- |||||||||| piperacillin sodium/tazobactam sodium / Generic mfg., doxycycline / Generic mfg.
A Unique Case of Phlegmonous Gastritis After a Recent Pancreatic Mass Biopsy (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_4667;
Early consideration of phlegmonous gastritis in the differential diagnoses and starting treatment is the key to avoiding rapid decompensation and the need for surgery. Figure: CT Image showing focal gastric wall thickening associated with hypoattenuating lesions within the gastric wall
- |||||||||| ceftriaxone / Generic mfg., doxycycline / Generic mfg.
Vibrio Vulnificus Septic Shock and Disseminated Intravascular Coagulation After Raw Oyster Consumption in a Patient With Cirrhosis (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_4482;
As delays in diagnosis and antibiotic therapy is associated with higher mortality rates, it is crucial that providers recognize the signs of infection and understand the occupational and behavioral risks to provide prompt intervention and the immediate initiation of antibiotics. Figure: Rapid progression of the patient's bilateral lower extremity hemorrhagic bullae from initial presentation (images A and C) to 4 hours later (images B and D).
- |||||||||| doxycycline / Generic mfg.
Murine Typhus: An Unusual Cause of Acute Hepatitis in Pregnancy (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_4480;
Patients can deteriorate rapidly; thus, prompt diagnosis based on endemic risk factors and initiation of treatment are crucial. Figure: A steep decline in both AST and ALT can be appreciated after the administration of Doxycycline between hospital day one and two.
- |||||||||| doxycycline / Generic mfg.
Cat Cautious: Doxycycline as a Possible Culprit of DrugInduced Liver Injury (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_4418;
The proposed pathophysiology focuses on the inhibition of transport via hepatocytes leading to cholestasis. Our case highlights the importance of clinicians keeping a wide differential when considering drug-induced cholestatic injury.
- |||||||||| Case Report: An Urban Case of Multi-Organ Failure Due to Weil Disease (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_4378;
Leptospira DNA PCR of the urine returned positive, confirming the diagnosis of icteric leptospirosis (Weil's disease) and antimicrobial therapy was narrowed to parenteral high-dose penicillin G. The patient made a full recovery and was discharged to a subacute nursing facility...Early recognition and treatment can improve outcomes. Figure: Graph 1: This graph shows the trend of this patient's renal failure with concomitant liver dysfunction, and the gradual improvement in kidney and liver function following supportive continuous renal replacement therapy
- |||||||||| doxycycline / Generic mfg.
Typhus in Texas: Rickettsial Infection as a Cause of Elevated Liver Enzymes (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_4354;
The patient was started on doxycycline empirically for suspected typhus and had subjective improvement with abatement of fevers...Our patient presented with similar non-specific viral symptoms and also had liver enzyme elevation nearly 10 times the upper limit of normal. This case highlights the importance of considering rickettsial infections in the differential diagnosis of patient
- |||||||||| Anaplasmosis Presenting as Acute Liver Injury (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_4346;
Due to concerns of sepsis, he got piperacillin-tazobactam and vancomycin empirically, and acetaminophen 500mg every eight hours for 3 days...DILI from acetaminophen and doxycycline was initially suspected but quickly dismissed given no worsening hepatic function despite continuing doxycycline...The lack of documented relationship between severe acute liver injury caused by HGA may cause unnecessary invasive testing like liver biopsy. This highlights the importance of disease awareness amongst gastroenterologists.
- |||||||||| doxycycline / Generic mfg., doxorubicin hydrochloride / Generic mfg.
Kaposi Sarcoma in an Acquired Immunodeficiency Syndrome Patient With Recurring Abdominal Pain and Rectal Bleed (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3972;
The patient followed up as an outpatient and started on Doxorubicin for Kaposi sarcoma, as he continued to have intermittent rectal bleeding and did not show a response to ART alone...Such patients need close follow-up to allow for monitoring of therapy, adverse effects of therapy and initiation of additional treatment when needed. Figure: Colonoscopy: Several scattered 1-2 cm and a large violaceous sessile lesion primarily in the rectum, extending to the anal canal and perianal skin; H&E Stain Perianal Skin Biopsy: Spindle cells in the dermis layer consistent with Kaposi Sarcoma
- |||||||||| doxycycline / Generic mfg., omeprazole / Generic mfg.
