RESUMEN
Pulmonary mucormycosis is a rare, devastating, opportunistic fungal infection, caused by the ubiquitous filamentous fungi of the Mucorales order of the class of Zygomycetes. This infection occurs principally in some particular conditions, specially in diabetic patients and immunocompromised host, and rarely in cirrhotic patients. The diagnosis of mucormycosis can only be confirmed by pathological and mycological examination of biopsy specimens. We report a case of pulmonary mucormycosis in a 68-year-old woman with underlying liver cirrhosis and diabetes mellitus. Endoscopic and radiologic findings supported the diagnosis of hydatid cyst of the lung. The patient underwent surgical resection and was started on amphotericin B, after pathological examination. Unfortunately, she succumbed to the infection within one month of surgery.
Asunto(s)
Enfermedades Pulmonares Fúngicas/microbiología , Mucorales/aislamiento & purificación , Mucormicosis/microbiología , Anciano , Diabetes Mellitus Tipo 2/fisiopatología , Equinococosis Pulmonar/diagnóstico , Resultado Fatal , Femenino , Humanos , Cirrosis Hepática/fisiopatología , Enfermedades Pulmonares Fúngicas/terapia , Mucormicosis/terapiaAsunto(s)
Carcinoma de Células Grandes/patología , Neoplasias Pulmonares/patología , Neoplasias Tonsilares/secundario , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carcinoma de Células Grandes/diagnóstico por imagen , Carcinoma de Células Grandes/tratamiento farmacológico , Humanos , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Radiografía , Neoplasias Tonsilares/diagnóstico por imagenAsunto(s)
Endocarditis Bacteriana/diagnóstico , Infecciones Estafilocócicas/diagnóstico , Abuso de Sustancias por Vía Intravenosa/complicaciones , Válvula Tricúspide/microbiología , Adulto , Endocarditis Bacteriana/etiología , Endocarditis Bacteriana/cirugía , Humanos , Masculino , Infecciones Estafilocócicas/complicaciones , Infecciones Estafilocócicas/cirugía , Staphylococcus aureus , Abuso de Sustancias por Vía Intravenosa/microbiología , Válvula Tricúspide/patología , Válvula Tricúspide/cirugíaRESUMEN
AIM: To compare efficacy of pain control, the consumption of local anaesthetics and opioids as well as the side effects between continuous epidural analgesia, patient controlled analgesia and patient controlled epidural analgesia in thoracic surgery. METHODS: Prospective randomised study included 66 patients who had thoracotomy. Patients were divided into 3 groups, to receive different pain control methods. Group 1 (n=22) received patient control analgesia Group 2 (n=22) received continuous epidural analgesia (Bupivacaine 0,125% + 5 microg/ml of Fentanyl) between 6 and 10 ml/h in order to obtain a T2 level Group 3 (n=22) received patient controlled epidural analgesia (Bupivacaine 0,08% + 3 microg/ml of Fentanyl) 6 ml/h and bolus of 5 ml. RESULTS: There was no difference between the three groups in age, delay of surgical operation and per operative morphine consumption. VAS was less at rest and after cough in patient group with patient controlled epidural analgesia. The difference was less significant in local anaesthetics and opioids consumption in patient with controlled epidural analgesia. CONCLUSION: The benefit of patient controlled epidural analgesia in thoracic surgery is proven by the following analgesic efficiency which allows good respiratory rehabilitation, decreasing the risk of drug toxicity by decreases consumption, weak hemodynamic effects and absence of motor block.