Résumé
A 47-year-old female patient was admission for back pain after she fell down on the table. T12 compression fracture was found for spinal magnetic resonance imaging. Absolute bed rest and pain control for non-steroidal anti-inflammatory drugs and muscle relaxant were received. After 7 days, she complained febrile sense, abdominal pain, and diarrhea. Septic shock was suspected, and then use of antibiotics and proper management were performed. Computed tomography of chest and abdomen was not revealed specific finding. Blood culture showed growth of Klebsiella pneumoniae. After patients completely resolved symptoms, colonoscopy was performed that showed erosive lesions of cecum, proximal A-colon, and rectum.
Sujets)
Adulte , Femelle , Humains , Adulte d'âge moyen , Abdomen , Douleur abdominale , Antibactériens , Dorsalgie , Alitement , Caecum , Colite , Coloscopie , Diarrhée , Fractures par compression , Klebsiella pneumoniae , Klebsiella , Imagerie par résonance magnétique , Rectum , Sepsie , Choc septique , ThoraxRésumé
Percutaneous mitral balloon valvuloplasty (PMBV) is the treatment of choice for mitral stenosis. Only a few reported cases have been reported in PMBV patients worldwide. In this study, a case of a 34 year-old female with infective endocarditis a year after PMBV is presented. The patient presented with fever, and peripheral vascular symptoms. Transthoracic echocardiography showed vegetation on the anterior mitral leaflets and Staphylococcus Viridans was isolated from blood cultures. The patient was successfully treated with Amoxicillin + Clavulate and Gentamicin. Further studies on the correlation between PMBV and infective endocarditis are needed.
Sujets)
Femelle , Humains , Amoxicilline , Valvuloplastie par ballonnet , Échocardiographie , Endocardite , Fièvre , Gentamicine , Sténose mitrale , StaphylococcusRésumé
PURPOSE: Hypersensitivity reactions to contrast media (CM) are one of the most common causes of drug adverse reactions. The overall prevalence of immediate hypersensitivity reaction (IHR) was 0.16%–7.7% to nonionic CM. Although IHR to CM has been traditionally considered nonallergic, there is growing evidence that the mechanism of IHR to CM is mediated by IgE. It can be severe, even fatal, and a legal problem. To reduce IHR, the prescreening skin test is on the rise. METHODS: We reviewed cases of IHR to CM during enhanced computed tomography (CT) from 2008 to 2015 at a secondary hospital in South Korea. Patients who underwent enhanced CT were performed the 2-step prescreening skin test before nonionic CM-enhanced CT. If patients had adverse reactions to CM, the reactions were reported. IHR to CM was defined as an immediate reaction within 1 hour after CM administration. The Ring and Messmer system was used to classify the severity of reactions by grades I to IV, and we defined grades III and IV as severe reactions. RESULTS: A total of 30,105 CM-enhanced CT cases were recruited from 2008 to 2015. A total 46 patients with CM adverse reactions were reported. The IHR were noted in 30 of the total patients (0.1%), of which 6 had severe reaction. CONCLUSION: The prevalences of IHR and severe IHR to CM were 0.1% and 0.02%, respectively. Further studies are needed to evaluate the usefulness of prescreening skin tests to prevent IHR to CM.
Sujets)
Humains , Produits de contraste , Hypersensibilité , Hypersensibilité immédiate , Immunoglobuline E , Corée , Prévalence , Tests cutanés , PeauRésumé
Eosinophilic gastroenteritis is an uncommon disease of unknown etiology that is characterized by massive tissue infiltration of eosinophils in the tissue layers of various areas of the gastrointestinal tract. An accurate diagnosis is difficult as clinical presentations, symptoms, endoscopic and radiologic findings are nonspecific. A 51-year-old man visited our hospital presenting with abdominal pain. Esophagogastroduodenoscopy revealed diffuse hyperemic mucosal lesions at the stomach, duodenum. Symptoms and endoscopic findings deteriorated rapidly after three days. Small amounts of eosinophilic infiltration without malignant cells was confirmed from biopsy. However, we could not exclude malignancy and performed a subtotal gastrectomy. Stomach specimen showed eosinophilic infiltrations, and the patient was finally diagnosed as eosinophilic gastroenteritis. We report a case of atypical eosinophilic gastritis with rapid deterioration mimicking Borrmann type 4 advanced gastric cancer.