ABSTRACT
This is a case report of a 38-year-old, previously healthy man who was initially seen at an otorhinolaryngological department due to "swelling" of his tongue. Further history revealed four days of severe, non-specific headache and lisping. Two weeks prior to hospital admission he had seen a chiropractor due to neck pain. On examination at the hospital there was isolated left hypoglossal nerve palsy. He was urgently referred to a department of neurology. Magnetic resonance angiography showed internal carotid artery dissection. Aspirin and clopidogrel were commenced. At the three months follow-up examination he had recovered completely symptom wise and a renewed magnetic resonance imaging was normal.
Subject(s)
Carotid Artery, Internal, Dissection , Hypoglossal Nerve Diseases , Male , Humans , Adult , Hypoglossal Nerve Diseases/diagnosis , Hypoglossal Nerve Diseases/etiology , Magnetic Resonance Imaging/adverse effects , Carotid Artery, Internal, Dissection/complications , Magnetic Resonance Angiography , AspirinABSTRACT
We present a case of Eggerthia catenaformis bacteremia originating from a dental abscess and imitating necrotizing fasciitis in a previously healthy adult. The isolates were easily identified by MALDI-TOF MS. The clinical course, surgical and antibiotic treatment as well as the successful outcome are reported.
Subject(s)
Abscess/complications , Bacteremia/diagnosis , Bacteremia/microbiology , Firmicutes/isolation & purification , Stomatognathic Diseases/complications , Abscess/surgery , Anti-Bacterial Agents/administration & dosage , Bacteremia/drug therapy , Bacteriological Techniques , Debridement , Firmicutes/chemistry , Firmicutes/classification , Humans , Male , Middle Aged , Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization , Stomatognathic Diseases/surgery , Treatment OutcomeABSTRACT
Purpose. The description of the alterations in the hemostatic system in children undergoing abdominal surgery is sparse. Enhanced clinical outcomes for previously untreatable conditions have led to an increased incidence of venous thromboembolic complications. Alterations in children's coagulation system during major abdominal operations compared to minor procedures were examined. Methods. Children (0-12 years) undergoing either laparotomy, thoracotomy, or minor surgery were included. Participants were divided into two groups: group 1 was open laparotomy including operations for solid abdominal tumours and thoracotomy, while group 2 was minor surgery. Activated partial thromboplastin time (aPTT), D-dimer, INR, and fibrinogen were measured. Results. Both groups had a shorter aPTT, higher INR, and lower fibrinogen concentrations after the operation, while D-dimer was unaltered. The changes were, however, discrete and probably not clinically significant. On day 3, all parameters except aPTT in group 1 (not measured in group 2) indicated a continuous coagulation activity. Conclusion. The tendency for coagulation activity altered based on the length and degree of surgery. A continuously altered activity was observed compatible with the reported increased risk of venous thromboembolism at day 3. However, before introducing thromboprophylaxis guidelines larger series of multicentre studies are needed.