RESUMO
We report a case of cefepime neurotoxicity characterised by myoclonic status epilepticus with coma, in a context of acute renal failure and requiring one discontinuous conventional haemodialysis. Cefepime is a fourth-generation broad-spectrum cephalosporin mainly used to treat hospital-acquired Gram-negative infections. Acute neurotoxicity is an increasingly reported adverse effect which occurs predominantly in patients with renal impairment. Renal replacement therapy has been proposed to treat this condition.
Assuntos
Injúria Renal Aguda/terapia , Antibacterianos/efeitos adversos , Cefepima/efeitos adversos , Epilepsias Mioclônicas/induzido quimicamente , Estado Epiléptico/induzido quimicamente , Injúria Renal Aguda/induzido quimicamente , Idoso de 80 Anos ou mais , Antibacterianos/toxicidade , Bronquiectasia/tratamento farmacológico , Cefepima/toxicidade , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Epilepsias Mioclônicas/fisiopatologia , Evolução Fatal , Feminino , Humanos , Síndromes Neurotóxicas/complicações , Síndromes Neurotóxicas/diagnóstico , Diálise Renal , Estado Epiléptico/fisiopatologiaRESUMO
Meningococcal pericarditis is a rare but severe form of acute purulent pericarditis. It is a classic complication of Neisseria meningitidis of serotype W135, usually occurring in pilgrims to Mecca and their household contacts. This severe form of meningococcaemia is difficult to diagnose and evolves frequently and gradually towards a tamponade, requiring emergency drainage. We report a case of meningococcal pericarditis caused by N. meningitidis W135 in an immunocompetent patient, without any other organ involvement especially meningeal, requiring pericardium drainage in emergency and then intrapericardial fibrinolysis.