RESUMO
Chronic relapsing pancreatitis is a rare cause of abdominal pain in children and exceptionally rarely is related to a scorpion sting. We describe a 13-year-old girl who, following envenoming by a scorpion, developed recurrent attacks of sharp, intermittent pain in the umbilical region associated with fever, nausea, anorexia and vomiting, and changes in her psychological behaviour. Thorough clinical evaluation, including CT scanning, disclosed unabated pancreatitis. A modified Puestow procedure was performed with very good results. Physicians should be aware that in chronic relapsing pancreatitis, particularly in children, a scorpion sting should be considered an aetiological possibility.
Assuntos
Pancreatite/etiologia , Picadas de Escorpião/complicações , Picadas de Escorpião/diagnóstico , Dor Abdominal/etiologia , Adolescente , Animais , Doença Crônica , Diagnóstico Diferencial , Feminino , Humanos , Pancreatite/diagnóstico por imagem , Recidiva , Escorpiões , Tomografia Computadorizada por Raios X , Trinidad e TobagoRESUMO
Chronic relapsing pancreatitis is a rare cause of abdominal pain in children and exceptionally rarely is related to a scorpion sting. We describe a 13-year-old girl who, following envenoming by a scorpion, developed recurrent attacks of sharp, intermittent pain in the umbilical region associated with fever, nausea, anorexia and vomiting, and changes in her psychological behaviour. Thorough clinical evaluation, including CT scanning, disclosed unabated pancreatitis, particularly in children, a scorpion sting should be considered an aetiologically possibility(AU)
Assuntos
Humanos , Feminino , 21003 , Adolescente , Picada de Aranha/complicações , Picada de Aranha/diagnóstico , Pancreatite/etnologia , Pancreatite/diagnóstico por imagem , Dor Abdominal , Doença Crônica , Diagnóstico Diferencial , Recidiva , Escorpiões , Tomografia Computadorizada por Raios X , Trinidad e TobagoRESUMO
We reviewed 18 cases of histoplasmosis in patients at risk for the acquired immunodeficiency syndrome seen at two New York City hospitals in the past 3 1/2 years. Seventeen patients were Hispanic, including 13 born in Puerto Rico and three in South America. Clinical presentation was subacute, with high fever, weight loss, and mild respiratory symptoms with well-maintained gas exchange. Five patients had normal chest roentgenograms. The most common chest roentgenographic abnormality was diffuse small nodules. A rapid diagnosis was established histologically in 72 percent of patients, most commonly by transbronchial lung biopsy; cultures were positive in 94 percent of patients while serology was positive in five of six patients. Mycobacterium tuberculosis was a concurrent, often unrecognized, pathogen in six cases. Most patients responded to amphotericin therapy. Histoplasmosis may represent an early sign of altered host immunity in the acquired immunodeficiency syndrome.