RESUMO
Targeted empirical antibiotic therapy based on local microbiology and antibiotic resistance patterns is essential for the treatment of empyema thoracis. Our retrospective review of 105 pleural empyema culture and sensitivity reports aimed at determining the causative microorganisms and their antimicrobial resistance pattern. Of 105 pleural aspirate samples, 46 (43.8%) were positive on culture. Gram-negative organisms (n = 43) were the predominant isolates, the commonest of which was Klebsiella pneumoniae. It was concluded that empyema thoracis is predominantly caused by Gram-negative organisms in our locality. This should guide protocols on the initiation of empirical therapy.
Assuntos
Antibacterianos , Empiema Pleural , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Resistência Microbiana a Medicamentos , Empiema Pleural/tratamento farmacológico , Empiema Pleural/epidemiologia , Humanos , Nigéria , Estudos RetrospectivosRESUMO
INTRODUCTION: Impalement injuries are well defined. Transfixion injuries involve impalement and are defined in terms of fixation usually to a large object. CASE REPORT: We report a spectacular case of sledge hammer impalement in the neck where the patient was transfixed, albeit to a small object, requiring movement of the patient and the transfixing object as a single unit. DISCUSSION: The patient was fixed to the head of the sledge hammer because he was unable to move with the heavy pendant. CONCLUSION: We argue that transfixion injuries should be defined in terms of weight of the object in relation to the patient's weight and the ability of the patient to move (with) the impaling object.
RESUMO
Postintubation tracheal stenosis (PITS) is a known complication of endotracheal intubation or tracheostomy. It is the most common indication for tracheal resection/reconstructive surgery. Despite technological improvement and skilled patient care in the ICU, PITS still constitutes an important group of iatrogenic sequela after intubation. With increasing number of patients requiring ICU admission and mechanical ventilation in Nigeria, it is important that this complication is prevented from occurring. The care of such patients often is technically challenging. The successful management by resection and end-to-end anastomosis of a 37-year-old man presenting with 2 cm length of severe tracheal stenosis of 4 mm luminal diameter following prolonged endotracheal intubation and who had had repeated bronchial dilatation is presented.
Assuntos
Anastomose Cirúrgica , Intubação Intratraqueal/efeitos adversos , Procedimentos de Cirurgia Plástica , Estenose Traqueal/etiologia , Estenose Traqueal/cirurgia , Adulto , Anastomose Cirúrgica/métodos , Humanos , Masculino , Respiração Artificial/efeitos adversos , Traqueia/cirurgia , Traqueostomia , Resultado do TratamentoRESUMO
Bronchogenic cancer can metastasize to several organs of the body. Metastases to skin and subcutaneous tissue are uncommon. We present our experience with the management of a patient with an unusual presentation of bronchogenic carcinoma with multiple skin nodules. In patients with bronchogenic cancer, metastasis to the skin and subcutaneous tissues could heighten the index of suspicion of advanced disease. The nodules should be histologically assessed and if confirmed metastatic, only palliative therapies are indicated.
RESUMO
Bronchogenic cancer can metastasize to several organs of the body. Metastases to skin and subcutaneous tissue are uncommon. We present our experience with the management of a patient with an unusual presentation of bronchogenic carcinoma with multiple skin nodules. In patients with bronchogenic cancer, metastasis to the skin and subcutaneous tissues could heighten the index of suspicion of advanced disease. The nodules should be histologically assessed and if confirmed metastatic, only palliative therapies are indicated.