Assuntos
Neoplasias Brônquicas/diagnóstico , Dispneia/etiologia , Infecções por Vírus Epstein-Barr/complicações , Hospedeiro Imunocomprometido , Transplante de Rim , Neoplasias Pulmonares/diagnóstico , Nódulos Pulmonares Múltiplos/diagnóstico , Tumor de Músculo Liso/diagnóstico , Broncopatias/etiologia , Neoplasias Brônquicas/complicações , Neoplasias Brônquicas/virologia , Constrição Patológica , Infecções por Vírus Epstein-Barr/imunologia , Feminino , Humanos , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/virologia , Pessoa de Meia-Idade , Tumor de Músculo Liso/virologiaRESUMO
Fulminant liver failure is an uncommon but life-threatening complication of severe dengue infection. Molecular adsorbent recirculating system (MARS), which reverses hepatic encephalopathy, is an emerging important element in the armamentarium of organ support in the intensive care unit in patients suffering from acute liver failure. We report an intensive care unit case of fulminant liver failure secondary to dengue hemorrhagic fever, which was supported with MARS. MARS led to rapid reversal of biochemical profile and encephalopathy, resulting in early extubation and intensive care unit discharge.
Assuntos
Encefalopatia Hepática/etiologia , Encefalopatia Hepática/terapia , Falência Hepática Aguda/etiologia , Falência Hepática Aguda/terapia , Dengue Grave/complicações , Desintoxicação por Sorção/métodos , Idoso , Transfusão de Sangue , Humanos , Unidades de Terapia Intensiva , Masculino , Dengue Grave/diagnóstico , Fatores de Tempo , Resultado do TratamentoRESUMO
An elderly woman with post-tuberculous stricture of the lower trachea and main bronchi underwent laser re-canalization, balloon dilation, and silicone stent insertion in the lower trachea and main bronchi. Subsequently she had recurrent dyspnea develop due to obstructing granulomas, which necessitated four endoscopic procedures in 2 years. The tracheal stent was removed and topical mitomycin-C was applied using saturated pledgets at a dose of 0.5 mg/mL for 2 minutes each over the lower trachea and both orifices of the main bronchi. Follow-up for 24 months showed no recurrence of symptoms. Bronchoscopy and spirometry performed at 2, 6, and 12 months showed resolution of the granulomas.
