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1.
BMJ Case Rep ; 14(11)2021 Nov 29.
Article in English | MEDLINE | ID: covidwho-1546478

ABSTRACT

Primary amyloidosis is a rare systemic disorder often associated with multiple organ dysfunction. The most common form, light chain amyloidosis, has an estimated age-adjusted incidence of 5.1-12.8 cases per million person-years. Spine involvement is extremely uncommon. We present the case of a young Asian man with newly diagnosed amyloidosis involving the lumbar spine among multiple organs with a pathological vertebral fracture that required urgent spine surgery. We believe this is the first reported case to discuss the perianaesthetic challenges in the management of lumbar spine amyloidosis.


Subject(s)
Amyloidosis , Anesthetics , Immunoglobulin Light-chain Amyloidosis , Amyloidosis/surgery , Child , Child, Preschool , Humans , Lumbar Vertebrae/diagnostic imaging , Lumbar Vertebrae/surgery , Lumbosacral Region , Male
2.
BMJ Case Rep ; 14(10)2021 Oct 13.
Article in English | MEDLINE | ID: covidwho-1467681

ABSTRACT

COVID-19 presents with a spectrum of severity, ranging from asymptomatic or mild symptoms to those with acute respiratory distress syndrome. Corticosteroids are widely used for their efficacy in reducing inflammatory responses. However, its use may be limited to patients with immunosuppression. An adjunct therapy for cytokine storm in COVID-19 is extracorporeal blood purification therapies using high adsorptive filters, such as oXiris, to remove cytokines. We share our experience in using continuous renal replacement therapy with oXiris haemofilter as a temporising measure to high-dose corticosteroids in managing cytokine storm in a deteriorating COVID-19 patient with concomitant bacterial infection.


Subject(s)
Bacterial Infections , COVID-19 , Respiratory Distress Syndrome , Adrenal Cortex Hormones , Humans , SARS-CoV-2
3.
BMJ Case Rep ; 14(7)2021 Jul 26.
Article in English | MEDLINE | ID: covidwho-1327625

ABSTRACT

Anaesthesia for patients with severe lung fibrosis post COVID-19 infection requires special consideration. This is due to its propensity to cause perioperative anaesthetic catastrophe and possibility of cross infection among healthcare workers if not properly managed. This interesting article elaborates in detail the anaesthetic and surgical challenges in a morbidly obese patient who had a severe COVID-19 infection presenting for an elective spine surgery.


Subject(s)
COVID-19 , Obesity, Morbid , Elective Surgical Procedures , Humans , Obesity, Morbid/complications , Obesity, Morbid/surgery , SARS-CoV-2 , Spine/diagnostic imaging , Spine/surgery
4.
BMJ Case Rep ; 14(6)2021 Jun 08.
Article in English | MEDLINE | ID: covidwho-1262388

ABSTRACT

Tracheostomy is an aerosol-generating procedure and performing it in patients with COVID-19 requiring mechanical ventilation raises significant concerns of infection risk to healthcare workers. We herein report a case of tracheostomy in a critically ill patient with severe COVID-19 acute respiratory distress syndrome. This article depicts the use of personal protective equipment, highlighting the common challenges it presents and ways to address them.


Subject(s)
COVID-19 , Obesity, Morbid , Humans , Obesity, Morbid/complications , Personal Protective Equipment , SARS-CoV-2 , Tracheostomy
5.
BMJ Case Rep ; 14(2)2021 Feb 17.
Article in English | MEDLINE | ID: covidwho-1088211

ABSTRACT

Placement of a double-lumen tube to achieve one lung ventilation is an aerosol-generating procedure. Performing it on a patient with COVID-19 will put healthcare workers at high risk of contracting the disease. We herein report a case of its use in a patient with traumatic diaphragmatic rupture, who was also suspected to have COVID-19. This article aims to highlight the issues, it presented and ways to address them as well as the perioperative impact of personal protective equipment.


Subject(s)
COVID-19/prevention & control , Health Personnel/standards , Infectious Disease Transmission, Patient-to-Professional/prevention & control , One-Lung Ventilation/standards , Personal Protective Equipment/standards , Accidents, Traffic , Adult , COVID-19/diagnosis , COVID-19/transmission , Diaphragm/injuries , Diaphragm/surgery , Humans , Male , One-Lung Ventilation/instrumentation , Practice Guidelines as Topic , Respiratory Distress Syndrome/diagnosis , Respiratory Distress Syndrome/etiology , Respiratory Distress Syndrome/therapy , Rupture/etiology , Rupture/therapy
6.
BMJ Case Rep ; 14(2)2021 Feb 05.
Article in English | MEDLINE | ID: covidwho-1066846

ABSTRACT

A young man presented to our centre needing an urgent debridement of his postcraniotomy wound due to massive myiasis during the COVID-19 pandemic in October 2020. Prior to the surgery, his nasopharyngeal swab real-time PCR test result was unknown. One day later, it returned as SARS-CoV-2 positive. All healthcare workers who were involved in the patient management avoided cross infection as they wore appropriate personal protective equipment. This article depicts the importance of adequate preparations when handling potentially infectious patients and the perioperative issues associated with it.


Subject(s)
COVID-19/complications , Debridement/methods , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Myiasis/complications , Myiasis/surgery , Perioperative Care/methods , Scalp/surgery , Adult , COVID-19/prevention & control , Humans , Male , Personal Protective Equipment , SARS-CoV-2 , Young Adult
7.
BMJ Case Rep ; 14(1)2021 Jan 28.
Article in English | MEDLINE | ID: covidwho-1054637

ABSTRACT

Acute stridor is often an airway emergency. We present a valuable experience handling an elderly woman who was initially treated as COVID-19 positive during the pandemic in November 2020. She needed an urgent tracheostomy due to nasopharyngeal (NP) diffuse large B-cell lymphoma causing acute airway obstruction. Fortunately, 1 hour later, her NP swab real-time PCR test result returned as SARS-CoV-2 negative. This interesting article depicts the importance of adequate preparations when handling potentially infectious patients with anticipated difficult airway and the perioperative issues associated with it.


Subject(s)
Airway Obstruction/etiology , Anesthesia/methods , COVID-19/prevention & control , Lymphoma, Large B-Cell, Diffuse/complications , Nasopharyngeal Neoplasms/surgery , Tracheostomy/methods , Acute Disease , Airway Obstruction/surgery , Anesthesia, General , Anesthesia, Local , Anesthetists , Diagnosis, Differential , Female , Humans , Laryngoscopy/methods , Lung/diagnostic imaging , Lymphoma, Large B-Cell, Diffuse/diagnostic imaging , Lymphoma, Large B-Cell, Diffuse/surgery , Middle Aged , Nasopharyngeal Neoplasms/complications , Nasopharyngeal Neoplasms/diagnostic imaging , Nasopharynx/diagnostic imaging , Nasopharynx/surgery , Radiography/methods , SARS-CoV-2
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