RESUMO
In this case report, we present a 70-year-old male who was brought to our hospital with signs of upper gastrointestinal bleeding. The patient was diagnosed with aortitis two and a half months prior. We suspected upper gastrointestinal bleeding, and the patient was taken to the operating room for an acute endoscopy, which showed blood in the oesophagus, ventricle, and duodenum, but no bleeding source. CT angiography showed erosion of aortic aneurism, at the site of known aortitis, with bleeding into the lung and pleura. The patient was transported to the nearest university hospital for thoracic endovascular repair and survived.
Assuntos
Aneurisma Aórtico , Aortite , Masculino , Humanos , Idoso , Hematemese , Hemoptise , Hemorragia Gastrointestinal/diagnóstico por imagem , Hemorragia Gastrointestinal/etiologia , Hospitais UniversitáriosRESUMO
AIM: Prompt and accurate aetiological diagnostics are needed if physicians are to improve and target antibiotic treatment. We aimed to investigate whether antibiotic-prescribing decisions are improved with availability of point-of-care polymerase chain reaction (POC-PCR) diagnostic testing of children with suspected respiratory tract infection, and if it had an impact on referral for additional medical procedures. METHODS: This was a single-centre one-group pre-test-post-test study. Children visiting our paediatric department with respiratory tract infection symptoms were included if the treating paediatrician was considering an antibiotic prescription. Throat swabs were analysed for pathogens using POC-PCR. The paediatrician registered treatment decisions, referrals for additional procedures and decisions about hospitalisation into a questionnaire before and after receiving the POC-PCR results. RESULTS: We included 95 children. The availability of results from POC-PCR analysis significantly changed the prescribed antibiotic treatment to non-antibiotic treatment in 46% (36%-56%) of the children and the reverse in 2% (1%-8%). Paediatricians referred significantly fewer patients to additional medical procedures with availability of POC-PCR. CONCLUSION: POC-PCR significantly reduced the odds of antibiotic prescription and referral for additional medical procedures. Thus, POC-PCR presents an opportunity to improve antibiotic-prescribing practices if it is combined with standard clinical evaluation.