ABSTRACT
Emphysematous cystitis and emphysematous pyelonephritis are rare entities, difficult to diagnose and with high morbidity and mortality. The non-specificity of the medical history and the little usefulness of laboratory tests contribute to diagnostic delay, which increases the possibility of therapeutic failure. We present 2 cases, one of cystitis and another of emphysematous pyelonephritis, who attended the emergency room due to severe urinary sepsis. Despite severity of the symptoms, conservative management was performed with bladder drainage and antibiotic treatment, without interventions or surgeries, presenting a favorable evolution and resolution of the infectious process. Each case must be individualized to offer the best possible therapeutic alternative.
Subject(s)
Cystitis , Diabetes Complications , Emphysema , Pyelonephritis , Cystitis/complications , Cystitis/diagnosis , Cystitis/therapy , Delayed Diagnosis , Emphysema/complications , Emphysema/therapy , Humans , Pyelonephritis/complications , Pyelonephritis/diagnosis , Pyelonephritis/therapyABSTRACT
El íleo biliar es una complicación rara y potencialmente grave de la colelitiasis. Se define como una obstrucción intestinal mecánica secundaria a la presencia de un cálculo biliar en la luz intestinal. La causa más frecuente es la impactación del cálculo en el íleon tras su paso a través de una fístula bilioentérica. Presenta una elevada morbimortalidad, debido principalmente a la dificultad y el retraso diagnóstico. Presentamos un estudio retrospectivo de 4 casos de íleo biliar tratados entre 2013 y 2017 en el Hospital Nuestra Señora del Prado. Se analizaron las características clínicas, las pruebas diagnósticas y el tratamiento quirúrgico realizado
Gallstone ileus is a rare and potentially serious complication of cholelithiasis. It is defined as a mechanical intestinal obstruction secondary to the presence of a gallstone in the intestinal luz. The most frequent cause is impaction of the calculus in the ileum after passing through a bilioenteric fístula. It has a high morbidity and mortality rate, mainly due to the difficulty and delay in its diagnosis. A retrospective study is presented of 4 cases of gallstone ileus treated between 2013 and 2017 in the Hospital Nuestra Señora del Prado. An analysis was performed on the clinical characteristics, diagnostic tests, and surgical treatment
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Ileal Diseases/diagnosis , Intestinal Obstruction/diagnosis , Gallstones/diagnosis , Ileal Diseases/surgery , Intestinal Obstruction/etiology , Ileal Diseases/complications , Gallstones/complications , Tomography, X-Ray Computed , Ultrasonography , Abdominal Pain/etiologyABSTRACT
Gallstone ileus is a rare and potentially serious complication of cholelithiasis. It is defined as a mechanical intestinal obstruction secondary to the presence of a gallstone in the intestinal luz. The most frequent cause is impaction of the calculus in the ileum after passing through a bilioenteric fístula. It has a high morbidity and mortality rate, mainly due to the difficulty and delay in its diagnosis. A retrospective study is presented of 4 cases of gallstone ileus treated between 2013 and 2017 in the Hospital Nuestra Señora del Prado. An analysis was performed on the clinical characteristics, diagnostic tests, and surgical treatment.
