RESUMO
We report a case of acute hemorrhagic edema in a 10-year-old girl caused by adder bite. Therapy consisted of analgesics, antihistamines, corticosteroids. Antivenum serum was applied in a single dose due to severe spreading of the edema. The patient recovered almost completely after 10 days of treatment.
Assuntos
Edema/etiologia , Mordeduras de Serpentes/complicações , Venenos de Víboras/toxicidade , Viperidae , Analgésicos Opioides/administração & dosagem , Animais , Anti-Inflamatórios/administração & dosagem , Antivenenos/administração & dosagem , Braço , Criança , Dimetideno/administração & dosagem , Quimioterapia Combinada , Edema/tratamento farmacológico , Feminino , Seguimentos , Mãos , Hemorragia/tratamento farmacológico , Hemorragia/etiologia , Antagonistas dos Receptores Histamínicos H1/administração & dosagem , Humanos , Meperidina/administração & dosagem , Prednisona/administração & dosagem , Venenos de Víboras/antagonistas & inibidoresRESUMO
We present the case of a 44-year-old wrestler suffering from persistent bronchitis and chronic rhinosinusitis which had been refractory to therapy. The patient underwent extensive diagnostic examinations throughout the disease. Recently, at the age of 42 years otorhinological controls led to presentation at a cystic fibrosis (CF) centre where CF with the genotype Fdel508/3849+10 kb C-->T was diagnosed despite borderline sweat tests. Atypical CF should be considered in chronic persistent rhinosinusitis even in patients with borderline sweat tests.
Assuntos
Fibrose Cística/complicações , Fibrose Cística/diagnóstico , Rinite/diagnóstico , Rinite/etiologia , Sinusite/diagnóstico , Sinusite/etiologia , Adulto , Doença Crônica , Diagnóstico Diferencial , Humanos , MasculinoRESUMO
We present the case of a female CF-patient with primary mild disease and pancreatic sufficiency. She did not attend any CF centres for long periods of time. With progression of the disease, she was referred to our thoracic surgery centre for lung transplantation (LTX) at the age of 16 years. 2? years previously, she had been diagnosed with CF in another CF centre. Follow-up in specialised centres was recommended, but was not followed. Nevertheless, the indication for LTX was questioned by the thoracic surgeons and she was referred to our CF centre. With CF-specific therapy according to the current standards, pulmonary function improved from initially FEV1 = 1.2 L (38 %) to 3.6 L (122 %). In parallel, the patient gained 13.1 kg in body weight. According to our case report and to recent data a significantly better pulmonary function and nutritional status is found in CF patients who had attended specialised centres. We discuss the special features of CF treatment. Our report underlines the necessity for CF patients to be treated in specialised centres.