Pill Esophagitis as a Complication of Eosinophilic Esophagitis (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3804;
Trial of over-the-counter omeprazole 20 mg daily over seven days provided minimal relief of odynophagia...Susceptible patients with dysphagia and EoE should be counseled appropriately when prescribed medications that are known to cause pill esophagitis. Our case emphasizes the need for prompt recognition and treatment of EoE to prevent future complications.
- |||||||||| doxycycline / Generic mfg.
Lymphogranuloma Venereum Proctitis (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3608;
The LGV was treated with oral doxycycline for 21 days...In these cases, it is important to obtain rectal swab testing, as urine chlamydia testing is typically negative. Figure: Sigmoidoscopy shows diffuse erythematous, granular mucosa with numerous erosions without focal ulcers until approximately 15 cm.
- |||||||||| TPOXX (tecovirimat) / SIGA Technologies
Acute Proctitis in a Patient With Mpox and Syphilis (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3603;
Prompt identification as well as a high index of suspicion are necessary for proper diagnosis and management of monkeypox and syphilis in immunocompromised patients with acute proctitis. Figure: CT scan of the pelvis
- |||||||||| benzylpenicillin / Generic mfg., doxycycline / Generic mfg.
Sexually Transmitted Infectious Colitis: A Case Series Highlighting an Uncommon Mimicker of Inflammatory Bowel Disease (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3598;
Immunohistochemical staining was positive for Treponema Pallidum and was treated with intramuscular Penicillin G, with resolution of symptoms...The patient was started on highly active antiretroviral therapy for HIV and doxycycline for Chlamydia trachomatis...A comprehensive history, including sexual history, is a vital component in the evaluation of these patients. IBD-symptoms, especially in patients with high-risk sexual behavior, should prompt a thorough STI work-up.
- |||||||||| hydroxychloroquine / Generic mfg., piperacillin sodium/tazobactam sodium / Generic mfg., doxycycline / Generic mfg.
Acalculous Cholecystitis and Splenic Infarction: An Unusual Presentation of Acute Q Fever Infection (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3441;
Coxiella burnetii serum titers and PCR resulted positive in a manner consistent with acute Q fever infection, and the patient was started on hydroxychloroquine as well...In addition, although transient antiphospholipid antibodies are a known phenomenon of Q fever, they are rarely associated with independent thrombotic complications in patients without prior diagnosis of antiphospholipid antibody syndrome or evidence of underlying Q fever endocarditis. However, our patient suffered an extensive thrombotic event necessitating anticoagulation and then complicated by GI bleed.
- |||||||||| rivaroxaban / Generic mfg., doxycycline / Generic mfg.
Neuroendocrine Carcinoma (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3269;
Further, these can be subclassified based on location and functional status. This case will highlight the hospital course of a 29-year-old pregnant female with rare metastatic neuroendocrine carcinoma.
- |||||||||| Whipple's Disease with Dermatologic Manifestations (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3172;
Tetracyclines are an alternative, but reports suggest higher risk of relapse. Duodenal biopsy should be repeated at 6-month intervals and therapy continued until biopsy is negative.
- |||||||||| doxycycline / Generic mfg.
A Rare Presentation of Acute Hepatitis: Q Fever (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3072;
He was started on a two-week course of doxycycline with subsequent normalization of his liver tests...B. Liver biopsy demonstrating granuloma with central lipid vacuole.
