TMP/SMX toxicity should be considered in the differential diagnosis of HIV-infected patients with acute metabolic acidosis. Metabolic acidosis can be expected to resolve shortly after discontinuation of the drug.
The clinical manifestations of acute Q fever may differ markedly from country to country. In this regard, fever and hepatitis seem to be the dominant clinical features of acute Coxiella burnetii infection in Lanzarote, Canary Islands. A possible interaction between environmental factors and some strains of C. burnetii could explain the different clinical presentations of acute Q fever.
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