RESUMO
We describe the first 2 patients admitted to the Monrovia Medical Unit, a facility established to treat Liberian and international response workers with suspected or known Ebola virus disease (EVD). Their recoveries illustrate the value of local point-of-care diagnostics, parenteral therapies, and electrolyte replacement in EVD supportive care.
Assuntos
Ebolavirus , Doença pelo Vírus Ebola/terapia , Injúria Renal Aguda , Adulto , Pessoal de Saúde , Humanos , Libéria , Masculino , Sistemas Automatizados de Assistência Junto ao LeitoRESUMO
Q fever is an emerging infectious disease among US soldiers serving in Iraq. Three patients have had atypical manifestations, including 2 patients with acute cholecystitis and 1 patient with acute respiratory distress syndrome. Providers must be aware of Q fever's signs and symptoms to avoid delays in treatment.
Assuntos
Militares , Febre Q/diagnóstico , Adulto , Doenças Transmissíveis Emergentes/microbiologia , Feminino , Humanos , Iraque , Masculino , Febre Q/tratamento farmacológico , Febre Q/epidemiologia , Febre Q/microbiologia , Estados UnidosRESUMO
Antiphospholipid antibody syndrome (APS) may lead to pulmonary hypertension, a lethal complication of chronic pulmonary thromboembolism. There are few viable treatment options for pulmonary hypertension, but pulmonary thromboendarterectomy (PTE) has been used to successfully treat this condition in many patient populations. Following is a description of a patient with APS and systemic lupus erythematosus (SLE) who presented with severe pulmonary hypertension and underwent lifesaving surgery with pulmonary thromboendarterectomy. Successful intervention with thromboendarterectomy for the treatment of severe pulmonary hypertension is possible in patients with the antiphospholipid antibody syndrome, and surgical referral of these patients is warranted.
Assuntos
Síndrome Antifosfolipídica/complicações , Endarterectomia , Hipertensão Pulmonar/etiologia , Hipertensão Pulmonar/cirurgia , Lúpus Eritematoso Sistêmico/complicações , Adulto , Feminino , Humanos , Hipertensão Pulmonar/diagnóstico por imagem , Hipertensão Pulmonar/fisiopatologia , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
Hansen disease, historically known as leprosy, is caused by Mycobacterium leprae. The disease is rare in the United States but remains endemic among certain immigrant populations, and may manifest years after infection. The US military has a number of active duty troops originally from endemic countries. Recently, three US soldiers with Hansen disease were evaluated at Walter Reed Army Medical Center. The mean time to diagnosis was 8 months (range, 2 to 18 months). All three patients were initially misdiagnosed and treated for other skin infections or contact dermatitis. These cases illustrate the importance of prompt recognition and treatment of Hansen disease to prevent permanent disability and disfigurement. The clinical presentation, diagnosis, classification, and currently recommended therapeutic regimens for Hansen disease are discussed.