- |||||||||| Remicade (infliximab) / Merck (MSD), Mitsubishi Tanabe, J&J
Paradoxical Pustular Psoriasis Secondary to TNF Alpha Inhibitor Use in Ulcerative Colitis (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_2736;
Introduction: Infliximab is a tumor necrosis factor- alpha inhibitor (TNFi) used in moderate-severe ulcerative colitis (UC)...Ketoconazole, clobetasol, and doxycycline were prescribed...Prednisone was initiated for concern of doxycycline drug reaction...It reinforces the importance of early clinical recognition and is an additional indication for close dermatology followup in UC. Figure: Figure 1A: numerous erythematous non-follicular based papules with scaling and serosanguineous drainage in right axilla Figure 1B: psoriasiform epidermal acanthosis with dilated capillaries in papillary dermis and lymphocytic inflammation, 10x H&E stain
- |||||||||| Humira (adalimumab) / AbbVie
Rash and Remedy: Leukocytoclastic Vasculitis Associated With Adalimumab Therapy in Crohn's Disease (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_2719;
After improving, he was discharged on a prolonged prednisone taper...There should be further discussion about deciding which biologic therapy to switch to based on side effect profiles. Figure: Figure 1: Images of skin lesions on thigh (A), lateral ankle (B), medial ankle (C), sole (D), forefoot (E), and elbow (F).
- |||||||||| aspirin / Generic mfg., fluconazole oral / Generic mfg., doxycycline / Generic mfg.
Navigating the Narrow Path: Chronic Benign, Severe Esophageal Strictures in a Patient With Acquired Immune Deficiency Syndrome (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_2385;
She had not been taking Aspirin, NSAIDs, oral bisphosphonates or doxycycline...EGD revealed esophageal ulcers, diffuse candida esophagitis treated with Fluconazole...Figure: Figure A. Endoscopic finding of one benign appearing intrinsic severe stenosis at Gastroesophageal junction trabeculated with 6 pinpoint openings. Figure B. Barium esophagram showing severe obstruction in the distal third of the esophagus.
- |||||||||| doxycycline / Generic mfg., omeprazole / Generic mfg.
Esophagitis Dissecans Superficialis in a Critically Ill and Debilitated Patient (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_2337;
After completion of intravenous antibiotics, he was started on doxycycline and fluconazole for a longer course...The patient was started on omeprazole 20mg twice daily with resolution of his symptoms...This is a largely uncommon cause of UGIB and highlights the importance of including it in the differential diagnosis of melena, as one requires sharp clinical acumen to identify such lesions. Figure: Upper endoscopy revealed whitish plaques of stripped-off mucosa throughout the esophagus.
- |||||||||| Valcyte (valganciclovir) / Roche, Mitsubishi Tanabe, Cytovene (ganciclovir) / Roche
You Can't Always Trust Your Gut: CMV Colitis in an Immunocompetent Patient With COVID-19 (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_2101;
While there are several known risk factors associated with CMV colitis amongst immunocompetent patients, a possible connection between COVID-19 with CMV colitis should be investigated. Figure: Colonoscopy showed severe inflammation in the descending colon
- |||||||||| prednisone / Generic mfg., doxycycline / Generic mfg., tetracycline / Generic mfg.
Murine Typhus Manifesting as Acalculous Cholecystitis (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_2035;
Figure: Colonoscopy showed severe inflammation in the descending colon Diagnosis is made with serologic testing and preferred treatment is with tetracycline though it can be self-limiting...Initial working diagnosis was Adult-Onset Still
- |||||||||| doxycycline / Generic mfg.
Yellow Granules: An Unusual Case of Gastritis (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_1822;
She was given doxycycline 100mg twice daily but developed a rash...After surgery, a much shorter course of antibiotics is needed, especially if the entire cite of actinomycosis was removed. In conclusion, actinomycosis is a rare cause of gastritis, it should be considered in patients with prior history of GI surgery who experience persistent symptoms so diagnostic investigation is undertaken and appropriate treatment is initiated.
- |||||||||| A Case of Hickam (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_1623;
Infectious workup was sent and piperacillin- tazobactam and metronidazole were started...He was discharged on itraconazole and doxycycline but was unable to complete itraconazole due to elevated liver enzymes...D: CT axial view showing marked improvement in previously visualized liver abscess along subcapsular segment 6. There is now residual slight defect seen along subcapsular segment 6 in this region measuring up to 2 cm without evidence for drainable collection.
