scholarly journals Repeated Sepsis in an 83-Year-Old Man With Cancer With Long-Lasting Invasive Treatments

2020 ◽  
Author(s):  
Masoomeh Imanipour ◽  
Nasrin Rasoulzadeh ◽  
Amin Hosseini
Keyword(s):  
Risk Factors ◽  
Immune Response ◽  
Immune System ◽  
Antibiotic Therapy ◽  
Major Trauma ◽  
Fluid Replacement ◽  
Underlying Condition ◽  
Threatening Condition ◽  
Life Threatening ◽  
Inflammatory Immune Response

Sepsis is a life-threatening condition that arises when the body's response to infection damages its own tissues and organs. Sepsis is caused by an inflammatory immune response triggered by an infection. Its risk factors include aging, weak immune system, major trauma, or burns. Treatment of sepsis is often based on fluid replacement and antibiotic therapy. In this study, an 83-year-old man is reported with two times of diagnosis of sepsis during three years. The first sepsis was due to an infection of the colostomy and the second one followed an infection at tracheostomy site. It seems that the disease and the underlying condition of the patient contribute to the occurrence of sepsis. The patient each time was discharged from the hospital after successful response to the treatment

scholarly journals Trauma-Induced Coagulopathy: Overview of an Emerging Medical Problem from Pathophysiology to Outcomes

Medicines ◽  
2021 ◽  
Vol 8 (4) ◽  
pp. 16
Author(s):  
Gabriele Savioli ◽  
Iride Francesca Ceresa ◽  
Luca Caneva ◽  
Sebastiano Gerosa ◽  
Giovanni Ricevuti
Keyword(s):  
Major Trauma ◽  
Management Strategies ◽  
Medical Problem ◽  
Current Evidence ◽  
Potential Drug ◽  
The Past ◽  
Trauma Induced Coagulopathy ◽  
Threatening Condition ◽  
Life Threatening ◽  
Trauma Mortality

Coagulopathy induced by major trauma is common, affecting approximately one-third of patients after trauma. It develops independently of iatrogenic, hypothermic, and dilutive causes (such as iatrogenic cause in case of fluid administration), which instead have a pejorative aspect on coagulopathy. Notwithstanding the continuous research conducted over the past decade on Trauma-Induced Coagulopathy (TIC), it remains a life-threatening condition with a significant impact on trauma mortality. We reviewed the current evidence regarding TIC diagnosis and pathophysiological mechanisms and summarized the different iterations of optimal TIC management strategies among which product resuscitation, potential drug administrations, and hemostatis-focused approaches. We have identified areas of ongoing investigation and controversy in TIC management.

Heterotopic pregnancy; case report

2019 ◽  
Vol 7 (05) ◽  
Author(s):  
Vipul R. Khandagale
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Adnexal Mass ◽  
Heterotopic Pregnancy ◽  
Free Fluid ◽  
Threatening Condition ◽  
Life Threatening ◽  
Ectopic Pregnancies ◽  
High Index Of Suspicion ◽  
Low Risk Women

Heterotopic pregnancy is a rare clinical condition in which intrauterine and extrauterine pregnancies occur at the same time. It can be a life threatening condition and easily missed with the diagnosis. We present the case of a 37 year old patient who was treated for a heterotopic pregnancy with live intrauterine gestation and ruptured left adnexal gestation.The ectopic pregnancy was not suspected at her initial presentation. A high index of suspicion is needed in women with risk factors for an ectopic pregnancy and in low risk women who have free fluid with or without an adnexal mass with an intrauterine gestation.It is difficult to estimate exactly the incidence of ectopic pregnancies, but on an average it is approximately 1:300 normal pregnancies worldwide.

