RESUMO
Cerebral fat embolism is a rare cause of stroke and therefore an overlooked diagnosis. Often it is seen as a consequence of major bone fractures or after arthroplasty, and can lead to respiratory or circulatory collapse. We present a case of a patient with a history of paraplegia after a thoracic spinal cord injury that developed cerebral fat embolism following a bilateral femur fracture. Since the patient was paraplegic and with an altered mental state upon admission, femoral bone fractures were not initially suspected. The case shows the difficulties in diagnosing this condition.
Assuntos
Embolia Gordurosa , Fraturas do Fêmur , Traumatismos da Medula Espinal , Humanos , Paraplegia/complicações , Fraturas do Fêmur/complicações , Fraturas do Fêmur/diagnóstico por imagem , Fraturas do Fêmur/cirurgia , Traumatismos da Medula Espinal/complicações , Embolia Gordurosa/complicações , Embolia Gordurosa/diagnóstico , Fêmur/diagnóstico por imagemRESUMO
We present a case of central nervous system aspergillosis in an immunocompromised 69-year-old male with a history of chemotherapeutic treatment for follicular lymphoma. The patient presented with aphasia, apraxia and confusion. An MRI of the central nervous system and Aspergillus antigen in the spinal fluid was suggestive for this invasive fungal infection. Despite treatment with voriconazole the patient succumbed to the infection. A rise in rare, severe infectious complications as presented is expected due to increasing dose-intensity of chemotherapy.