We present a case of previously healthy, immunocompetent, 41-year-old woman who developed systemic inflammatory response syndrome secondary to Neisseria gonorrhoeae bacteremia. Clinical course was complicated by the simultaneous formation of multiple muscular abscesses, epidural abscess, and septic spondylodiscitis. The patient responded well to prolonged ceftriaxone treatment and was released 10 weeks after initial admission. Spinal lesions and/or pyomyositis individually constitute rare complications of disseminated gonococcal infection. This case, combining both manifestations, is to our knowledge unique. Apropos, diversity of the clinical presentation, and therapeutic challenges for this historical disease are discussed for the practicing physician.
Rituximab treatment is efficient in both seropositive and seronegative RA. However, seropositive RA patients tend to respond favorably compared with seronegative patients. The differential CD20 receptor expression in the two groups at relapse potentially suggests a different pathogenetic mechanism of relapse and merits further investigation.
Background:
Hyperkalemia is an important clinical problem that is associated with significant lifethreatening
complications. Several conditions are associated with increased risk for hyperkalemia such as chronic
kidney disease, diabetes mellitus, heart failure, and the use of renin-angiotensin-aldosterone system (RAAS)
inhibitors.
Objective:
The purpose of this review is to present and critically discuss treatment options for the management of
hyperkalemia.
Method:
A comprehensive review of the literature was performed to identify studies assessing the drug-induced
management of hyperkalemia.
Results:
The management of chronic hyperkalemia seems to be challenging and includes a variety of traditional
interventions, such as restriction in the intake of the dietary potassium, loop diuretics or sodium polystyrene sulfonate.
In the last few years, several new agents have emerged as promising options to reduce potassium levels in
hyperkalemic patients. Patiromer and sodium zirconium cyclosilicate 9 (ZS-9) have been examined in hyperkalemic
patients and were found to be efficient and safe. Importantly, the efficacy of these novel drugs might allow
the continuation of the use of RAAS inhibitors, morbidity- and mortality-wise beneficial class of drugs in the
setting of chronic kidney disease and heart failure.
Conclusion:
Data support that the recently emerged patiromer and ZS-9 offer significant hyperkalemia-related
benefits. Larger trials are needed to unveil the impact of these drugs in other patients’ subpopulations, as well.
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