RESUMO
Only few reports have looked into the risk of invasive bacterial infection in children with neutropenia that is not malignancy related. The objective of the current study was to determine the clinical significance of neutropenia as a predictor of serious bacterial infection (SBI) in immunocompetent children. We conducted a retrospective case-control study including children 3 months to 18 years of age with fever ≥ 38°C hospitalized or presenting to the emergency department. Patients who had neutropenia ≤ 1000 ANC/µL and had a blood culture taken were matched for age with the consecutive febrile patients for whom a blood culture was taken. The main outcome was the rate of SBI. SBIs were more prevalent among the control group than in the group of children with neutropenia, 19/71 and 6/71, respectively (P = 0.0005). More children were treated with antibiotics among the control group than in the group of children with neutropenia, 39/71 and 20/71, respectively (P < 0.0001). Acute-phase reactants including CRP and platelets were higher in the control group. We concluded that immunocompetent patients with fever and moderate neutropenia do not carry a higher risk for SBIs compared with patients with fever who do not have neutropenia.
Assuntos
Infecções Bacterianas/epidemiologia , Febre/epidemiologia , Imunocompetência , Neutropenia/complicações , Proteínas de Fase Aguda/análise , Adolescente , Antibacterianos/uso terapêutico , Infecções Bacterianas/diagnóstico , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/microbiologia , Proteína C-Reativa/análise , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Febre/diagnóstico , Febre/tratamento farmacológico , Febre/microbiologia , Seguimentos , Humanos , Lactente , Masculino , Estadiamento de Neoplasias , Neutropenia/imunologia , Prevalência , Prognóstico , Estudos RetrospectivosRESUMO
AIM: To describe the incidence of acute renal insufficiency after dipyrone overdose in children. METHODS: The medical records of all patients < or =18 years of age during a 3-year period presenting at Assaf Harofeh Medical Center due to toxic exposure were retrospectively reviewed. Patients suffering from dipyrone overdose were compared with all the other patients. RESULTS: 235 cases were included in the final analysis. Of these, 26 (11%) patients were exposed to dipyrone (median age 15 years). Three of the 26 patients (12%) had transient non-oliguric renal insufficiency. One other patient who did not receive dipyrone also developed transient renal insufficiency. CONCLUSIONS: Dipyrone overdose is frequent and may cause acute non-oliguric renal insufficiency. Renal function should be monitored in such patients.
Assuntos
Injúria Renal Aguda/induzido quimicamente , Anti-Inflamatórios não Esteroides/intoxicação , Dipirona/intoxicação , Adolescente , Criança , Overdose de Drogas , Feminino , Humanos , Masculino , Estudos RetrospectivosRESUMO
Methylenedioxymethamphetamine (MDMA), commonly known as Ecstasy, is a hallucinogenic compound structurally related to amphetamine. Ecstasy's severe neurological toxicity includes seizures, subarachnoidal hemorrhage, cerebral infarction, intracranial bleeding and cerebral venous thrombosis. We describe the first case of spinal cord damage presenting as acute quadriplegia and respiratory insufficiency in a healthy adolescent following Ecstasy recreational usage.
Assuntos
Alucinógenos/intoxicação , N-Metil-3,4-Metilenodioxianfetamina/intoxicação , Quadriplegia/induzido quimicamente , Doença Aguda , Adolescente , Alucinógenos/urina , Humanos , Masculino , N-Metil-3,4-Metilenodioxianfetamina/urina , Quadriplegia/terapia , Insuficiência Respiratória/induzido quimicamente , Insuficiência Respiratória/terapia , Resultado do TratamentoAssuntos
Síndrome de DiGeorge/complicações , Hipocalcemia/complicações , Vértebras Lombares/diagnóstico por imagem , Compressão da Medula Espinal/diagnóstico , Fraturas da Coluna Vertebral/diagnóstico , Tetania/complicações , Vértebras Torácicas/diagnóstico por imagem , Adolescente , Dor nas Costas/etiologia , Feminino , Humanos , Hipocalcemia/fisiopatologia , Contração Muscular/fisiologia , Cintilografia , Convulsões/complicações , Compressão da Medula Espinal/etiologia , Fraturas da Coluna Vertebral/etiologia , Tetania/fisiopatologiaRESUMO
A 77-y-old patient developed weakness of extremities, legs paralysis, dysarthria and tremor 1 h after ingestion of 200 mg ketoconazole for the first time in his life. All complaints faded away within 24 h. Few days later, the patient used another 200 mg ketoconazole tablet, and within an hour experienced a similar clinical picture, which resolved again spontaneously within hours. Laboratory evaluations, including head CT scan, were normal. This case illustrates the need for close vigilance in adverse drug reactions, particularly in the elderly.
