ABSTRACT
Lyell's disease is a rare, life-threatening, acute dermatologic disease. The mucous membranes are also often involved. Nearly all cases are induced by medications. There is currently no specific treatment and interdisciplinary cooperation is very important. The authors present a case report of a 15 year old boy with the ocular manifestations of Lyell's disease, triggered by lamotrigine. He was admitted to the burn unit with involvement of 85% of his body surface area. Ocular manifestations documented during hospitalization were classified as mild (lid edema, conjunctival injection) and later severe (multiple symblepharons). The patient was treated with antibiotic eyedrops/ointment, corticosteroid eyedrops/ointment, topical lubricants and a glass rod was used to lyse the symblepharons. At 23 months of follow-up our patient had a symblepharon which blocked the superior and inferior punctum in both eyes, without conjunctival fornix foreshortening or corneal abnormalities, minimal ocular discomfort.
Subject(s)
Eye Diseases/diagnosis , Stevens-Johnson Syndrome/diagnosis , Adolescent , Eye Diseases/etiology , Humans , Lamotrigine , Male , Stevens-Johnson Syndrome/etiology , Triazines/adverse effectsABSTRACT
Acetaminophen is the most widely used analgesic drug in pediatrics. It is also the most frequently ingested drug in overdoses. The incidence of paracetamol poisoning has increased and it is accompanied with high morbidity and mortality. The use, abuse and ways of reducing paracetamol toxicity are reviewed. A case report of lethal acetaminophen intoxication in 2-year-old child is described. Authors draw attention to the health care providers--they should consider acetaminophen toxicity in all cases when the child has signs of acute hepatic dysfunction.
Subject(s)
Acetaminophen/poisoning , Analgesics, Non-Narcotic/poisoning , Drug Overdose , Female , Humans , InfantABSTRACT
Evaluation of procalcitonin levels is a sensitive investigation which is significant for differentiation between microbial and non-microbial infection, a determination of its dynamics and a prediction of therapy results. It is, however, necessary to evaluate its levels in relation to other investigations and their dynamics (other inflammatory markers, organ function dynamics), which specify diagnosis with the clinical condition of a patient. Even today, 10 years after the discovery of procalcitonin as an inflammatory marker and likely mediator of a cytokine cascade, there are many unanswered questions regarding its production in relation to physiological significance during the defensive response of an organism (12). Boucher formulated a simple conclusion in 2000: Procalcitonin should not be seen as the marker of sepsis but as one of many potentially useful markers.
Subject(s)
Calcitonin/physiology , Inflammation/physiopathology , Protein Precursors/physiology , Animals , Biomarkers , Calcitonin/blood , Calcitonin Gene-Related Peptide , Humans , Inflammation Mediators , Protein Precursors/blood , Sepsis/physiopathologyABSTRACT
Continuous renal replacement therapy (CRRT) is a relatively new therapeutic procedure which helps in the treatment of critically ill patients with renal failure as well as those without renal failure. CRRT effectively removes urea and creatinine and maintains a balanced milieu interleur and water balance. A role in the elimination of pro-inflammatory cytokines is also ascribed to this method. Most frequently venovenous haemofiltration and venovenous haemodiafiltration are used. The authors present their experience with the CRRT treatment of 40 patients in the Burn Centre Ostrava and with the results attained.