RESUMO
A congenital diaphragmatic hernia is a serious, complex condition with high mortality. It is actually mostly diagnosed prenatally. In most cases, it presents in the neonatal period, but can rarely present later in life when it becomes symptomatic. The clinical presentation and prognosis depend on the time of visceral herniation. We report two cases of left Bochdalek hernia with delayed presentation. The two cases shared some important characteristics. In both patients, the asymptomatic period ended with an acute attack of disease. To initiate appropriate therapy, emergency doctors need to be aware of the various presentations of a delayed left-sided diaphragmatic hernia.
Assuntos
Hérnia Diafragmática/diagnóstico , Hérnias Diafragmáticas Congênitas , Doença Aguda , Criança , Pré-Escolar , Cólica/etiologia , Emergências , Feminino , Hérnia Diafragmática/complicações , Hérnia Diafragmática/diagnóstico por imagem , Humanos , Radiografia , Insuficiência Respiratória/etiologiaRESUMO
We report a case of Pott's puffy tumor (PPT) with Pseudomonas infection occurring after acupuncture therapy in a ventilator-dependent child. Acupuncture use has been growing during the past decade in the whole world. Infectious complications range from benign to lethal. PPT is a subperiosteal abscess of the frontal bone associated with underlying osteomyelitis. It presents as a localised swelling of the forehead. This paper describes a 12-year-old girl with PPT. To our knowledge, this is the first case report of PTT caused by acupuncture therapy.
Assuntos
Terapia por Acupuntura/efeitos adversos , Osso Frontal/patologia , Osteomielite/etiologia , Osteomielite/patologia , Infecções por Pseudomonas/etiologia , Antibacterianos/uso terapêutico , Criança , Edema/etiologia , Feminino , Osso Frontal/microbiologia , Humanos , Hipóxia-Isquemia Encefálica/tratamento farmacológico , Hipóxia-Isquemia Encefálica/etiologia , Infusões Intravenosas , Osteomielite/microbiologia , Infecções por Pseudomonas/tratamento farmacológico , Infecções por Pseudomonas/microbiologiaRESUMO
We report a 12-year-old child presented with cutaneous pustular lesions. The lesions are associated with disseminated septic embolism due to Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA). The mortality of CA-MRSA sepsis associated with cutaneous findings is high. In areas where CA-MRSA is endemic, empiric treatment of suspected cutaneous manifestations should include antibiotics predictably active against this pathogen.
Assuntos
Bacteriemia/diagnóstico , Toxinas Bacterianas/sangue , Infecções Comunitárias Adquiridas/diagnóstico , Exotoxinas/sangue , Leucocidinas/sangue , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Embolia Pulmonar/microbiologia , Infecções Cutâneas Estafilocócicas/diagnóstico , Bacteriemia/terapia , Criança , Terapia Combinada , Infecções Comunitárias Adquiridas/terapia , Estado Terminal , Progressão da Doença , Serviço Hospitalar de Emergência , Evolução Fatal , Humanos , Masculino , Insuficiência de Múltiplos Órgãos , Embolia Pulmonar/diagnóstico por imagem , Embolia Pulmonar/terapia , Radiografia , Infecções Cutâneas Estafilocócicas/terapiaRESUMO
An 8-year-old boy, treated with a short course of steroids for asthma, developed a fever with abdominal pain and a generalized vesicular rash after contact with varicella-infected classmates. The clinical presentation was disseminated varicella infection with multiple organ involvement. We confirmed varicella zoster virus using a direct fluorescent antibody test. This report demonstrates the increased risk of complicated varicella associated with the use of corticosteroids, even for a short period of time.
