amoxycillin/clavulanate / Generic mfg. - LARVOL DELTA

Smoking Cessation Leading to Ulcerative Colitis and Autoimmune Pancreatitis (ACG 2025) - "Here, we present a case of a 37-year-old-male who was newly diagnosed with both pancreatitis and severe pancolonic UC that manifested after abrupt smoking cessation.Case Description/ A 37-year-old male with a history of alcohol and tobacco use disorder presented with nausea, vomiting, diarrhea, and abdominal cramping that resolved with amoxicillin-clavulanic acid...He was transitioned to oral steroids on discharge and then initiated on infliximab and azathioprine therapy, with complete resolution UC symptoms and parenchymal pancreas injury and lesion on cross-sectional imaging with MRI...Tobacco smoking has been associated with significantly more pancreatic damage, and potentially disease relapse rates, impacting the clinical course and increasing rates of complications, such as diabetes or exocrine pancreatic insufficiency. This case highlights the complex role of nicotine in immune modulation and clinical course of UC and AIP.Figure: Figure 1: Index colonoscopy during..."

Colorectal Cancer • Diabetes • Gastroenterology • Gastrointestinal Disorder • Immune Modulation • Immunology • Inflammation • Inflammatory Bowel Disease • Metabolic Disorders • Nicotine Addiction • Pancreatitis • Tobacco Addiction • Tobacco Cessation • Ulcerative Colitis

Cytological diagnosis of paracoccidioidomycosis in pleural fluid (ECP 2025) - " The hospitalized patient initially received treatment with Koide D and Dipyrone...Subsequently, Amoxicillin and Clavulanate were prescribed. After seeking care at another hospital, Clarithromycin, Atrovent inhalations, and another course of corticosteroids were added to her treatment regimen... Diagnosing paracoccidioidomycosis through pleural fluid cytology presents a significant challenge due to the rarity and complexity of identifying Paracoccidioides brasiliensis. This case underscores the importance of meticulous cytological evaluation, particularly in patients who do not respond to conventional treatments for respiratory symptoms. Accurate identification of the fungus is crucial for effective clinical management, highlighting the value of cytology as a vital, though sometimes underutilized, diagnostic tool in complex clinical scenarios."

Cough • Infectious Disease • Pulmonary Disease • Respiratory Diseases

Coexisting hepatic actinomycosis and IgG4-related disease mimicry: a diagnostic challenge (ECP 2025) - "A multidisciplinary team agreed to treat the patient with amoxicillin/clavulanate... This unique case highlights the diagnostic complexity of hepatic lesions with IgG4 positivity in the context of infection and emphasizes the importance of differentiating between IgG4-RD and conditions that mimic it. Although persistent IgG4 elevation may be misleading, microbiological studies confirmed Actinomyces and Fuso-bacterium co-infection, allowing appropriate treatment without unnecessary intervention for IgG4-RD. At the most recent follow-up, there was a marked clinical improvement and a significant reduction in the size of the liver mass."

Anemia • Cardiovascular • Endocrine Disorders • Fibrosis • Hepatology • Immunology • Infectious Disease • Inflammation • Thrombosis

A Rare Case of TMP-SMX Induced Idiosyncratic Drug-Induced Liver Injury (ACG 2025) - "Direct DILI (dDILI) is dose-dependent, predictable, and commonly linked to agents such as acetaminophen, aspirin, tetracyclines, and vitamin A. In contrast, idiosyncratic DILI (iDILI) is dose-independent, unpredictable, and difficult to replicate in preclinical models...Agents such as amoxicillin-clavulanate, isoniazid, ciprofloxacin, and trimethoprim-sulfamethoxazole (TMP-SMX) have been implicated among antibiotics.Case Description/ We present a case of a 59-year-old female with no significant medical history who developed iDILI following a short course of TMP-SMX...TMP-SMX was discontinued, and she was treated with prednisone, famotidine, and diphenhydramine...Given the widespread use of TMP-SMX, clinicians should maintain a high index of suspicion for iDILI, particularly in patients presenting with systemic symptoms after recent drug exposure. Prompt identification, cessation of the offending agent, and supportive care are essential to prevent progression to severe..."

