A 72-year-old woman developed a lichen planus pemphigoides-like eruption following the administration of cinnarizine. The eruption recurred on challenge with the drug. Direct immunofluorescence studies of the lesions demonstrated deposition of IgG, IgM and C3 on colloid bodies and fibrin at the epidermal basement membrane zone. Circulating IgG antibasement membrane zone antibodies were detected at high titres, with no complementfixing activities. To our knowledge, this is the first report of immunologically defined lichen planus pcmphigoides induced by a drug.

No abstract

Based on the results presented here, the severity rating proposed in this guideline for HAP appears reasonable, as the response rate for the first-line antibiotic was better in Group II than in Groups III and IV. It will be important to analyse 'clinical outcome' in accordance with this guideline.

Background and Methods: We compared the bacteriological, pharmacological and histopathological effects of parenterally administered ciprofloxacin (CPFX) to those of imipenem/cilastatin (IMP/CS) and cefozopran (CZOP) in a murine model of mucoid Pseudomonas aeruginosa pneumonia mimicking ventilator-associated pneumonia. Results: The minimum inhibitory concentrations (MICs) of CPFX, IMP and CZOP were 1.0, 1.0 and 4.0 mg/l, respectively. Treatment with CPFX resulted in a significant decrease in the number of viable bacteria [control, IMP/CS, CZOP and CPFX (mean ± SEM): 5.02 ± 0.20, 4.96 ± 0.38, 5.44 ± 0.13 and 3.27 ± 0.02 log₁₀ colony-forming units lung, respectively]. Histopathological examination revealed that inflammatory changes in the CPFX-treated group were less marked than in other groups. Of the drugs analyzed, the pharmacokinetic parameters of area under the time-concentration curve (AUC)/MIC, AUC exceeding MIC and the time that lung concentrations of drug remained above the MIC were highest for CPFX. Conclusion: Our results suggest that parenterally administered ciprofloxacin is effective in ventilator-associated P. aeruginosa pneumonia.

A 63-year old female was admitted because of an abnormal shadow on chest X-ray film. Chest CT showed a nodular shadow in the right S6 and a patchy shadow in the right S10. Right lower lobectomy was performed under a diagnosis of lung cancer made by TBLB in the right S6. Pathological examination of the resected lung revealed papillary adenocarcinoma in the right S6 and numerous cryptococci in the right S10. No cryptococcal infection was found in the resected lymph nodes.