Subject(s)
Abdominal Pain/etiology , Gallstones/complications , Ileus/complications , Intestinal Obstruction/etiology , Abdominal Pain/diagnostic imaging , Aged , Aged, 80 and over , Female , Gallstones/diagnostic imaging , Gallstones/surgery , Humans , Ileus/diagnostic imaging , Ileus/surgery , Intestinal Obstruction/diagnostic imaging , Intestinal Obstruction/surgery , Male , Retrospective Studies , Vomiting/etiologyABSTRACT
No disponible
Subject(s)
Humans , Female , Aged, 80 and over , Endocarditis, Bacterial/microbiology , Heart Valves/microbiology , Escherichia coliSubject(s)
Endocarditis, Bacterial/microbiology , Escherichia coli Infections/microbiology , Escherichia coli/isolation & purification , Heart Valve Diseases/microbiology , Mitral Valve , Urinary Tract Infections/microbiology , Aged, 80 and over , Female , Humans , Urinary Tract Infections/complicationsABSTRACT
El dolor óseo es un problema frecuente y constituye uno de los principales motivos de consulta, puede tratarse de un problema simple o puede ser el síntoma inicial de una patología más compleja y grave. En pacientes de edad avanzada con dolor óseo no asociado a traumatismo, que no mejora con tratamiento habitual, debemos realizar el diagnóstico diferencial con mieloma múltiple entre otros. Presentamos el caso de una mujer de 83 años que acude por dolor óseo en el miembro inferior izquierdo de meses de evolución que no mejora con tratamiento analgésico. Se realiza un estudio radiografico, en el que se objetiva una lesión lítica en el fémur izquierdo y ensanchamiento mediastínico en relación con plasmocitoma esternal que causaba compresión cardiaca. Se realizó estudio complementario que confirmó el diagnóstico de mieloma múltiple
Bone pain is one of the most common chief complaints. It can be a simple problem or an initial symptom of a more complex and serious disease. In older patients with non-traumatic bone pain that does not improve with conventional treatment, differential diagnosis with multiple myeloma, among others, is required. We present the case of an 83-year-old woman with bone pain in lower limb of several months' duration that does not improve with pain medications. X-ray reveal lytic lesion in her left femur and mediastinal widening related to sternal plasmacytoma causing cardiac compression. A complementary study confirmed the diagnosis of multiple myeloma
Subject(s)
Humans , Female , Aged, 80 and over , Musculoskeletal Pain/etiology , Multiple Myeloma/diagnosis , Plasmacytoma/diagnosis , Leg Bones , Diagnosis, Differential , Osteoporosis/complicationsABSTRACT
La varicela es una enfermedad propia de la infancia; su presentación en adultos es muy poco frecuente y suele asociarse a cuadros de mayor gravedad y afectación sistémica. Se presenta como un exantema generalizado de diseminación centrípeta, pruriginoso y pleomórfico, de predominio facial y troncular, que respeta las extremidades. La neumonía es la complicación extracutánea más frecuente y la principal causa de hospitalización en este grupo etario. La afectación palmo-plantar es excepcional y suele estar asociada a enfermedad diseminada en pacientes con importante comorbilidad o algún tipo inmunosupresión. Presentamos el caso de un paciente de 71 años que presenta enfermedad varicelosa diseminada, caracterizada por neumonía y afectación palmo-plantar, en el contexto de tratamiento con corticoides
Varicella is a childhood disease; it occurs very rarely in adults, usually associated with more severe cases and systemic involvement. It presents as a generalized rash of centripetal spread, pruritic and pleomorphic, occurring in the face and trunk but not in the limbs. Pneumonia is the most frequent extracutaneous complication and the leading cause of hospitalization among this age group. Palmoplantar involvement is uncommon, usually associated with disseminated disease in patients with significant comorbidity or some kind of immunosuppression. We present the case of a 71-year-old patient with disseminated varicella infection, characterized by pneumonia and palmoplantar involvement, and treated with corticosteroids
Subject(s)
Humans , Male , Aged , Chickenpox/diagnosis , Pneumonia/diagnosis , Eczema, Dyshidrotic/etiology , Chickenpox/complications , Exanthema/etiology , Herpesvirus 3, Human/pathogenicity , Acyclovir/therapeutic useABSTRACT