Haemophagocytic lymphohistiocytosis secondary to brucellosis in a young child

2021 ◽  
Vol 14 (3) ◽  
pp. e240759
Author(s):  
Jashan Mittal ◽  
Prawin Kumar ◽  
Jagdish Prasad Goyal ◽  
Abhishek Purohit
Keyword(s):  
Haemophagocytic Lymphohistiocytosis ◽  
Appetite Loss ◽  
Specific Therapy ◽  
Adequate Treatment ◽  
Underlying Condition ◽  
Persistent Fever ◽  
Threatening Condition ◽  
Life Threatening ◽  
History Of ◽  
Life Threatening Complication

Brucellosis is a common zoonotic disease worldwide. It has protean clinical manifestation and sometimes may has a life-threatening complication. A 4-year-old boy presented with a history of fever, myalgia and appetite loss for 3 weeks. On examination, he had hepatosplenomegaly. The initial working diagnosis was an infection, autoimmune disease and malignancy. Investigations showed positive Brucella serology, and he was started on rifampicin and cotrimoxazole. He was further investigated because of persistent fever, which revealed evidence of haemophagocytic lymphohistiocytosis (HLH). He continued treatment for brucellosis, except rifampicin which was replaced with doxycyclin due to a worsening liver function. The child showed complete clinical and biochemical improvement after 6 weeks of therapy. HLH is a life-threatening condition and should be suspected in children with brucellosis, who did not respond to appropriate antibiotics treatment. Secondary HLH does not always require specific therapy; it may improve with adequate treatment of the underlying condition.

scholarly journals Necrotising fasciitis caused by metastatic endometrial cancer: a rare cause of a life-threatening condition

2017 ◽  
Vol 99 (2) ◽  
pp. e72-e74
Author(s):  
S Hendrickson ◽  
N Bystrzonowski ◽  
C Kokkinos ◽  
P Butler
Keyword(s):  
Risk Factors ◽  
Endometrial Cancer ◽  
Lumbar Spine ◽  
Endometrial Adenocarcinoma ◽  
Necrotising Fasciitis ◽  
Iliopsoas Muscle ◽  
Iliopsoas Abscess ◽  
Threatening Condition ◽  
Life Threatening ◽  
Common Risk Factors

We report a case of necrotising fasciitis caused by metastatic endometrial adenocarcinoma. Metastases to the lumbar spine with local invasion to the iliopsoas muscle led to an iliopsoas abscess, which subsequently progressed to necrotising fasciitis of the flank. This patient lacked common risk factors for necrotising fasciitis. There are no previous reports in the literature of necrotising fasciitis with this aetiology. We discuss the available evidence for aetiology of and risk factors for necrotising fasciitis, and the relation of time to surgery with prognosis.

scholarly journals Aortic Dissection in a Pregnant Patient without Other Risk Factors

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Priya V. Patel ◽  
Raanan Alter ◽  
Recia Frenn ◽  
Thaddeus P. Waters
Keyword(s):  
Risk Factors ◽  
Aortic Dissection ◽  
Aortic Rupture ◽  
Treatment Options ◽  
Pregnant Patient ◽  
Physical Exam ◽  
Vascular Events ◽  
Increased Risk ◽  
Threatening Condition ◽  
Life Threatening

Background. An aortic dissection is a life-threatening condition in which the intima of the artery tears causing separation of the intima and media. Pregnancy places women at a significantly increased risk of common vascular events including venous thromboembolism, myocardial infarction, and stroke, while also increasing the risk of rarer vascular events such as aortic dissection and aortic rupture. Case. A 30-year-old previously healthy multiparous woman presenting at 36 weeks of pregnancy with a Type A aortic dissection. She underwent a combined emergent cesarean delivery followed by repair of her aortic root. Conclusions. Aortic dissection should be high on the differential for pregnant patients presenting with the characteristic complaints and physical exam findings given the high mortality rate associated with this vascular event. Teaching Points. (1) This report reviews the characteristic presentation, risk factors, and physical exam findings in a patient with an aortic dissection. (2) The report includes treatment options for pregnant patients based on the classification of the dissection.

scholarly journals Importance of haemodynamic stability and adjuvant therapy in the treatment of patients with sepsis and septic shock

