RESUMO
We report the cases of 22 patients who were hospitalized for pine oil cleaner ingestion. The toxic manifestations most commonly observed were mucous membrane and gastrointestinal irritation. Ataxia, which did not occur in adults, was a frequent presenting sign of intoxication in children. Fifty-nine percent of patients who ingested only pine oil cleaner developed central nervous system depression, and three of these developed coma. Three of five children and three of 17 adults developed acute hydrocarbon pneumonitis. Unlike aspiration pneumonitis, which follows petroleum distillate ingestion, chemical pneumonitis from pine oil cleaner may occur from gastrointestinal absorption of pine oil and deposition in lung tissue. However, recovery from pneumonitis in our patients was typically rapid and complete. Only two adults developed secondary bacterial pneumonia; no patient died. Ingestion of pine oil cleaner was rarely life threatening; most patients needed only gastrointestinal decontamination and minimal supportive care.
Assuntos
Doenças do Sistema Nervoso Central/induzido quimicamente , Produtos Domésticos/intoxicação , Estomatite/induzido quimicamente , Adolescente , Adulto , Ataxia/induzido quimicamente , Coma/induzido quimicamente , Feminino , Gastrite/induzido quimicamente , Humanos , Masculino , Pessoa de Meia-Idade , Mucosa/efeitos dos fármacos , Pneumonia/induzido quimicamenteRESUMO
We report the case of a 59-year-old diabetic woman with emphysematous pyelonephritis. The patient presented with nausea, vomiting, and right flank pain of three days duration. The diagnosis was established by a plain abdominal radiograph in the emergency department. Aggressive rehydration, control of diabetes, broad-spectrum antibiotic therapy, and early right nephrectomy resulted in rapid clinical improvement. Emphysematous pyelonephritis is rare and often fatal. Survival depends on early diagnosis and aggressive combined medical and surgical management.
Assuntos
Complicações do Diabetes , Enfisema/diagnóstico por imagem , Pielonefrite/diagnóstico por imagem , Radiografia Abdominal , Antibacterianos/uso terapêutico , Diabetes Mellitus/terapia , Emergências , Enfisema/etiologia , Enfisema/terapia , Infecções por Escherichia coli/complicações , Feminino , Humanos , Pessoa de Meia-Idade , Nefrectomia , Pielonefrite/etiologia , Pielonefrite/terapia , Tomografia Computadorizada por Raios X , Infecções Urinárias/complicaçõesRESUMO
We report the case of a 27-year-old man with bilateral chylothorax. The patient presented with shortness of breath and bilateral pleural effusions three days after a motor vehicle accident. The diagnosis was established when tube thoracostomy revealed chylous drainage. During hospitalization approximately 8 L of chyle were removed. Bilateral chylothorax secondary to blunt trauma has rarely been reported. The etiology, pathogenesis, clinical presentation, and recommended therapy are reviewed.
