RESUMO
Fat embolism syndrome remains a rare, but potentially life threatening complication of long bone fractures. The true incidence is difficult to assess as many cases remain undiagnosed. Cerebral involvement varies from confusion to encephalopathy with coma and seizures. Clinical symptoms and computed tomography are not always diagnostic, while magnetic resonance imaging is more sensitive in the detection of a suspected brain embolism. Two cases of post-traumatic cerebral fat embolism, manifested by prolonged coma and diffuse cerebral oedema, are presented. The clinical course of the disease as well as the intensive care unit management are discussed.
Assuntos
Coma/etiologia , Embolia Gordurosa/etiologia , Embolia Intracraniana/etiologia , Fraturas da Tíbia/complicações , Adolescente , Adulto , Embolia Gordurosa/complicações , Humanos , Embolia Intracraniana/complicações , Masculino , Fatores de TempoRESUMO
Malaria remains today one of the major health problems in the tropics with increased morbidity and mortality. The most serious complications are caused by Plasmodium falciparum, which, in contrast to the benign malarias, may progress to a life-threatening multi-system disease. Our case concerns a young woman in the 14th week of pregnancy, admitted to the ICU in a coma, with pulmonary oedema, haemolytic anaemia, renal failure and thrombocytopenia as complications of P. falciparum malaria. The case is discussed and possible explanations for the clinical picture and complications of P. falciparum malaria are given in the light of experiences from the literature.