RESUMO
Se presenta el caso de un paciente con trauma craneoencefálico grave por proyectil de arma de fuego a quien se le documentó en el curso de su enfermedadbacteriemia por Leuconostoc citreum. Se presenta y se discute la evolución del paciente y su manejo antibiótico. Se discute la probable vía de entrada del germen al torrente sanguíneo y se revisa la literatura mundial. Lo inusual del caso motivó a los autores a publicarlo.
A case of severe head trauma by firearm missilesis presented; bacteremia by Leuconostoc citreumwas documented in the course of the disease. Theclinical course of the patient and the antibiotictreatment are presented and discussed. The pro-bable route of contamination and the entrance ofthe bacteria into the blood stream are discussedand the worldwide literature is reviewed. Therarity of this case encouraged the authors topublish it
Assuntos
Humanos , Bacteriemia , Ferimentos por Arma de Fogo , Leuconostoc , Traumatismos Craniocerebrais , Ferido de GuerraRESUMO
In times of conflict, physicians can encounter all types of trauma, even uncommon trauma. The case we present is one of those cases. A 30-year-old, male, Army sergeant suffered polytrauma caused by fragmentation missiles and the shock wave from an antipersonnel mine in combat; the amputated fingers of the right hand produced ocular trauma, with loss of the right eyeball. The patient also suffered facial injuries and mild head trauma. Computed tomographic scans demonstrated intracerebral osseous objects. The patient underwent cranial wound debridement and dural repair, and several osseous objects, which corresponded to the victim's phalanges, were found in the cerebral parenchyma. In shock wave accidents, body parts from the victim can serve as missiles and can cause the same or greater damage, compared with conventional missiles. This is the first case of this kind of trauma published in the worldwide literature.