Clinical • Cardiovascular • Dermatology • Fatigue • Hepatology • Infectious Disease • Liver Failure • Musculoskeletal Pain • Nephrology

A Rare Complication of Hepatic Cysts in Advanced Autosomal Dominant Polycystic Kidney and Liver Disease (ACG 2025) - "Patient was empirically started on intravenous meropenem and later de-escalated to ampicillin-sulbactam...The patient improved clinically and was discharged on oral amoxicillin-clavulanate, with plans for outpatient dialysis, and outpatient kidney and liver transplant evaluation. This case highlights a rare, but serious complication of ADPKD/PLD: hepatic cyst infection leading to sepsis and AKI on CKD...Figure: Figure 1: Non-contrast CT Imaging of the Abdomen Showing Extensive Polycystic Changes in Both Kidneys and Liver, Consistent with Advanced Autosomal Dominant Polycystic Kidney and Liver Disease. Liver cyst with measurement (13.8 cm x 11 cm) indicates the hepatic cyst that was drained percutaneously, with 1000 mL serous drainage output."

Metastases • Autosomal Dominant Polycystic Kidney Disease • Chronic Kidney Disease • Genetic Disorders • Hepatology • Infectious Disease • Nephrology • Polycystic Kidney Disease • Renal Disease • Septic Shock

Rare but Real: Doxycycline-Induced Hepatocellular Liver Injury (ACG 2025) - "Several antibiotics are commonly associated with DILI, such as amoxicillin-clavulanate, sulfonamides, and isoniazid. This case emphasizes the importance of high suspicion of DILI, even with antibiotics considered relatively safe.Figure: Figure 1. Trend of LFTs improvement after doxycycline discontinuation"

ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Fatigue • Hepatology • Immunology • Infectious Disease • Inflammation • Inflammatory Arthritis • Liver Failure • Lyme Disease • Psychiatry

Lawsonella clevelandensis as a Rare Cause of Complex Liver and Abdominal Wall Abscess: A Case Report and Literature Review (ACG 2025) - "The patient improved following insertion of three separate pig-tail drains and treatment with broad spectrum intravenous antibiotics that were eventually transitioned to oral amoxicillin-clavulanic acid...Clinicians should pursue molecular diagnostics when conventional cultures fail and involve infectious diseases specialists early. Recognition of this elusive pathogen can facilitate timely diagnosis and appropriate therapy, reducing morbidity associated with delayed or inadequate treatment.Figure: Contrast abdominal CT showing liver abscess at initialpresentation.Figure: Contrast abdominal CT showing abscess improvement fivemonths after initial presentation"

Case report • Clinical • Review • Diabetes • Gastrointestinal Disorder • Hepatology • Infectious Disease • Metabolic Disorders

A Rare Case of Fusobacterium Nucleatum Causing Greater Than 20 Pyogenic Hepatic Abscesses (ACG 2025) - "He was started on a heparin drip for the nonocclusive portal vein thrombus and piperacillin/tazobactam...The patient was discharged against medical advice with amoxicillin/clavulanic acid and apixaban. This case presents a patient with no significant periodontal disease however, found to have Fusobacterium nucleatum bacteremia. There have been some associations of the bacteria with colon cancer, which remains a risk in this patient has he had no historical colonoscopies. However, this case highlights the extensive disease with numerous abscess that may be formed with the organism requiring both drainage and long-term antibiotic therapy.Figure: Computed tomography of the abdomen demonstrating multi-level views of the liver with numerous, complex cystic appearing lesions with largest hepatic lesion measuring 6 cm."

Clinical • Colon Cancer • Colorectal Cancer • Dental Disorders • Hepatology • Human Immunodeficiency Virus • Infectious Disease • Pancreatitis • Periodontitis • Solid Tumor • Thrombosis

Mesenteric Venous Ischemia Due to Splanchnic Venous Thrombosis in a Case of Clostridioides difficile Colitis (ACG 2025) - "Two weeks prior, he was treated for presumed diverticulitis at urgent care with amoxicillin-clavulanate but noted worsening symptoms...The patient began a 10-day course of vancomycin and apixaban with symptomatic improvement...showed almost twice the chance of VTE formation in C. diff positive versus negative patients (p = 0.049). Abdominal deep vein thromboses should be considered in the setting of C. diff colitis given risks in morbidity and mortality.Figure: Figure 1: CT angiogram showing filling defects are noted again in the posterior right portal vein branch.Figure: Figure 2: CT angiogram showing thrombus at the distal aspect of the main portal vein at the portal splenic confluence."

