Revolutionary medicine

This essay might be construed as something of a missive in the vein of Kropotkin’s “An Appeal to the Young,” from old radicals who accomplished little, to young radicals who must accomplish much. We intend our remarks as preliminary, for it will be the young who will re-make the world, and in the process they will learn much to teach their descendants. This essay draws on both Marxist and anarchist currents in its formulation of revolutionary medicine for the current situation. Marx is necessary for his analysis of capitalism, his historical materialism, for his labor theory of value, for his formulation of history as the history of class struggle, for his emphasis on praxis. Anarchism is necessary for its hatred of capitalism, emphasis on freedom, its defiance of authority, and its radical democracy

A Case Report of Antibiotic-Induced Aseptic Meningitis in Psoriasis.

Although frequently prescribed, certain antibiotics such as trimethoprim-sulfamethoxazole carry the risk of a rare yet life-threatening adverse effect, termed drug-induced aseptic meningitis. Morbidity can be avoided if the medication is identified and discontinued. Patients in reported cases tend to be female and have an autoimmune disease or prior adverse reaction to the offending agent. As a rare and poorly characterized condition, the subset of patients using antibiotics at risk for aseptic meningitis remains unclear; hence, cataloging these adverse events remains critical for better elucidating the disease. Here, we report a 62-year-old man with psoriasis and no prior history of sulfa allergy, who presented with a sudden onset of fever, chills, vomiting, and muscle aches 5 hours after taking single doses of trimethoprim-sulfamethoxazole and ciprofloxacin. Common infectious causes were ruled out, and his medications were discontinued. Despite initial symptom resolution with discontinuation, the patient neurologically deteriorated over the next two days before eventually recovering with supportive care. This case highlights the variable presentation of drug-induced aseptic meningitis. In contrast to previous reports of drug-induced aseptic meningitis, our patient was male, older than the median age of 40 years, and did not have a prior adverse reaction to the antibiotic. Furthermore, to the best of our knowledge, we report a possible case of antibiotic-induced aseptic meningitis in a patient with psoriasis. Lastly, the case emphasizes not only the value of a thorough medication history but also the importance of recognizing that patients may deteriorate in the first 48 hours before resolution