RESUMO
An 18-month-old male infant with oral albuterol intoxication was admitted to our pediatric emergency medicine unit with agitation, moderate hypokalemia (2.36 mEq/L), and hyperglycemia (180 mg/dL). His initial electrocardiogram showed sinus tachycardia with a low-amplitude T waves. He was admitted for observation, intravenous hydration was started with added potassium, blood glucose levels were closely monitored along with serum potassium and magnesium, and serial electrocardiography was performed. It should be stressed that as an oral bronchodilator, albuterol does not improve symptoms of asthma, and it can lead to severe complications, which can be avoided when this drug is delivered by inhalation or by a metered dose inhaler.
Assuntos
Agonistas de Receptores Adrenérgicos beta 2/intoxicação , Albuterol/intoxicação , Overdose de Drogas/diagnóstico , Administração Oral , Agonistas de Receptores Adrenérgicos beta 2/administração & dosagem , Albuterol/administração & dosagem , Overdose de Drogas/complicações , Humanos , Hiperglicemia/induzido quimicamente , Hipopotassemia/induzido quimicamente , Lactente , MasculinoRESUMO
We report an unusual case of ventriculoperitoneal (VP) shunt intrathoracic migration, associated with massive symptomatic hydrothorax. The VP shunt was inserted 10 years before presentation, after hemorrhagic hydrocephalus caused by prenatal intraventricular hemorrhage. The pleural fluid was drained via tube thoracostomy and the shunt was externalized, with full resolution of symptoms and signs. The patient was subsequently managed with shunt revision with drainage into the abdominal cavity. We review the 10 pediatric cases of cerebrospinal fluid hydrothorax reported in the literature and discuss the mechanism of shunt tip migration. Pleural effusion secondary to VP shunt insertion is a rare and potentially life-threatening occurrence, and it should be suspected in any patient with a VP shunt and respiratory distress.