem M, Puehler T, Schoettler J, Schoeneich F, Cremer J, Haneya A. Active Infective Native and Prosthetic Valve Endocarditis: Short- and Long-Term Outcomes of Patients after Surgical Treatment. J Clin Med 2021; 10:jcm10091868. [PMID: 33925866 PMCID: PMC8123486 DOI: 10.3390/jcm10091868] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 04/13/2021] [Accepted: 04/21/2021] [Indexed: 12/02/2022] Open
Abstract
Background: Active infective endocarditis (IE) is a serious disease associated with high mortality. The current study represents our experience over 18 years with surgical treatment for active infective native and prosthetic valve endocarditis (INVE, IPVE). Method: Analysis of 413 patients (171 with IPVE vs. 242 with INVE) who underwent cardiac surgery due to IE between 2002 and 2020. Results: Patients with IPVE were significantly older (64.9 ± 13.2 years vs. 58.3 ± 15.5 years; p < 0.001) with higher EuroSCORE II (21.2 (12.7; 41.8) vs. 6.9 (3.0; 17.0); p < 0.001)) and coronary heart disease (50.6% vs. 38.0%; p < 0.011). Preoperative embolization was significantly higher within INVE (35.5% vs. 16.4%; p < 0.001) with high incidence of cerebral embolization (18.6% vs. 7.6%; p = 0.001) and underwent emergency curative surgery than the IPVE group (19.6% vs. 10.6%; p < 0.001). However, patients with IPVE were significantly represented with intracardiac abscess (44.4% vs.15.7%; p < 0.001). Intraoperatively, the duration of surgery was expectedly significantly higher in the IPVE group (356 min vs. 244 min.; p = 0.001) as well as transfusion of blood (4 units (0–27) vs. 2 units (0–14); p < 0.001). Post-operatively, the incidence of bleeding was markedly higher within the IPVE group (700 mL (438; 1163) vs. 500 mL (250; 1075); p = 0.005). IPVE required significantly more permanent pacemakers (17.6% vs. 7.5%: p = 0.002). The 30-day mortality was higher in the IPVE group (24.6% vs. 13.2%; p < 0.003). Conclusion: Patients with INVE suffered from a higher incidence of cerebral embolization and neurological deficits than patients with IPVE. Surgical treatment in INVE is performed mostly as an emergency indication. However, patients with IPVE were represented commonly with intracardiac abscess, and had a higher indication of pacemaker implantation. The short- and long-term mortality rate among those patients was still high.
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Affiliation(s)
- Mohamed Salem
- Department of Cardiovascular Surgery, Christian-Albrechts-University of Kiel, School of Medicine, Arnold-Heller-Str. 3, D-24105 Kiel, Germany; (C.F.); (T.P.); (J.S.); (F.S.); (J.C.); (A.H.)
- Correspondence: or ; Tel.: +49-431500-67089
| | - Christine Friedrich
- Department of Cardiovascular Surgery, Christian-Albrechts-University of Kiel, School of Medicine, Arnold-Heller-Str. 3, D-24105 Kiel, Germany; (C.F.); (T.P.); (J.S.); (F.S.); (J.C.); (A.H.)
| | - Mohammed Saad
- Department of Cardiology and Angiology, Christian-Albrechts-University of Kiel, School of Medicine, Arnold-Heller-Str. 3, D-24105 Kiel, Germany; (M.S.); (D.F.); (M.S.)
| | - Derk Frank
- Department of Cardiology and Angiology, Christian-Albrechts-University of Kiel, School of Medicine, Arnold-Heller-Str. 3, D-24105 Kiel, Germany; (M.S.); (D.F.); (M.S.)
| | - Mostafa Salem
- Department of Cardiology and Angiology, Christian-Albrechts-University of Kiel, School of Medicine, Arnold-Heller-Str. 3, D-24105 Kiel, Germany; (M.S.); (D.F.); (M.S.)
| | - Thomas Puehler
- Department of Cardiovascular Surgery, Christian-Albrechts-University of Kiel, School of Medicine, Arnold-Heller-Str. 3, D-24105 Kiel, Germany; (C.F.); (T.P.); (J.S.); (F.S.); (J.C.); (A.H.)
| | - Jan Schoettler
- Department of Cardiovascular Surgery, Christian-Albrechts-University of Kiel, School of Medicine, Arnold-Heller-Str. 3, D-24105 Kiel, Germany; (C.F.); (T.P.); (J.S.); (F.S.); (J.C.); (A.H.)
| | - Felix Schoeneich
- Department of Cardiovascular Surgery, Christian-Albrechts-University of Kiel, School of Medicine, Arnold-Heller-Str. 3, D-24105 Kiel, Germany; (C.F.); (T.P.); (J.S.); (F.S.); (J.C.); (A.H.)
| | - Jochen Cremer
- Department of Cardiovascular Surgery, Christian-Albrechts-University of Kiel, School of Medicine, Arnold-Heller-Str. 3, D-24105 Kiel, Germany; (C.F.); (T.P.); (J.S.); (F.S.); (J.C.); (A.H.)
| | - Assad Haneya
- Department of Cardiovascular Surgery, Christian-Albrechts-University of Kiel, School of Medicine, Arnold-Heller-Str. 3, D-24105 Kiel, Germany; (C.F.); (T.P.); (J.S.); (F.S.); (J.C.); (A.H.)
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