La oftalmoplejía dolorosa es una entidad poco frecuente que se caracteriza por dolor orbitario asociado a parálisis oculomotora ipsilateral, en algunos casos con afectación simpática ocular y alteraciones sensitivas a nivel de los territorios inervados por las ramas maxilar y oftálmica del trigémino. Puede ser causada por gran número de procesos, entre ellos, alteraciones vasculares, traumatismos, enfermedades tumorales o infecciones. Presentamos el caso de un varón de 83 años que acude por cuadro de cefalea en región frontal izquierda que englobaba la región orbitaria, asociada a sensación de hipoestesia y ptosis palpebral ipsilateral. Fue diagnosticado de síndrome de Tolosa-Hunt, una inflamación granulomatosa idiopática a nivel del seno cavernoso de causa desconocida. Se inició tratamiento empírico con corticoides presentando una rápida e importante recuperación
Painful ophthalmoplegia is a rare entity characterized by orbital pain associated with ipsilateral oculomotor paralysis, and sometimes with ocular sympathetic involvement and sensitive impairment in the areas supplied by the maxillary and ophthalmic branches of the trigeminal nerve. It can be caused by numerous conditions, among them, vascular alterations, traumas, tumor diseases, or infections. We present the case of an 83-year-old man with headache in the left frontal region including the orbital region, associated with hypoesthesia and ipsilateral ptosis. He was diagnosed with Tolosa-Hunt syndrome, an idiopathic granulomatous inflammation of the cavernous sinus of unknown cause. Empirical treatment with corticosteroids was initiated, resulting in a rapid and significant recovery
Subject(s)
Humans , Male , Aged, 80 and over , Ophthalmoplegia/diagnosis , Tolosa-Hunt Syndrome/diagnosis , Eye Pain/etiology , Headache/etiology , Oculomotor Nerve Injuries/diagnosis , Diagnosis, Differential , Adrenal Cortex Hormones/therapeutic useABSTRACT
Hyperthyroidism is one of the most common endocrinology disorders. Treatment can be either pharmacological, surgical or using radioactive iodine. In Europe methimazole is the antithyroid drug of choice because it can be administered in a single daily dose and has a lower risk of adverse reactions. Around 5% of patients taking thionamides can present any of their side effects, which are usually mild. Liver toxicity due to thionamides is very rare, and severe due to propylthiouracil. We present a clinical case of a cholestatic jaundice and acute toxic hepatitis due to methimazole and a cross-reaction with propylthiouracil. Based on this case a review is presented.
Subject(s)
Antithyroid Agents/adverse effects , Chemical and Drug Induced Liver Injury/etiology , Methimazole/adverse effects , Aged , Antithyroid Agents/therapeutic use , Case Management , Cholestasis, Intrahepatic/chemically induced , Female , Graves Disease/drug therapy , Graves Disease/surgery , Humans , Methimazole/therapeutic use , ThyroidectomyABSTRACT
El hipertiroidismo es uno de los trastornos endocrinológicos más frecuentes. Su tratamiento actual consiste en fármacos, yodo radiactivo y cirugía. El metimazol es el fármaco antitiroideo de elección en Europa, porque puede administrarse en una sola dosis diaria y por su menor riesgo de efectos secundarios. En un 5% de los pacientes pueden aparecer efectos secundarios por los fármacos antitiroideos, que suelen ser menores. La enfermedad hepática asociada con estos fármacos es excepcional, y es más común y grave en el caso del propiltiouracilo. Presentamos el caso clínico de un paciente con hipertiroidismo, que desarrolló una hepatitis aguda tóxica colestásica tras la administración de metimazol y, posteriormente, una reacción cruzada con propiltiouracilo. Debido a la rareza del caso, nos parece interesante su presentación.
Hyperthyroidism is one of the most common endocrinology disorders. Treatment can be either pharmacological, surgical or using radioctive iodine. In Europe methimazole is the antithyroid drug of choice because it can be administered in a single daily dose and has a lower risk of adverse reactions. Around 5% of patients taking thionamides can present any of their side effects, which are usually mild. Liver toxicity due to thionamides is very rare, and severe due to propylthiouracil. We present a clinical case of a cholestatic jaundice and acute toxic hepatitis due to methimazole and a cross-reaction with propylthiouracil. Based on this case a review is presented
Subject(s)
Female , Aged , Humans , Hyperthyroidism/complications , /complications , Chemical and Drug Induced Liver Injury/etiology , Propylthiouracil/adverse effects , Methimazole/adverse effects , Hyperthyroidism/drug therapy , Liver Function TestsABSTRACT
No disponible
Subject(s)
Male , Aged , Humans , Insect Bites and Stings/complications , Anaphylaxis/complications , Myocardial Infarction/etiology , Hymenoptera/pathogenicity , Bee Venoms/adverse effectsABSTRACT
No disponible
No disponible
Subject(s)
Humans , Female , Referral and Consultation/trends , Breast Neoplasms/epidemiology , Surgery Department, Hospital/statistics & numerical data , Obstetrics and Gynecology Department, Hospital/statistics & numerical dataABSTRACT
No disponible