Clinical • Cardiovascular • Crohn's disease • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Hypertension • Immunology • Infectious Disease • Inflammation • Inflammatory Bowel Disease • Septic Shock • Thrombosis • Venous Thromboembolism

A Case Report of Clostridium perfringens Bacteremia Following Colorectal Cancer Resection (ACG 2025) - "Infectious Disease was consulted and recommended treatment with ampicillin-sulbactam with the transition to oral amoxicillin-clavulanate upon discharge. CT abdomen and pelvis showing colitis in the sigmoid colon (red arrows).Figure: Figure 2. CT abdomen and pelvis showing colitis in the descending colon (red arrows) and colonic hyperemia (blue arrow)."

Case report • Clinical • Biliary Cancer • Colon Cancer • Colorectal Cancer • Gastroenterology • Gastrointestinal Cancer • Gastrointestinal Disorder • Genito-urinary Cancer • Immunology • Infectious Disease • Nephrology • Neutropenia • Oncology • Prostate Cancer • Renal Disease • Solid Tumor

Primary HSV Esophagitis in an Immunocompetent Young Adult: A Diagnostic Challenge (ACG 2025) - "He was started on amoxicillin-clavulanate. However, due to lack of improvement, noticeable tonsillar enlargement, and worsening odynophagia, treatment was escalated with clindamycin and dexamethasone...Empiric treatment with fluconazole, acyclovir, esomeprazole, and continued clindamycin was initiated...Endoscopic images showing esophageal ulcerations and exudates indicative of Herpes Simplex Virus (HSV) infection. The left image shows early-stage ulceration with white exudate, while the right image demonstrates more extensive ulcerations and mucosal damage"

Clinical • Gastrointestinal Disorder • Herpes Simplex • Human Immunodeficiency Virus • Infectious Disease • Otorhinolaryngology

Gastric Delay, Bacterial Display: Sarcina Ventriculi in Gastroparesis (ACG 2025) - "Based on clinical presentation, the patient was treated with oral metronidazole 500 mg for 10 days.At the three-month follow-up, the patient reported complete resolution of symptoms...Reported antibiotic regimens include metronidazole, ciprofloxacin, amoxicillin-clavulanate, penicillin, or tetracyclines, often combined with proton pump inhibitors to reduce gastric acidity. Further studies are needed to clarify the pathogenic mechanisms and to establish when antimicrobial treatment is warranted. Until then its presence in gastroparesis cases should not be dismissed.Figure: Figure 1: Sarcina ventriculi histological examination"

Constipation • Diabetes • Dyspepsia • Gastroenterology • Gastroesophageal Reflux Disease • Gastrointestinal Disorder • Infectious Disease • Inflammation • Metabolic Disorders • Respiratory Diseases

Cholecystoenteric Fistula Presenting with Acute Cholecystitis and Acute Diverticulitis (ACG 2025) - "After 2 days of piperacillin-tazobactam he completed oral amoxicillin-clavulanate. Gallbladder distention with pericholecystic fat stranding.Figure: Figure 2. Fluoroscopic-guided placement of a cholecystectomy tube."

Gastroenterology • Gastrointestinal Disorder • Hepatology • Infectious Disease • Inflammation

A Rare Case of Pylephlebitis Arising From Sigmoid Diverticulitis (ACG 2025) - "Patient was treated with ampicillin-sulbactam and discharged on amoxicillin-clavulanate. Thrombophlebitis was thought to be provoked, heparin drip was initiated, and transitioned to Eliquis with plans for 3 months of therapy...It was seen that these individuals did not have an underlying hypercoagulable state or mesenteric vein involvement. Overall, the decision to use anticoagulation should be individualized to patient risk factors and comorbidities."

