RESUMO
An 18-year-old, previously healthy man admitted with abdominal pain, high-grade fevers, nausea and emesis was found to have multiple hepatic abscesses. Aspiration cultures grew Fusobacterium necrophorum, a rare bacterium causing potentially fatal liver abscesses in humans. Following sequential percutaneous drainages and narrowing of antibiotics, the patient was discharged on a 6-week antibiotic course and showed no signs of infection. A week after presentation it was discovered that he had experienced upper respiratory symptoms and sore throat prior to presentation. Because oropharyngeal infections are a potential source of bacteremia, they must be considered in the differential diagnosis of patients presenting with hepatic abscesses and no evidence of immunocompromise.
RESUMO
Mesenteric venous thrombosis (MVT) is an uncommon clinical condition with potential high morbidity. We report here a patient who presented with acute-onset MVT and bowel infarction, which was successfully ameliorated with intramesenteric vein thrombolytic therapy.
Assuntos
Cateterismo Venoso Central/métodos , Fibrinolíticos/administração & dosagem , Veias Mesentéricas , Veia Porta , Terapia Trombolítica/métodos , Trombose Venosa/tratamento farmacológico , Adulto , Feminino , Seguimentos , Humanos , Infusões Intravenosas , Tomografia Computadorizada por Raios X , Trombose Venosa/diagnóstico por imagemAssuntos
Processamento de Imagem Assistida por Computador , Pneumatose Cistoide Intestinal/diagnóstico por imagem , Pneumatose Cistoide Intestinal/cirurgia , Tomografia Computadorizada por Raios X , Adulto , Humanos , Mucosa Intestinal/patologia , Pneumatose Cistoide Intestinal/patologia , Prognóstico , Sistema de Registros , Sensibilidade e EspecificidadeRESUMO
Myocardial injury is known to occur in victims of both thermal and electrical burns. A variety of mechanisms have been ascribed to the pathogenesis of cardiac damage during burn shock. However, limited evidence exists that coronary artery thrombosis plays a frequent role. Distinguishing between acute coronary syndrome (impending myocardial infarction from coronary artery occlusion) vs global cardiac injury is essential; the care diverges drastically. The following case describes a patient who was angiographically proven to have acute coronary thrombosis amidst burn shock ftera 50% TBSA electrical flash burn. Managing the patient's burn shock, myocardial injury, and multiple surgical procedures while considering antiplatelet medications for a newly placed coronary artery stent presented a number of challenges not previously reported.