- |||||||||| piperacillin sodium/tazobactam sodium / Generic mfg., doxycycline / Generic mfg., ibuprofen / Generic mfg.
Leptospirosis Misdiagnosed as Alcoholic Hepatitis (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_1615;
This case report serves to raise awareness regarding the potential consequences of misdiagnosing leptospirosis, emphasizing its potential fatality when left untreated. It is strongly advised to obtain a detailed patient history and maintain a high index of suspicion for this disease.
- |||||||||| An Unfamiliar Case of Pyogenic Liver Abscess: Hepatic Actinomycosis (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_1535;
The patient was continued on intravenous (IV) piperacillin tazobactam and a repeat CT scan done 1 week later revealed near resolution of the abscess...Treatment modalities include source control via surgical/PC drainage or hepatic resection and appropriate antibiotics such as amoxicillin and higher penicillin derivatives, fluoroquinolones, doxycycline and aztreonam...It is also prudent to address the underlying predisposing factors for systemic actinomycosis, such as poor dentition and recent peptic ulcer perforation in our patient. Figure: Figure A: CT abdomen revealing a 8.7 X 5.1 X 3.1 cm multilobulated peripherally enhancing gas containing fluid collection (yellow arrow) concerning for pyogenic liver abscess; Figure B: Repeat CT abdomen 1 week post percutaneous drainage showing near resolution of the abscess with the 14 Fr percutaneous drain in place (yellow arrow)
- |||||||||| prednisone / Generic mfg., doxycycline / Generic mfg.
Unpasteurized Milk-Associated Brucellosis Hepatitis: A Rare Cause of Cirrhosis (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_1514;
A trial of prednisone slightly improved her transaminitis but her symptoms persisted...Her Brucella serology was positive and she was treated with doxycycline 100 mg BID for 6 weeks...Clinicians should remain vigilant about this atypical presentation of brucellosis and promote public awareness of the risks associated with the consumption of unpasteurized dairy products. Figure: Trends of Liver Enzymes
- |||||||||| Vyndaqel (tafamidis meglumine) / Pfizer
Hematemesis Unveils a Hidden Culprit (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_1089;
Figure: Figure A, B: Gastric wall nodularity with associated friability and mucosal thickening of duodenum noted on EGD. Figure C, D: Duodenal biopsy showing amyloid deposits on Hematoxylin-eosin and Congo red staining.
- |||||||||| doxycycline / Generic mfg.
See It to Believe It: A Rare Case of Human Intestinal Spirochetosis (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_783;
He was treated with a fourteen day course of oral doxycycline with improvement in symptoms...As a result, HIS should be included in the differential diagnosis of diarrhea in an immunocompetent individual with a normal appearing colon on colonoscopy. Figure: A) normal appearing descending colon B) normal appearing transverse colon
- |||||||||| tetracycline / Generic mfg.
Review, Journal: Oral Tetracycline-Class Drugs in Dermatology: Impact of Food Intake on Absorption and Efficacy. (Pubmed Central) - Jul 29, 2023
If patients find it more tolerable to take doxycycline, minocycline, and sarecycline with food to avoid gastrointestinal distress, this may merit consideration to encourage patient adherence. Since the impact of food intake on absorption varied with the dosage form of doxycycline and minocycline, consulting the appropriate package insert may give clinicians additional insight into differences in the various formulations.
- |||||||||| doxycycline / Generic mfg.
Journal: Can Serum Drops Containing Doxycycline Provide a Supplemental Anti-Bacterial Effect in the Treatment of Bacterial Keratitis? (Pubmed Central) - Jul 29, 2023
Since the impact of food intake on absorption varied with the dosage form of doxycycline and minocycline, consulting the appropriate package insert may give clinicians additional insight into differences in the various formulations. Our data suggest that autologous serum drops containing theoretic concentrations of doxycycline may provide an additional anti-bacterial effect in the treatment of bacterial keratitis, especially for Gram-positive bacterial keratitis compared to Gram-negative bacterial keratitis.
- |||||||||| doxycycline / Generic mfg.
