ABSTRACT
Encephalopathy is a disorder characterized by altered brain function, which can be attributed to various causes. Encephalopathy associated with metronidazole administration occurs rarely and depends on the cumulative metronidazole dose, and most patients with this condition recover rapidly after discontinuation of therapy. Because metronidazole is metabolized in the liver and can be transported by the cerebrospinal fluid and cross the blood-brain barrier, it may induce encephalopathy even at a low cumulative dose in patients with hepatic dysfunction. We experienced a patient who showed ataxic gait and dysarthric speech after receiving metronidazole for the treatment of hepatic encephalopathy that was not controlled by the administration of lactulose. The patient was diagnosed as metronidazole-induced encephalopathy, and stopping drug administration resulted in a complete recovery from encephalopathy. This case shows that caution should be exercised when administering metronidazole because even a low dose can induce encephalopathy in patients with liver cirrhosis.
Subject(s)
Humans , Male , Middle Aged , Anti-Infective Agents/adverse effects , Brain Diseases/chemically induced , Hepatic Encephalopathy/drug therapy , Liver Cirrhosis/complications , Magnetic Resonance Imaging , Metronidazole/adverse effects , Tomography, X-Ray ComputedABSTRACT
Subacute thyroiditis is a spontaneously resolving inflammatory disease of the thyroid gland, which is usually associated with a viral infection and genetic factors. In some cases of this disorder, thyroid autoantibodies can appear, probably due to the inflammatory release of thyroid antigens, althoughtheir pathophysiological role in the course of this disease is not yet fully understood. The occurrence of Graves' disease after subacute thyroiditis is extremely rare, and only a few cases have been reported. Here, we report a case of a middle-aged woman who developed Graves' disease after subacute thyroiditis.
Subject(s)
Female , Humans , Autoantibodies , Graves Disease , Thyroid Gland , Thyroiditis , Thyroiditis, SubacuteABSTRACT
Intramural hematoma of the gastrointestinal tract is an uncommon occurrence with the majority being localized to the esophagus or duodenum. Hematoma of the gastric wall is very rare, and has been reported most commonly in association with coagulopathy, trauma, hematologic disease, and therapeutic endoscopy. Here we describe a case of intramural gastric hematoma after epinephrine injection therapy for a gastric ulcer with underlying liver cirrhosis that was successfully managed with conservative therapy.
Subject(s)
Humans , Duodenum , Endoscopy , Epinephrine , Esophagus , Gastrointestinal Tract , Hematologic Diseases , Hematoma , Hemorrhage , Hemostasis, Endoscopic , Liver , Liver Cirrhosis , Stomach UlcerABSTRACT
Negative pressure pulmonary edema is a recognized complication of airway obstruction, particularly after endotracheal extubation. The application of oxygen therapy and continuous positive airway pressure with the administration of diuretics under a rapid diagnosis usually clears pulmonary edema. We report a case of 61-year-old man who developed negative pressure pulmonary edema following extubation after an endoscopic submucosal dissection under general anesthesia.
Subject(s)
Humans , Middle Aged , Airway Extubation , Airway Obstruction , Anesthesia, General , Continuous Positive Airway Pressure , Diuretics , Oxygen , Pulmonary EdemaABSTRACT
Pseudoaneurysm formation in the pulmonary vasculature is a rare but fatal condition. Several etiologies have been described including trauma, complication after cardiac or other surgeries, tuberculosis, necrotizing pneumonia, congestive heart disease, atherosclerosis, cancer and vasculitis. We report a case of pseudoaneurysm found in a patient being treated with status asthmaticus, who developed complications of pneumonia and brain abscess secondary to sepsis.