Prednisolone
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Tuberculosis, Strongyloides-stercoralis infection and oral candidiasis A 62-year-old woman developed tuberculosis, Strongyloides-stercoralis infection and oral candidiasis during treatment with prednisolone for immune thrombocytopenia. The woman, who presented with gum and skin bleeding was subsequently diagnosed with immune thrombocytopenia. She was started on prednisolone 40mg [route not stated] resulting in improved platelet count. Prednisolone was not tapered for 6 months. Later, she presented with loose stool, productive cough and fever. On examination she had face puffiness, oedema, oral candidiasis and crackles bilaterally. Stool examination showed larva of Strongyloides-stercoralis. Consequently, she was diagnosed with Strongyloides-stercoralis infection. A chest x-ray revealed consolidation in right middle and lower zone. Pleural fluid analysis suggested of tuberculosis with secondary infection. A CECT-thorax revealed feature suggestive of pulmonary koch with empyema thoracis [duration of treatment to reactions onsets not stated]. The woman’s prednisolone was tapered off quickly over next 10 days. She was treated with ivermectin, albendazole, unspecified antitubercular drugs and supportive medications. Subsequently, she improved with this treatment. Niangneihching T, et al. Immune thrombocytopenia: An atypical presentation. Indian Journal of Hematology and Blood Transfusion 35 (Suppl.): S61-S62 abstr. 7, No. 1, Jan 803503075 2019. Available from: URL: http://doi.org/10.1007/s12288-019-01207-5 [abstract]
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Reactions 26 Sep 2020 No. 1823
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