Acute pneumonitis presumed to be silicone embolism.

A 39-year-old housewife who underwent intramammary injections of a proprietary silicone fluid mixture showed clinical and novel transbronchial lung biopsy (TBLB) findings. She presented with complaints of progressive dyspnea, dry cough, and pleuritic chest pain 2 days after the last silicone injections. The chest X-ray and CT scan showed diffuse interstitial infiltrates. TBLB demonstrated translucent, presumably silicone globules embolized within the pulmonary capillaries. The documentation of intramammary injections, the clinical and radiographic features of acute pneumonitis, and the histopathologic evidence by TBLB, may support the causal relationship between illicit injections and the silicone embolism. We discuss the pathogenesis and urge that this potentially toxic source of pulmonary embolism be removed.

A successfully treated case of Vibrio vulnificus septicemia with shock.

Vibrio vulnificus infection often causes serious or fatal disease. Recently, in Japan there have been numerous reports of Vibrio vulnificus infection. Here, we report a successfully treated case of Vibrio vulnificus septicemia with shock, disseminated intravascular coagulation (DIC) and necrotizing cellulitis in a middle-aged heavy drinker with chronic alcoholic liver disease. On reviewing 38 cases in Japan including ours, the overall mortality rate was 68%. Although the incidence is relatively low, it is recommended to warn patients in the high risk category, such as liver disease patients, to avoid raw fish and shellfish and limit sea water exposure.