Clinical • Cardiovascular • Fibrosis • Gastroenterology • Gastroesophageal Reflux Disease • Gastrointestinal Disorder • Hematological Disorders • Hepatology • Hypertension • Immunology • Infectious Disease • Pancreatitis • Portal Hypertension • Thrombosis

Beyond Probiotics: Lactobacillus paracasei Infection in a Ruptured Hepatic Cyst Mimicking Malignancy (ACG 2025) - "Due to size, location, and vascular involvement, she was not a surgical candidate and was started on ceftriaxone and metronidazole...Following drainage and stabilization, she was discharged on oral amoxicillin-clavulanate to rehabilitation. This case highlights an unusual but serious complication of probiotic-associated Lactobacillus paracasei infection leading to hepatic cyst abscess, rupture, and septic shock...Satellite lesions appeared T2 hypointense (brown arrows).C. Diffusion Weighted Image and D. corresponding ADC Map showing restricting satellite lesions with peripheral restriction in the larger cystic lesion."

Cardiovascular • Hepatology • Infectious Disease • Oncology • Septic Shock

Abscess Denied: Hepatic Abscess in a Young Patient With Diabetic Ketoacidosis (ACG 2025) - "He was treated with intravenous antibiotics and transitioned to oral fluconazole and amoxicillin/clavulanate for 6 weeks...The combination of chronic bilirubin elevation and rectosigmoid inflammation raises concern for underlying inflammatory bowel disease or biliary pathology (e.g., primary sclerosing cholangitis), which may predispose to PLA.1 Because patients can present with nonspecific symptoms and laboratory findings, the presence of predisposing factors can be helpful in increasing the level of diagnostic suspicion to prompt work up. Clinicians should consider PLA in immunocompromised individuals who present with unexplained liver enzyme changes, even without overt signs of infection"

Clinical • Diabetes • Gastroenterology • Gastrointestinal Disorder • Hepatology • Immunology • Infectious Disease • Inflammation • Inflammatory Bowel Disease • Metabolic Disorders • Type 2 Diabetes Mellitus

Hidden Hepatotoxicity: Amoxicillin-Clavulanate-Induced Liver Injury in a Diabetic Patient (ACG 2025) - "Cholestatic hepatitis: Hepatocytes exhibiting cytoplasmic bile pigment and a moderate chronic inflammatory infiltrate at the interface and periportal areas, with sparse neutrophils (A). Bile duct proliferation is observed, accompanied by areas of fibrosis (B)."

Clinical • Dermatology • Diabetes • Fibrosis • Hepatology • Immunology • Inflammation • Liver Failure • Metabolic Disorders • Type 2 Diabetes Mellitus • HLA-DRB1

Removing the Benign on Routine Colonoscopy: A Rare Case of Appendiceal Inversion (ACG 2025) - "Patient was prescribed a five-day course of amoxicillin/clavulanic acid for infection prophylaxis and instructed to seek medical attention for infectious symptoms or bleeding signs...Pedunculated polyp at the appendiceal orificeFigure: Figure 2. Status post snare polypectomy and placement of three hemostatic clips"

Clinical • Colon Cancer • Colorectal Cancer • Cystic Fibrosis • Genetic Disorders • Immunology • Infectious Disease • Respiratory Diseases • Solid Tumor

An Uncommon Cause of Esophageal Perforation in a Patient with Chronic Pancreatitis (ACG 2025) - "The patient had an uncomplicated hospital course, received broad-spectrum antibiotics and antifungals, and was discharged on oral fluconazole and amoxicillin-clavulanate. This rare mechanism underscores the importance of considering esophageal perforation in patients with obstructive GI symptoms presenting with back or chest pain. Rapid multidisciplinary intervention was crucial to survival.Figure: Esophageal PerforationFigure: Fully covered metal stent placement"

Clinical • Addiction (Opioid and Alcohol) • Back Pain • Cardiovascular • Gastrointestinal Disorder • Musculoskeletal Pain • Pancreatitis

Augmentin-Induced Pancreatitis: A Case Report (ACG 2025) - "Here, we report a rare case of acute pancreatitis associated with Augmentin (amoxicillin-clavulanate)Case Description/ A 24-year-old male with no significant past medical history presented with acute epigastric pain radiating to the back, accompanied by nausea and vomiting...While rare, Augmentin should be recognized as a potential trigger. Early identification and cessation of the offending agent are key to recovery and prevention of recurrence."

