RESUMO
We report two patients with cirrhosis and peritoneovenous shunts (LeVeen) in whom fatal Streptococcus pneumoniae sepsis and meningitis developed 10 months and 22 days, respectively, after insertion of the shunts. The association between pneumococcal bacteremia and meningitis is well established. The potential implications of a LeVeen shunt in increasing risk for meningitis are discussed.
Assuntos
Meningite/etiologia , Derivação Peritoneovenosa/efeitos adversos , Infecções Estreptocócicas , Procedimentos Cirúrgicos Vasculares/efeitos adversos , Idoso , Líquido Cefalorraquidiano/microbiologia , Coagulação Intravascular Disseminada/etiologia , Varizes Esofágicas e Gástricas/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Síndrome do Desconforto Respiratório/etiologia , Soluções Esclerosantes/uso terapêutico , Choque Séptico/etiologia , Streptococcus pneumoniae/isolamento & purificaçãoRESUMO
Sclerotherapy for esophageal varices has recently gained wide acceptance in major medical centers for the control of bleeding esophageal varices. We have described two elderly patients with preexisting cardiac disease (right bundle branch block) in whom persistent bradyarrhythmia followed sclerotherapy using 5% sodium morrhuate. Both patients required insertion of a permanent pacemaker. This is the first report associating sclerotherapy with significant bradyarrhythmias.
