RESUMEN
Human trichinellosis is a potentially severe parasitic disease occurring after ingestion of undercooked meat infected with Trichinella sp. larvae. We report the case of a patient who ate an undercooked bear meat hunted in Canada; he presented with the usual symptoms of trichinellosis (i.e, facial oedema, myalgias and fever) complicated with an asymptomatic myocarditis. Myocarditis is a rare, but potentially lethal complication of trichinellosis. Myocarditis should be screened systematically even when specific symptoms are missing; dosage of troponin serum is a simple and reliable mean for such screening.
Asunto(s)
Miocarditis/etiología , Viaje , Triquinelosis/complicaciones , Troponina/sangre , Albendazol/administración & dosificación , Albendazol/uso terapéutico , Animales , Antihelmínticos/administración & dosificación , Antihelmínticos/uso terapéutico , Antiinflamatorios/administración & dosificación , Antiinflamatorios/uso terapéutico , Western Blotting , Quimioterapia Combinada , Electrocardiografía , Ensayo de Inmunoadsorción Enzimática , Glucocorticoides/administración & dosificación , Glucocorticoides/uso terapéutico , Humanos , Masculino , Carne/efectos adversos , Persona de Mediana Edad , Miocarditis/diagnóstico , Prednisolona/administración & dosificación , Prednisolona/uso terapéutico , Factores de Tiempo , Resultado del Tratamiento , Triquinelosis/diagnóstico , Triquinelosis/tratamiento farmacológico , Triquinelosis/etiología , UrsidaeRESUMEN
The aim of this retrospective study was to evaluate the immediate and long-term results of various treatments for patients with a primary lesion of intra-stent restenosis (ISR). The study included 214 patients (233 endoprostheses, site of a primary ISR), with an average age of 61+/-11 years. These patients had received one of the following treatments: balloon angioplasty alone (101 patients), implantation of a second endoprosthesis (32 patients), medical treatment (65 patients), or revascularisation surgery with aorto-coronary bypass (16 patients). After retrospective analysis of the initial data, clinical follow-up was studied for all patients, and severe cardiac events were recorded. The immediate treatment of the ISR with angioplasty or bypass had an initial success rate of 100%. At the end of follow up (26+/-1.8 months) for the series as a whole, 9 patients (4.1%) had died, 7 (3.2%) had suffered a myocardial infarction, and 22 (10.3%) had had to undergo a secondary revascularisation procedure. 111 (52%) patients had angiographic follow up. A second ISR was noted in 43 cases (39%). The type of treatment provided was not a predictive factor for the occurrence of a severe cardiac event. In conclusion, whatever treatment of ISR is used, the immediate result is satisfactory. The rate of severe cardiac events is acceptable and in 10.3% of cases necessitates a secondary revascularisation procedure within 2 years. The very promising recent development of new active endoprostheses could alter the management of coronary patients in the years to come.