Case report • Clinical • Dyslipidemia • Endocrine Disorders • Gastroenterology • Hypertriglyceridemia • Immunology • Metabolic Disorders • Otorhinolaryngology • Pancreatitis • Respiratory Diseases • Sinusitis

Antibiotic-Induced Ischemic Colitis: A Case of Amoxicillin-Associated Vascular Compromise (ACG 2025) - "After his first episode of colitis with suspicion for possible infectious etiology, the patient was placed on amoxicillin-clavulanate despite unremarkable infectious work-up...10x: Acute inflammatory exudate (pseudomembranes) on the mucosa (*), superficial mucosal damage (arrows) with underlying crypt dropout (withering) in middle image. 20x: Acute inflammatory exudate (*) on the mucosa, mucosal surface damage, lamina propria hyalinization, mucosal necrosis and vascular congestion in bottom image."

Clinical • Cardiovascular • Congestive Heart Failure • Gastroenterology • Gastrointestinal Disorder • Heart Failure • Immunology • Infectious Disease • Inflammatory Bowel Disease • Septic Shock • Vasculitis

Risk factors of methicillin-resistant Staphylococcus aureus colonization in the nasal cavity of people living with HIV: a cross-sectional study from Dongyang hospital, Zhejiang Province. (PubMed, Front Microbiol) - "MRSA had a high prevalence of resistance to a wide range of antibiotics, including penicillin, oxacillin, amoxicillin and amoxicillin/clavulanic acid...The study provides valuable insights into the characteristics and distribution of MRSA and MSSA cases, as well as the factors influencing the nasal carriage of Staphylococcus aureus, particularly MRSA, in PLWH. These findings can guide clinical practice and infection control measures to reduce the incidence and spread of MRSA infections in high-risk populations."

Journal • Observational data • Human Immunodeficiency Virus • Infectious Disease • Respiratory Diseases

DOUBLE TROUBLE – RADIAL EBUS-GUIDED DIAGNOSIS OF UNDERLYING LUNG ADENOCARCINOMA MASQUERADING AS INFECTION (MTS 2025) - "Bronchoscopy and lavage cultured Klebsiella pneumoniae, and intravenous amoxicillin-clavulanate was initiated...Its success is influenced by lesion characteristics, bronchus sign, guide sheath use, and operator experience. Conclusion This case underscores the importance of considering malignancy in non-resolving pneumonia and demonstrates the effectiveness of radial EBUS-guided biopsy in achieving timely and accurate diagnosis."

Endobronchial ultrasound • Cardiovascular • Chronic Kidney Disease • Coronary Artery Disease • Cough • Diabetes • Infectious Disease • Lung Adenocarcinoma • Lung Cancer • Metabolic Disorders • Nephrology • Non Small Cell Lung Cancer • Oncology • Pneumonia • Renal Disease • Respiratory Diseases • Solid Tumor

WHEN IT'S NOT TB: A CASE OF STAPHYLOCOCCUS AUREUS CAVITARY LUNG ABSCESS MIMICKING PULMONARY TUBERCULOSIS (MTS 2025) - "Empirical antibiotic therapy with amoxicillin-clavulanate was initiated...Antibiotic therapy was adjusted to intravenous cefazolin, resulting in significant clinical and radiological improvement...Prompt identification and targeted antibiotic therapy are essential for favourable outcomes. Clinicians should maintain a high index of suspicion for bacterial lung abscesses in patients with cavitary lung lesions, even when tuberculosis is initially suspected."

Clinical • Cough • Infectious Disease • Respiratory Diseases • Tuberculosis • CRP

ENZYMATIC STABILITY OF CRYOPRESERVATION RT-PA IN PLEURAL INFECTION (MTS 2025) - "The pleural collection was drained, and intravenous Amoxicillin-Clavulanic Acid was initiated. In our case, cryofreeze Alteplase usage in our case showed significant clinical and radiological improvement. However more clinical studies needed to look into reliability of cryofreeze rt-PA and its cost effectiveness."

Cardiovascular • Cough • Hypertension • Infectious Disease • Respiratory Diseases