Résumé
Sepsis due to streptococcus pneumoniae has a high mortality. We report a retrospective review of 40 episodes of S pneumonia sepsis in adult patients during a two yaer period in a general hospital, that represented 11,3 percent of all sepsis observed in such hospital. Ninety two percent of infections were community acquired and in 95 percent, the portal of entry was the respiratory tract. 85 percent of patients had at least one risk factor such as alcohol abuse, unconsciousness of chronic pulmonary disease. Nine patients had suppurative complications (empyema in 4 cases, spontaneous bacterial peritonitis in 2, septic arthritis in 2 and meningitis in 1 case) and 12 (30 percent) died. The potential benefit of antipneumococcal vaccine as prevention should be considered in high risk subjects
Sujets)
Humains , Mâle , Femelle , Adolescent , Adulte , Adulte d'âge moyen , Streptococcus pneumoniae/pathogénicité , Sepsie/épidémiologie , Infections à streptocoques/épidémiologie , Infections de l'appareil respiratoire/épidémiologie , Causalité , Troubles de la conscience/complications , Diabète/complications , Alcoolisme/complications , Troubles nutritionnels/épidémiologie , Répartition par âge , Répartition par sexe , Infection croisée/épidémiologieRésumé
Accidental hypothermia, a condition seldomly seen in Chile, is defined as a spontaneous core temperature reduction to less than 35§ C and is associated with great morbidity and mortality. We report a 16 years old female intoxicated with liquefied petroleum gas that was admitted in coma, hypothermic, with severe hemodynamic derangement, lactic acidosis, rhabdomyolysis and iliofemoral phlebothrombosis. Peritoneal dialysis with solutions at 27§ C was used as a quick and safe means to revert hypothermia and avoid its complications
Sujets)
Humains , Femelle , Adolescent , Intoxication au gaz/complications , Hypothermie/thérapie , Dialyse péritonéale , Thrombophlébite/complications , Thrombose , Troubles de la conscience/complications , Hypothermie/complications , Hypothermie/physiopathologie , Hypothermie/thérapie , Acidose lactique/complications , Hypotension artérielle/complications , Rhabdomyolyse/complicationsRésumé
En los pacientes con fatores de riesgo, tales como los portadores de enfermedades respiratorias crónicas; los sujetos con compromiso de conciencia (alcohólicos, epilépticos, comatosos; los enfrmos con accidentes vasculares encefálicos); los ancianos y los unmunodeprimidos; las neumopatías agudas son atípicas en sus manifestaciones clínicas y en su evolución; tienden a la recurrencia y a la abscedación y son provocadas por gérmenes especiales, tales como anaerobios y Gram negativos (Klebsiella pneumoniae, Proteus mirabilis, Pseudomona aeruginosa, etc.) En los pacientes infectados por virus de la inmunodeficiencia humana adquirida hay que tener presente la posibilidad de lesiones pulmonares tuberculosas y las neumopatías por Pneumocystis carinii
Sujets)
Pneumopathie infectieuse/épidémiologie , Alcoolisme/complications , Troubles de la conscience/complications , Diabète/complications , Infections bactériennes à Gram négatif/diagnostic , Pneumopathie de déglutition/diagnostic , Pneumopathie infectieuse/étiologie , Maladies pulmonaires/complications , Pneumonie à Pneumocystis/diagnostic , Facteurs de risque , Déficits immunitaires/complicationsRésumé
A síndrome maligna (SM) é uma reaçäo idiossincrásica e potencialmente fatal ao uso de neurolépticos, caracterizada por febre, rigidez muscular, alteraçöes da consciência e disfunçöes autonômicas. No presente trabalho, apresentamos uma revisäo da literatura sobre a SM nos últimos oito anos, a luz da qual discutimos um possível novo caso que ilustra as dificuldades e a importância de um diagnóstico precoce, condiçäo fundamental para um tratamento efetivo e uma evoluçäo bem-sucedida da SM. Fazemos ainda sugestöes quanto a procedimentos necessários ao pronto diagnóstico, bem como ressaltamos aspectos importantes para futuros estudos