RESUMO
This is a retrospective study to evaluate epidemiology and etiologies of childhood meningitis in Kuwait after the routine introduction of the pneumococcal conjugate vaccine. The data was collected from 196 patients in the period of 2010-2014. Aseptic meningitis accounted for 51% of the cases, bacterial meningitis accounted for 29% cases and partially treated meningitis were 20%. Organisms causing bacterial meningitis were: Streptococcus pneumoniae 40.4%, Neisseria meningitidis 17.6%, Haemophilus spp. 12.2%, other gram positive or negative 19.3%, and Group B Streptococcus 8.8%. The hospitalization was complicated by admission to the ICU in 16.3% patients. Sequelae on discharge were seen in 4%, and 2.5% died of complications of meningitis. In children with pneumococcal meningitis, 48% were admitted to the ICU, 35% were discharged with sequelae and 13% died. In the era of post pneumococcal conjugate vaccination, S. pneumoniae remains the leading cause of bacterial meningitis with the greatest morbidity and mortality.
Assuntos
Meningite Asséptica/epidemiologia , Meningite Asséptica/etiologia , Meningites Bacterianas/epidemiologia , Meningites Bacterianas/etiologia , Vacinas Pneumocócicas/administração & dosagem , Criança , Pré-Escolar , Feminino , Haemophilus/isolamento & purificação , Humanos , Lactente , Recém-Nascido , Kuweit/epidemiologia , Masculino , Meningite Asséptica/mortalidade , Meningites Bacterianas/mortalidade , Neisseria meningitidis/isolamento & purificação , Estudos Retrospectivos , Streptococcus pneumoniae/isolamento & purificação , Análise de Sobrevida , Vacinação/estatística & dados numéricos , Vacinas Conjugadas/administração & dosagemRESUMO
OBJECTIVE: To report a case of ruptured hepatocellular carcinoma with massive hemoperitoneum which was successfully controlled with isoamyl 2-cyanoacrylate. CLINICAL PRESENTATION AND INTERVENTION: A 46-year-old Bangladeshi gentleman presented to our casualty complaining of acute abdominal pain and distension, associated with jaundice. Bedside abdominal ultrasound showed multiple focal lesions in the liver with fluid in the abdomen. The patient was vitally unstable, so he was resuscitated and underwent emergency laparotomy for massive hemoperitoneum due to a ruptured tumor nodule. Isoamyl 2-cyanoacrylate was applied to the ruptured nodule which stopped bleeding within 1-2 min. CONCLUSION: This case shows the effectiveness of isoamyl 2-cyanoacrylate in controlling bleeding in ruptured liver tumors.
