Résumé
Here, we describe a case of acute disseminated encephalomyelitis (ADEM) that occurred during a plausible risk interval following inactivated influenza vaccination in a previously healthy 27-year-old man from Manaus, Brazil. He was treated with intravenous methylprednisolone and immunoglobulin. One-month follow-up revealed resolution of the brain lesions, but not of the spinal cord lesions. No recurrence or progression of the main neurological symptoms was observed. After two years of monitoring, the patient continues to experience weak lower limbs and urinary retention. Thus, we recommend that ADEM should be considered in a patient presenting with neurological symptoms after influenza vaccination.
.Sujets)
Adulte , Humains , Mâle , Encéphalomyélite aigüe disséminée/étiologie , Vaccins antigrippaux/effets indésirables , Encéphalomyélite aigüe disséminée/diagnostic , Imagerie par résonance magnétiqueRésumé
São relatados dois casos de pacientes com malária por Plasmodium falciparum, evoluindo com síndrome do choque. Receberam suporte hemodinâmico em unidade de terapia intensiva, sem uso de antibióticos, evoluindo com melhora. Malária álgida deve ser um diagnóstico sindrômico, de etiologia diversa (desidratação, infecção bacteriana, sangramento e/ou insuficiência adrenal).
Two patients with malaria due to Plasmodium falciparum who progressed to shock syndrome are reported. They received hemodynamic support in an intensive care unit without using antibiotics and presented improvements. Algid malaria should be a syndromic diagnosis of varying etiology (dehydration, bacterial infection, bleeding and/or adrenal insufficiency).