RESUMEN
A 69-year-old woman presented with pneumonia and subacute bacterial endocarditis. Nine days after intravenous vancomycin and ciprofloxacin were commenced, the patient developed a bullous mucocutaneous eruption. Clinical presentation and histopathology were consistent with drug-induced linear IgA bullous disease (LABD). The patient's lesions resolved with cessation of antibiotics. A review of the features of drug-induced LABD and the drugs that have been implicated are presented.
Asunto(s)
Antibacterianos/efectos adversos , Antiinfecciosos/efectos adversos , Ciprofloxacina/efectos adversos , Erupciones por Medicamentos/etiología , Enfermedades Cutáneas Vesiculoampollosas/inducido químicamente , Vancomicina/efectos adversos , Anciano , Antibacterianos/administración & dosificación , Antiinfecciosos/administración & dosificación , Brazo , Ciprofloxacina/administración & dosificación , Erupciones por Medicamentos/patología , Endocarditis Bacteriana/complicaciones , Endocarditis Bacteriana/tratamiento farmacológico , Femenino , Pie , Humanos , Infusiones Intravenosas , Neumonía/complicaciones , Neumonía/tratamiento farmacológico , Enfermedades Cutáneas Vesiculoampollosas/patología , Vancomicina/administración & dosificaciónRESUMEN
A female infant was delivered at term with complications of severe meconium aspiration and birth asphyxia. Surface cooling was performed in the first 24 hours as part of the management of her birth asphyxia. Woody erythema was noted at 24 hours, followed by the formation of red-purple nodules on the 6th day. Clinical findings in the first 24 hours were suggestive of cold panniculitis. However, clinical and histological findings progressed to be in keeping with the diagnosis of subcutaneous fat necrosis of the newborn (SCFN). Furthermore, the immediate postnatal period was complicated by pain resistant to treatment with opiates. Asymptomatic hypercalcaemia was noted on periodic testing at 7 weeks and treated by rehydration, diuretics, prednisolone, etidronate and a low-calcium and -vitamin D diet. A review of the clinical and histological findings of the relevant panniculitides occurring in the postnatal period is presented, as well as a review of the treatment of hypercalcaemia in SCFN.
Asunto(s)
Asfixia Neonatal/terapia , Necrosis Grasa/diagnóstico , Hipercalcemia/diagnóstico , Hipotermia Inducida , Síndrome de Aspiración de Meconio , Diagnóstico Diferencial , Necrosis Grasa/complicaciones , Necrosis Grasa/patología , Femenino , Humanos , Hipercalcemia/complicaciones , Hipercalcemia/dietoterapia , Recién Nacido , Dolor/prevención & control , Paniculitis/diagnósticoRESUMEN
One hundred nine Wagner resurfacing arthroplasty acetabular components retrieved at revision surgery were examined for type, depth, and extent of wear at the periphery of the components. Ninety-two components were found to have evidence of peripheral wear caused by impingement of the femoral neck on the edge of the component. The thickness of the wall loss due to this impingement wear was found to be less the farther that measurements were taken from the edge of the component. Thus, when those components with any evidence of impingement wear were analyzed, it was found that significantly fewer components had evidence of impingement at depths of 3 mm and 5 mm in from the edge of the component. It is suggested that future designs of resurfacing hip arthroplasty acetabular components should be at least 3 mm and possibly 5 mm less than a hemisphere. This is likely to lead to less impingement on the femoral neck and therefore less cause for mechanical loosening and less production of wear debris.