Asunto(s)
Azitromicina/administración & dosificación , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus , Trasplante de Riñón/métodos , Ácido Micofenólico/administración & dosificación , Pandemias , Neumonía Viral , Prednisolona/administración & dosificación , Tacrolimus/administración & dosificación , Antiinfecciosos/administración & dosificación , COVID-19 , Prueba de COVID-19 , Técnicas de Laboratorio Clínico/métodos , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/fisiopatología , Infecciones por Coronavirus/terapia , Relación Dosis-Respuesta a Droga , Monitoreo de Drogas , Femenino , Humanos , Inmunosupresores/administración & dosificación , Fallo Renal Crónico/cirugía , Masculino , Persona de Mediana Edad , Monitorización Inmunológica , Terapia por Inhalación de Oxígeno , Neumonía Viral/diagnóstico , Neumonía Viral/fisiopatología , Neumonía Viral/terapia , SARS-CoV-2 , Resultado del TratamientoRESUMEN
HistoryA 64-year-old woman with a medical history notable for hypertension, hyperlipidemia, cigarette smoking, type II diabetes mellitus, and end-stage renal disease requiring dialysis presented to the emergency department with tender swelling of her neck, which began 2 days prior to presentation.Four days prior to presentation, her dialysis catheter (Palindrome; Medtronic, Mannsfield, Mass) was partially pulled during dialysis. The next day, she underwent successful percutaneous transluminal balloon angioplasty with an iodinated contrast medium (20 mL Iopamiro; Bracco, Milano, Italy) via the existing right subclavian vein dialysis catheter because of stenosis in the superior vena cava. In addition, exchange of the dialysis catheter via guidewire was performed, without any reported complications. The following day, the patient underwent an uneventful scheduled hemodialysis treatment via the newly exchanged catheter.The patient denied trauma prior to the swelling. She had no known allergies, and prior exposure to iodinated contrast media on two occasions (2 months and 5 years before this presentation) was uneventful.Upon examination, the patient was fully alert and calm without any signs of distress and had bilateral submandibular firm nonpulsatile tender masses, each estimated at 3-4 cm in diameter.Because of a recent major vascular intervention, CT angiography of the neck was urgently performed.
Asunto(s)
Angioplastia de Balón , Arteriopatías Oclusivas/terapia , Angiografía por Tomografía Computarizada , Medios de Contraste/efectos adversos , Yopamidol/efectos adversos , Glándula Submandibular/efectos de los fármacos , Glándula Submandibular/diagnóstico por imagen , Femenino , Humanos , Persona de Mediana Edad , Diálisis Renal , Arteria SubclaviaRESUMEN
History A 64-year-old woman with a medical history notable for hypertension, hyperlipidemia, cigarette smoking, type II diabetes mellitus, and end-stage renal disease requiring dialysis presented to the emergency department with tender swelling of her neck, which began 2 days prior to presentation (Fig 1).