2020 ◽  
Vol 45 (4) ◽  
pp. 153-158
Author(s):  
Vesna Marjanović ◽  
Ivana Budić ◽  
Saša Ignjatijević ◽  
Marija Stević ◽  
Dušica Simić
Keyword(s):  
Septic Shock ◽  
Adjuvant Therapy ◽  
Isotonic Saline ◽  
Fluid Replacement ◽  
Initial Assessment ◽  
Hemodynamic Stability ◽  
Threatening Condition ◽  
Life Threatening ◽  
Sepsis And Septic Shock ◽  
Vasoactive Medications

Sepsis represents a life-threatening condition that requires prompt recognition, detailed initial assessment and energetic administration of therapy. Guidelines published in 2016 emphasized the importance of early fluids replacement and infection control together with assessment based on laboratory parameters and precise monitoring of hemodynamic status of septic patients within the first 3-6 hours after diagnosis. Revision that followed in 2018 stressed that all therapeutic actions should be initiated within the first hour after diagnosis. Urgent administration of isotonic saline and balanced crystalloids in a dose of 30ml/kg should provide adequate hemodynamic stability of septic patients. If the fluid replacement fails to achieve hemodynamic stability and mean arterial pressure >65 mmHg, addition of vasopressors is mandatory. The vasopressor of choice for septic patients is norepinephrine. It may be used alone or in combination with other vasopressors such as epinephrine, vasopressin, terlipresine or phenylephrine. Septic patients with inadequate cardiac output after fluid replacement, and cardiomyopathy induced by sepsis or those with combined shock may need treatment with inotropic medication such as epinephrine or dobutamine. Adjuvant therapy with steroids, immunoglobulins, anticoagulants, statins, vitamin C and Bl, may be useful, but no benefit regarding the overall outcome was observed. In conclusion, early detection of sepsis and septic shock within the first hour and immediate adequate fluid administration with vasoactive medications to maintain hemodynamic stability, are crucial for achievement of better outcome of these patients.

scholarly journals Staphylococcus pseudintermedius, both commensal and pathogen

2018 ◽  
Vol 74 (1) ◽  
pp. 6042-2018
Author(s):  
Dorota Chrobak-Chmiel ◽  
Anna Golke ◽  
Kourou Dembele ◽  
Katarzyna Ćwiek ◽  
Magdalena Kizerwetter-Świda ◽  
...  
Keyword(s):  
Immune Response ◽  
Atopic Dermatitis ◽  
Immune System ◽  
Virulence Factors ◽  
Innate Immune Response ◽  
Innate Immune ◽  
Staphylococcus Pseudintermedius ◽  
Underlying Condition ◽  
Secondary Infections ◽  
Pathogenic Effects

Staphylococcus pseudintermedius is considered to be a both commensal and opportunistic canine pathogen. The anal, perineal and nasal locations appear to be the main S. pseudintermedius colonization sites, from which bacteria are transmitted to other body sites, causing secondary infections. When the immune system is compromised because of an underlying condition, the skin becomes susceptible to infection. Thus, the host’s condition seems to play a crucial role in the pathogenesis of S. pseudintermedius infections. There are some predisposing factors, one of which is atopic dermatitis. The pathogenic effects of S. pseudintermedius are mediated by several virulence factors, for instance superantigens, which play an important role by causing dermatitis. The immune system has evolved many different mechanisms to recognize and deal with pathogens, but bacteria have also developed various strategies to evade them. In this review, we focus on early stages of the innate immune response with particular emphasis on the mechanisms of recognition of staphylococci and the action of antimicrobial peptides. .

scholarly journals A Case of Unilateral Coccidioidal Chorioretinitis in a Patient with HIV-Associated Meningoencephalitis

2019 ◽  
Vol 2019 ◽  
pp. 1-3 ◽  
Author(s):  
Christopher B. Toomey ◽  
Andrew Gross ◽  
Jeffrey Lee ◽  
Doran B. Spencer
Keyword(s):  
Risk Factors ◽  
Vision Loss ◽  
Complement Fixation ◽  
Rare Condition ◽  
Threatening Condition ◽  
Life Threatening ◽  
History Of ◽  
Blurry Vision ◽  
Systemic Symptoms ◽  
The Right

