ABSTRACT
Arsenic (As) intoxication is nowadays extremely rare. Two cases of acute and chronic As criminal poisoning leading to death of a couple of retired people, are reported. Clinical presentation was simulating a gastro-enteritidis with fast evolution to refractory shock. Toxicological analysis confirmed this diagnostic, with respectively blood As concentrations at 579 and 21 765 microg/l for our two patients.
Subject(s)
Arsenic Poisoning/pathology , Gastroenteritis/chemically induced , Homicide , Aged , Arsenic/blood , Arsenic Poisoning/diagnosis , Arsenic Poisoning/therapy , Blood Chemical Analysis , Female , Gastroenteritis/pathology , Humans , Male , Pharmaceutical Preparations/analysis , Poisons/bloodABSTRACT
This manuscript describing a case of intravascular lymphoma, displays the difficulties underlying its diagnosis. We emphasize that intravascular lymphoma should be considered in patients with multisystemic manifestations without obvious etiology. Despite the heterogeneous presentation of this lymphoma, some clinical and biological investigations should prevail clinicians to do tissue biopsy which is required to make the diagnosis.
Subject(s)
Lymphoma, Large B-Cell, Diffuse/complications , Multiple Organ Failure/etiology , Neoplasms, Vascular Tissue/complications , Aged , Diagnosis, Differential , Fatal Outcome , Humans , Lymphoma, Large B-Cell, Diffuse/diagnosis , Male , Multiple Organ Failure/diagnosis , Neoplasms, Vascular Tissue/diagnosisABSTRACT
Few adverse effects have been reported with adjunctive dexamethasone treatment in pneumococcal meningitis. Nevertheless, we report a case of cerebral vasculitis. A 49-year-old man was admitted for fever and altered mental status. Lumbar puncture revealed a high inflammatory response and Streptococcus pneumoniae was identified by culture. Antibacterial therapy and adjunctive dexamethasone treatment were initiated as recommended. The immediate outcome was favorable but due to the onset of focal cerebral abnormalities, a CT scan was performed on the ninth day showing cerebral vasculitis. The patient died on the thirteenth day despite antibacterial therapy and resuscitation. In our case, a secondary neurological worsening appeared when adjunctive dexamethasone treatment was stopped suggesting a rebound effect. Observation of similar cases may lead to modifying adjunctive dexamethasone treatment protocol in bacterial meningitis.
