Mycobacterium gordonae is a slow-growing acid-fast bacilli mycobacterium with low pathogenic potential. Patients with this infection are treated with antimycobacterial agents such as ethambutol, clarithromycin, and rifampin. We present a rare side effect of ethambutol causing peripheral neuropathy, along with regression of this upon discontinuation of the inciting medication. A 78-year-old male with a past medical history of lumbar degenerative disc disease and lumbosacral radiculopathy presented to the clinic with three weeks of progressively worsening rhinorrhea, nasal congestion, and productive cough with yellow sputum. After a bronchoalveolar lavage (BAL) and a chest computed tomography (CT) scan, he was diagnosed with an M. gordonae infection. He was started on a 12-month triple regimen of rifampin, clarithromycin, and highdose ethambutol. During the first three months of antibiotic therapy, the patient began to have symptoms of gastrointestinal upset and worsening numbness in bilateral lower extremities, especially at night. Because he was unable to tolerate these adverse effects, the patient stopped taking these medications three months into his 12-month course. Upon stopping the antimycobacterial therapy, the patient's neuropathy began to return to baseline. Based on imaging, electromyography (EMG), nerve conduction studies (NCS), and a literature search of antimycobacterial medicines, we concluded that the high dose of ethambutol is the most likely cause of this patient's peripheral neuropathy. An important takeaway is that while ethambutol is a well-known cause of optic neuritis, it may also lead to peripheral neuropathy, which may regress upon discontinuation of the medication.
In this study, we reviewed the laws and legal regulations that mandate banks and financial services organizations to implement anti-money laundering efforts which are responsible to detect and mitigate the risks of money laundering and modern financing. We examined the topics of money laundering and modern financing in greater depth to understand the risk factors related to each financial crime. Understanding the aspects of each financial crime is necessary to comprehend predicate offense typologies. We continued with a review and synthesis of the literature on money laundering and modern financing typologies. We concluded the review with an analysis of Gary Becker’s economic theory of criminal behavior and the neoclassical approach to criminal behavior. As suggested by the key concepts reviewed in this literature review, predicate offenses are evolving as prevailing conditions of society change. A major global challenge in recent times is the Covid-19 pandemic crisis which has increased financial risks worldwide (Klimczak et al., 2021). Understanding the different types of predicate offenses and typologies portrays a holistic process of how criminals launder money or finance modern acts. A review of the existing literature demonstrated intensive research on the topic of financial crime but there is a gap in the current legislative and financial risk management framework. The legislative and financial risk management framework detects economic uncertainties and risk factors requiring a reevaluation of financial risk measurement methodologies to mitigate the risk consequences of money laundering and modern financing activities. A best practice to provide a sound framework to manage financial risks is for U.S. banking and financial service company compliance managers to identify predicate offense typologies. American society could benefit from the results of the study (Klimczak et al., 2021). The banking and financial industries ought to be prepared for the future and continue to adapt to new emerging threats, varying consumer classification, and changing environment. It is essential for compliance leaders to implement public education initiatives and help their customers recognize their role in combating money laundering and modern financing activities. Overall, the study has contributed to positive social change by identifying predicate offense typologies that can help U.S. banking and financial services company compliance managers reduce the risks of money laundering and modern financing activities (Klimczak et al., 2021).
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