Our analysis suggests a quantitative signal between tigecycline use and pancreatitis; however, given the limitations of our study, a cause-and-effect relationship cannot be inferred. Thus, additional rigorous scientific analyses are warranted to explore these findings.
Patient: Male, 79Final Diagnosis: Leukocytoclastic vasculitis and tubulointerstitial nephritisSymptoms: Dyspnea • edema of lower extermities • fever • rashMedication: VancomycinClinical Procedure: He came with fever • shortness of breath • pedal edema and rash. He was in acute renal failureSpecialty: Infectious DiseasesObjective:Unusual or unexpected effect of treatmentBackground:Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia and sepsis are commonly treated with intravenous vancomycin. However, vancomycin treatment is associated adverse reactions, including skin rashes and nephrotoxicity. We present a case of acute renal failure due to acute tubulointerstitial nephritis associated with a diffuse leukocytoclastic vasculitic skin eruption following intravenous vancomycin treatment.Case Report:A 79-year-old Caucasian male patient was treated with intravenous vancomycin for MRSA bacteremia. Prior to treatment, his creatinine was normal at 0.6 mg/dl. He presented one week later with shortness of breath, lower limb edema, and acute renal failure. He had a diffuse maculopapular rash involving the trunk and both upper and lower extremities. A renal biopsy and left arm skin biopsy were examined histologically. The skin biopsy showed leukocytoclastic vasculitis. Renal biopsy showed some sclerosed glomeruli, some with mesangial proliferation, and tubulointerstitial inflammation with eosinophils and plasma cells and mild interstitial fibrosis. Although there was some renal arteriolosclerosis, no vasculitic changes were seen, and no vascular thrombosis was present. A diagnosis of leukocytoclastic vasculitis and acute tubulointerstitial nephritis secondary to intravenous vancomycin therapy was made.Conclusions:Although skin reactions associated with drug therapy are common, vancomycin-associated dermal vasculitis is rare. Tubulointerstitial nephritis is also a rare association with vancomycin treatment. This case report has highlighted that patients being treated with intravenous vancomycin should be carefully observed for acute skin rashes and deterioration in renal function, which can be managed by ceasing treatment with vancomycin, steroid challenge, and preventing future exposure to similar antimicrobial agents.
A coordination polymer with the composition C 12 H 20 O 16 Zn 2 (ZnBTC) (BTC = benzene-1,3,5-tricarboxylate) was synthesized under hydrothermal conditions at 120 °C, and its crystal structure was determined using single-crystal X-ray crystallography. Firstprinciples electronic structure investigation of the compound was carried out using the density functional theory computational approach. The highest occupied molecular orbital, the lowest unoccupied molecular orbital, the energy gap, and the global reactivity descriptors of ZnBTC were investigated in both the gas phase and the solvent phase using the implicit solvation model, while the donor−acceptor interactions were studied using natural bond orbital analyses. The results revealed that ZnBTC is more stable but less reactive in solvent medium. The larger stabilization energy E (2) indicates a greater interaction of ZnBTC in the solvent than in the gas phase. Orange peel activated carbon and banana peel activated carbon chemically treated with ZnCl 2 and/or KOH were used to modify the synthesis of ZnBTC to obtain nanocomposites. ZnBTC and the nanocomposites were characterized by powder Xray diffraction (PXRD), thermogravimetric analysis, and Fourier transform infrared. The specific surface area (S BET ) and the average pore diameter of the materials were determined by nitrogen sorption measurements using the Brunauer−Emmett−Teller (BET) method, while scanning electron microscopy and transmission electron microscopy were used to observe their morphology and particle size, respectively. The PXRD of all the activated carbon materials exhibited peaks at 2θ values of 12.7 and 13.9°corresponding to a d-spacing of 6.94 and 6.32 Å, respectively. The N 2 adsorption−desorption isotherm of the materials are of type II with nanocomposites showing enhanced S BET compared to the pristine ZnBTC. The results also revealed that activated carbons from the banana peel and the derived nanocomposites exhibited better porous structure parameters than those obtained from orange peel. The degradation efficiency of methyl orange in aqueous solutions using ZnBTC as a photocatalyst was found to be 52 %, while that of the nanocomposites were enhanced up to 79 %.
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