RESUMO
INTRODUCTION: Orbital compartment syndrome may rarely occur in the setting of burns where therapy includes aggressive fluid resuscitation. CASE: We report a case of bilateral orbital compartment syndrome in a 13-year-old male, with superficial facial burns secondary to hydrobromic acid, who did not receive aggressive fluid resuscitation. The patient was treated successfully with bilateral lateral canthotomy and cantholysis. COMMENT: Facial burns may lead to orbital compartment syndrome without aggressive fluid resuscitation, likely due to excessive leakage of fluid and protein into the orbit combined with an inflammatory reaction.
Assuntos
Queimaduras Químicas/etiologia , Síndromes Compartimentais/etiologia , Queimaduras Oculares/induzido quimicamente , Traumatismos Faciais/induzido quimicamente , Hidratação , Ácido Bromídrico/efeitos adversos , Doenças Orbitárias/etiologia , Adolescente , Síndromes Compartimentais/cirurgia , Pálpebras/cirurgia , Humanos , Pressão Intraocular , Masculino , Procedimentos Cirúrgicos Oftalmológicos , Doenças Orbitárias/cirurgia , Tomografia Computadorizada por Raios XAssuntos
Matadouros , Ácido Bromídrico/efeitos adversos , Exposição Ocupacional/efeitos adversos , Pneumonia/induzido quimicamente , Pneumonia/complicações , Adulto , Tosse/etiologia , Dispneia/etiologia , Febre/etiologia , Glucocorticoides/uso terapêutico , Humanos , Masculino , Pneumonia/tratamento farmacológico , Prednisona/uso terapêutico , Resultado do TratamentoRESUMO
Acute generalized exanthematous pustulosis (AGEP, toxic pustuloderma, pustular drug eruption) is a not uncommon cutaneous reaction pattern that is usually related to drug administration. The eruption is of sudden onset and appears 7-10 days after the medication is started. A 22-year-old male patient who was a student at a chemical faculty attended our outpatient clinic with a complaint of pustular eruption on his face. According to his history, the eruption started with pruritus and erythema on his chin 3 days ago and spread to his face and chest. He explained that he had performed an experiment with sulfuric acid and bromic acid and was exposed to their vapor. His dermatological examination revealed erythema and pustules on his cheeks, on his chin, above his upper lip, and on his eyebrows. He also had a few pustules on his chest. There were no ocular, mucous membrane, or pulmonary symptoms. Histopathological examination of the skin biopsy specimen revealed superficial orthokeratosis, focal subcorneal pustule formation, and perivascular chronic inflammatory cell infiltration in superficial dermis. After administration of systemic antihistamines and wet dressing topically, we observed rapid healing of the lesions. Because there was no systemic drug intake in his history, we were concerned that exposure to sulfuric acid and bromic acid vapor caused AGEP in this patient. We present this rare case to show that the vapor of chemical materials may cause AGEP or other drug eruptions.
