ABSTRACT
Liver involvement is an unusual manifestation of Mycoplasma pneumoniae infection. Cases of cholestatic hepatitis without pulmonary involvement have been described in children with M. pneumoniae infection but only two cases of cytolytic hepatitis have been reported in adults. We report here the case of an 18-year-old woman who presented with febrile epigastric pain of short duration associated with an elevation of gamma-glutamyl transpeptidase and alkaline phosphatase levels and with a mononuclear syndrome. Serological tests for M. pneumoniae were positive for IgG and IgM. Clinical symptoms and blood test perturbations completely resolved after treatment with macrolide.
Subject(s)
Cholestasis, Intrahepatic/microbiology , Hepatitis/microbiology , Pneumonia, Mycoplasma/diagnosis , Acute Disease , Adolescent , Anti-Bacterial Agents/therapeutic use , Cholestasis, Intrahepatic/drug therapy , Female , Hepatitis/drug therapy , Humans , Pneumonia, Mycoplasma/drug therapy , Roxithromycin/therapeutic useABSTRACT
OBJECTIVE: HemoCue is routinely used to manage bleeding patients, but few studies have evaluated its accuracy in this population. We compared HemoCue with laboratory determination of blood hemoglobin in patients with gastrointestinal bleeding. DESIGN AND SETTING: A prospective observational study in a 14-bed medicosurgical ICU and an emergency department in an urban general hospital. PATIENTS: 94 patients admitted to the emergency department or to the ICU for gastrointestinal bleeding. INTERVENTIONS: Blood was drawn at admission to measure laboratory hemoglobin and capillary hemoglobin was measured simultaneously by HemoCue. The unit of hospitalization and the presence or absence of impaired vital signs (tachycardia and/or hypotension and/or shock) were recorded. MEASUREMENTS AND RESULTS: The mean difference between HemoCue and hemoglobin (bias) was -0.06 g/dl and standard deviation (precision) 0.87 g/dl. (95% CI -1.8 to 1.68). Discrepancies between HemoCue and hemoglobin were greater than 1 g/dl in 21% of cases. Bias was comparable between patients admitted to the ICU and those in the emergency department. The accuracy of HemoCue was not affected by the presence of impaired vital signs or by a hemoglobin level below 9 g/dl or 7 g/dl. CONCLUSIONS: Although we demonstrated a low bias between HemoCue and blood hemoglobin determination, large HemoCue vs. hemoglobin differences may still occur, and therefore therapeutic decisions based upon capillary HemoCue alone should be very cautious.
Subject(s)
Gastrointestinal Hemorrhage/blood , Hemoglobins , Hemoglobinometry/methods , Humans , Intensive Care Units , Prospective Studies , Reproducibility of ResultsABSTRACT
The field of application for endoscopic hemoclips has been increasingly extended, especially thanks to improvements in clips and additional clinical indications. Hemoclips are used more frequently for upper gastrointestinal (GI) bleeding and sometimes after therapeutic endoscopy. We report the successful use of endoscopic hemoclips in the management of two cases of postoperative colonic haemorrhage.