Journal: Galectin-12 modulates Kupffer cell polarization to alter the progression of non-alcoholic fatty liver disease. (Pubmed Central) - Jul 28, 2023
Furthermore, the effects of Gal12 on M2 macrophages during the progression of NAFLD was investigated by studying Kupffer cells from Gal12 knockout mice and doxycycline-inducible Gal12-/-THP-1 cells...Finally, we demonstrated that Gal12 knockdown negatively regulated the suppressor of cytokine signaling 3 levels. These findings suggested that Gal12 balances M1/M2 polarization of Kupffer cells to prevent NAFLD progression.
- |||||||||| doxycycline / Generic mfg.
Journal: Phase Inversion-Based Doxycycline Hyclate-Incorporated Borneol In Situ Gel for Periodontitis Treatment. (Pubmed Central) - Jul 28, 2023
ISG containing 5% triacetin efficiently prolonged Dox release up to 10 days with Fickian diffusion and presented effective antimicrobial activities against periodontitis pathogens such as Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans. Therefore, the Dox-loaded 40% borneol-based ISG with 5% triacetin is a potential effective local ISG for periodontitis treatment.
- |||||||||| doxycycline / Generic mfg.
Enrollment open, Enrollment change, Trial completion date, Trial primary completion date: Prophylactic Antibiotics Useful With Antibiotic Impregnated External Ventricular Drains (EVDs)? (clinicaltrials.gov) - Jul 27, 2023
P1, N=84, Recruiting,
As the carriers were designed to reduce local bacterial infections, among others in dentistry, the released antibiotics were amoxycillin, metronidazole, and doxycycline. Suspended --> Recruiting | N=150 --> 84 | Trial completion date: Jul 2023 --> Jun 2024 | Trial primary completion date: Jun 2023 --> Jun 2024
- |||||||||| Clinical, Journal: Antibiotic resistance profile of Helicobacter pylori to 14 antibiotics: a multicenter study in Fujian, China. (Pubmed Central) - Jul 21, 2023
In Fujian, the prevalence of H. pylori resistance to AZM, CLR, LVFX, SPFX, MTZ, and TID was high, whereas that to AMX, AMC, GEN, CFM, TET, DOX, RFP and FZD was relatively low. CFM and DOX are promising new choices for H. pylori eradication.
- |||||||||| Journal: The search for better treatment strategies for mansonellosis: An expert perspective. (Pubmed Central) - Jul 21, 2023
We recommend that human infections with Mansonella species be treated, regardless of any apparent clinical manifestations. We argue that mansonellosis, despite being widely considered a benign infection, may represent a direct or indirect cause of significant morbidity that remains poorly characterized at present.
- |||||||||| Journal: Genomic analysis of multidrug-resistant Escherichia coli strains carrying the mcr-1 gene recovered from pigs in Lima-Peru. (Pubmed Central) - Jul 20, 2023
MDR E. coli genomes exhibited other ARGs encoding resistance to fosfomycin (fosA3), quinolones (qnrB19, qnrS1, qnrE1), tetracyclines (tetA, tetB, tetD, tetM), sulfonamides (sul1, sul2, sul3), amphenicols (cmlA1, floR), lincosamides (inuE), as well as various aminoglycoside resistance genes...This information provides evidence of the dissemination of highly significant ARGs in public health. Therefore, it is imperative to implement measures aimed at mitigating and preventing the transmission of MDR bacteria carrying ARGs to urban environments.
- |||||||||| doxycycline / Generic mfg.
Journal: Chemogenetic regulation of the TARP-lipid interaction mimics LTP and reversibly modifies behavior. (Pubmed Central) - Jul 20, 2023
Selective expression of active ExSYTE in these neurons potentiates AMPAR-mediated synaptic transmission in a doxycycline-dependent manner, occludes synaptically induced LTP, and mimics freezing triggered by cued fear conditioning. Thus, chemogenetic controlling of the TARP-membrane interaction is sufficient for LTP-like synaptic AMPAR insertion, which mimics fear conditioning.
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