Intraocular coccidioidomycosis is a rare condition, with the most commonly reported presentation being an idiopathic iritis in patients who live in or have traveled thorough endemic areas. A paucity of reports exists describing the chorioretinal manifestations of coccidioidomycosis. Here we report a case of unilateral coccidioidal chorioretinitis and meningoencephalitis in an AIDS patient that led to near complete unilateral loss of vision. A 48-year-old Hispanic female with poorly controlled HIV/AIDS in southern California presented with a three-week history of headache, nausea, vomiting, right eye blurry vision, and a one-day history of subjective fever. Examination of the right eye revealed vitritis and several large chorioretinal lesions scattered throughout the periphery and macula with optic disc pallor. Serum coccidioidomycoses complement fixation (CF) was positive (titers of 1 : 256). Neuroimaging revealed a new area of enhancement in the left anterior frontal lobe consistent with meningoencephalitis. The patient was treated with intravenous fluconazole and intravitreal voriconazole with resolution of systemic symptoms and vitritis but persistence of unilateral, severe chorioretinal scarring and vision loss. In conclusion, in spite of the rarity of intraocular coccidioidomycosis, one must carry a degree of suspicion for this vision- and life-threatening condition as a potential etiology of chorioretinitis in individuals with pertinent risk factors.

scholarly journals Colic in the British military working horse population: a retrospective analysis

2018 ◽  
Vol 184 (1) ◽  
pp. 24-24
Author(s):  
Victoria J Tannahill ◽  
Jacqueline M Cardwell ◽  
Tom H Witte
Keyword(s):  
Risk Factors ◽  
Population Data ◽  
Horse Population ◽  
Multiple Risk Factors ◽  
British Military ◽  
Incidence And Mortality ◽  
Threatening Condition ◽  
Life Threatening ◽  
Intensively Managed ◽  
Careful Management

Colic is a common and potentially life-threatening condition of horses. Multiple risk factors have been previously identified and it is known that a careful management routine can help reduce colic rates. The British military working horse population represents a unique cohort of horses that are intensively managed with a strict regimen. This retrospective study examined the incidence and mortality rate of colic within this population, as well as the signalment of affected horses, and compared these with the general population. Data for 717 horses over a five-year period (2008–2012) were analysed. Of these, 163 horses (22.7 per cent) experienced 267 colic episodes and 13 horses (1.8 per cent) died because of colic. Recurrent colic was experienced by 35 per cent (57/163) of horses. The incidence of colic was 11.1 episodes per 100 horse-years and of colic-related death was 0.5 deaths per 100 horse-years. Horses purchased from mainland Europe were more likely to suffer from colic (OR 4.6; P<0.001) and from recurrent colic (OR 6.0; P=0.005) than horses purchased from Ireland. Only 3 per cent (8/267) of colic episodes were treated surgically. It was concluded that the incidences of colic and colic-related deaths within the British military working horse population are similar to those of the general horse population.

Catastrophic antiphospholipid syndrome presenting with aortic barrage: case report and review of the literature

Lupus ◽  
2021 ◽  
Vol 30 (6) ◽  
pp. 1005-1009
Author(s):  
Luca Moroni ◽  
Paolo Righini ◽  
Giuseppe A Ramirez ◽  
Nicola Farina ◽  
Gaia Mancuso ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Report ◽  
Antiphospholipid Syndrome ◽  
Unusual Case ◽  
Thromboembolic Events ◽  
Review Of The Literature ◽  
Catastrophic Antiphospholipid Syndrome ◽  
Short Period ◽  
Threatening Condition ◽  
Life Threatening

Catastrophic antiphospholipid syndrome (CAPS) is a life-threatening condition characterized by multiple thromboembolic events occurring in a short period of time, frequently accompanied by significant systemic inflammation. Aortic involvement is rare in antiphospholipid syndrome and it had been never described in the context of its catastrophic variant. Here, we report an unusual case of aortic occlusion as a debut manifestation of CAPS and discuss its clinical features with an up-to-date review of the literature to identify risk factors and clues for clinical practice.

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