RESUMO
We report the case of a 37-year-old female with a complex manifestation of serogroup C meningococcal disease. The patient presented with symptoms and signs of pneumonia, sepsis and diffuse intravascular coagulation. Moreover, she suffered from a culture-proven pyogenic pericarditis that deteriorated into cardiac tamponade. Immediate pericardiocentesis was successful and eventually the patient recovered.
Assuntos
Tamponamento Cardíaco/microbiologia , Infecções Meningocócicas/diagnóstico , Neisseria meningitidis Sorogrupo C , Pericardite/microbiologia , Adulto , Tamponamento Cardíaco/diagnóstico , Tamponamento Cardíaco/terapia , Feminino , Humanos , Infecções Meningocócicas/terapia , Pericardite/diagnóstico , Pericardite/terapiaRESUMO
BACKGROUND: Few placebo-controlled studies with ß-blockers have been performed in patients suffering from neurocardiogenic syncope. METHODS: We investigated the efficacy of metoprolol in 26 patients with recurrent syncope, suspected to be of neurocardiogenic origin, and positive tilt table test (TTT) outcome in a single-centre, double-blind, placebo-controlled, crossover study, with treatment periods of two weeks. Therapeutic efficacy was defined as a negative TTT after metoprolol and a positive TTT after placebo. Therapeutic failure was defined as a positive TTT after metoprolol and a positive or negative TTT after placebo. Patients with a negative TTT test after both metoprolol and placebo comprised the third group. RESULTS: The 24 patients who completed the study consisted of 14 females and 10 males, mean age 53 years, range 18-75 years. Therapeutic efficacy was observed in nine patients, therapeutic failure in eight patients and seven patients had a negative TTT after both placebo and metoprolol. According to the exact binomial test for paired proportions, the 95% confidence interval is 12 to 38% and p<0.01 in favour of treatment with metoprolol. CONCLUSION: These findings indicate a favourable effect of metoprolol.
