Sharath Madhyastha

Meropenem induced hypokalemia

Meropenam, a beta-lactam antibiotic has been used for severe infections of skin, tissue, intra- abdominal and urogenital infections in hospitalized patients. The common adverse effects reported are diarrhoea, vomiting, rashes and hypersensitivity reactions. Here we report two cases of meropenam induced hypokalemia, wherein, meropenam was prescribed for cellulitis and urinary tract infection in the first and second case respectively. Hypokalemia can manifest as muscular weakness, fatigue, muscle cramps, constipation, ileus, flaccid paralysis, hyporeflexia, hypercapnia, tetany, rhabdomyolysis or respiratory failure. Hence, it is necessary to make physicians aware of such an adverse effect which can develop with meropenam.

A Case of Accidental Formic Acid Poisoning

Formic acid is a commonly available compound, available commercially for the purpose of coagulating rubber. It is a highly corrosive agent. Consumption of this pungent liquid has resulted in dire consequences, based on the available literature. There have been a few reports of accidental/suicidal consumption of formic acid in the past. This is one such case report of an accidental poisoning with formic acid, with successful management and recovery.

HALF AND HALF NAIL OR LINDSAY’S NAIL

A 62-year-old diabetic patient came to the outpatient department due to increasing tiredness in the past few months. On examination, his distal half of fingernails revealed pinkish red transverse band which is sharply demarcated by a dull white band proximally, consistent with half and half nail. Further evaluation showed evidence of chronic kidney disease due to long standing poorly controlled diabetes. Although half and half nail is seen in many conditions, it is relatively a specific clinical marker of end stage kidney disease and hence serves as an important diagnostic clue.