ABSTRACT
Ethylene glycol is the active ingredient used in radiator antifreeze. Severe ingestions of ethylene glycol are uncommon in Australia, but if untreated, can result in multiorgan dysfunction, particularly renal failure and cerebral oedema. We report on a patient who consumed a large quantity of ethylene glycol. He was treated with enteral ethanol and went on to make a full recovery, despite an initial moribund state. We briefly review the pathophysiology and current treatment strategies for ethylene glycol intoxication, and discuss issues surrounding enteral versus parenteral ethanol administration.
Subject(s)
Ethanol/therapeutic use , Ethylene Glycol/poisoning , Suicide, Attempted , Adult , Ethanol/administration & dosage , Humans , Male , Treatment OutcomeABSTRACT
Group B streptococcal (GBS) infections are increasing in incidence as a cause of serious disease in the adult population. Risk factors for this infection include age, diabetes mellitus, liver disease, history of stroke, breast cancer and HIV infection, which are all becoming more common. We report a patient with severe GBS meningitis who made a good recovery following appropriate treatment, despite a delay in specific diagnosis of the organism. We believe this to be the first case of GBS meningitis in a non-pregnant adult in Australia or New Zealand to be reported in the literature.
Subject(s)
Meningitis, Bacterial/physiopathology , Streptococcal Infections/physiopathology , Streptococcus agalactiae/pathogenicity , Anti-Bacterial Agents/therapeutic use , Comorbidity , Female , Humans , Meningitis, Bacterial/diagnosis , Meningitis, Bacterial/drug therapy , Middle Aged , Streptococcal Infections/diagnosis , Streptococcal Infections/drug therapy , Streptococcus agalactiae/isolation & purificationABSTRACT
OBJECTIVE: To review the frequency of use, possible efficacy and safety profile of Prothrombinex-HT (CSL Bioplasma, Melbourne, VIC) in treatment of patients with microvascular bleeding refractory to standard measures after cardiothoracic surgery. METHODS: A retrospective chart review was performed of 60 consecutive cardiothoracic surgical patients who received Prothrombinex-HT between February and August 2003. Data collected included baseline demographic information, nature and complexity of surgery, preoperative medications, baseline haematological parameters and evidence of clinically significant prothrombotic complications. Consumption of blood products, haematological parameters and mediastinal bleeding rates before and after administration of Prothrombinex-HT were documented in 22 patients who received Prothrombinex-HT in the ICU. RESULTS: No major prothrombotic complications were noted in the series of 60 patients. Two patients had superficial thrombophlebitis. Blood product consumption and haematological parameters were markedly reduced after administering Prothrombinex-HT. CONCLUSIONS: Use of Prothrombinex-HT was not associated with significant prothrombotic complications. Limited evidence of its efficacy suggests that it should be further evaluated in the setting of cardiothoracic surgery.
