ABSTRACT
Pneumomediastinum is an uncommon finding in patients with diabetic ketoacidosis (DKA) and may occur spontaneously or secondary to an effort rupture of the oesophagus. Excluding oesophageal rupture is important, as delaying treatment increases the risk of mortality. We discuss a case of DKA complicated by vomiting, pneumomediastinum, pneumopericardium and air in the epidural space. Instead of fluoroscopic oesophagography, chest CT was used to investigate oesophageal rupture. We present an overview of case reports and retrospective studies illustrating the utility of chest CT in the investigation of oesophageal rupture over fluoroscopic oesophagography.
Subject(s)
Diabetes Mellitus , Diabetic Ketoacidosis , Esophageal Diseases , Mediastinal Emphysema , Thoracic Injuries , Humans , Mediastinal Emphysema/etiology , Mediastinal Emphysema/complications , Diabetic Ketoacidosis/complications , Diabetic Ketoacidosis/therapy , Retrospective Studies , Thorax , Tomography, X-Ray Computed/adverse effects , Esophageal Diseases/complications , Thoracic Injuries/complicationsABSTRACT
High energy trauma may cause injury to tracheobronchial structures. This is sometimes difficult to diagnose immediately. Pneumomediastinum and (bilateral) pneumothorax seen on a CT-scan of the thorax may suggest possible damage to central airways. Emergency bronchoscopy should be performed to detect and locate a possible tracheobronchial injury.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/adverse effects , Brain Neoplasms/chemically induced , Lung Neoplasms/drug therapy , Neoplasm Recurrence, Local/chemically induced , Small Cell Lung Carcinoma/drug therapy , Aged, 80 and over , Carboplatin/administration & dosage , Etoposide/administration & dosage , Fatal Outcome , Female , Humans , Lung Neoplasms/pathology , Small Cell Lung Carcinoma/pathology , Time FactorsABSTRACT
Heat-killed pathogenic Leptospira interrogans serovar rachmati induced the production of gamma interferon (IFN-gamma) and the IFN-gamma-inducing cytokines interleukin-12p40 (IL-12p40) and tumor necrosis factor alpha in human whole blood in vitro. The production of IFN-gamma was largely dependent on IL-12. These data establish that pathogenic leptospires can stimulate the production of type I cytokines involved in cellular immunity.
