Case Report
Escherichia coli meningitis has been reported rarely in adult patients. Moreover, it is very rare in an adult patient without diabetes mellitus or neurosurgical shunts. Even with treatment, it carries a high mortality ranging from 27% to 90%, and mortality without treatment is 100% [1-3].
We describe a rare case of an adult patient, without known predisposing factors such as diabetes mellitus or neurosurgical shunts, who presented with E. coli meningitis.
Strongyloides infection is usually confi ned to small intestine in gastrointestinal tract. Gastric mucosal Strongyloides with ulceration is extremely uncommon. We describe a patient who presented with gastrointestinal bleeding with gastric Strongyloides diagnosed by biopsy from the base of the gastric ulcer. Patient was treated with ivermectin 9 mg once a day for 2 days. The hospital stay was complicated by severe Klebsiella pneumoniae bacteraemia which needed treatment with meropenem for 2 weeks. Patient was discharged after 40 days of hospital stay.
Abdominal compartment syndrome (ACS) was originally described in trauma patients but is now known to occur in critically ill patients with a myriad of acute illnesses. Recent epidemiological studies have characterized the prevalence of intraabdominal hypertension (defi ned as an intraabdominal pressure [IAP] measured at the urinary bladder ¡Ý12 mmHg) between 2% and 33% [1,2] and the prevalence of ACS (defi ned as an IAP ¡Ý20 mmHg and associated organ system dysfunction) between 1% and 15%. These prevalences are similar to those quoted for sepsis and septic shock in trauma patients.
A 66 year-old female with long-standing history of rheumatoid arthritis on chronic steroid therapy, presented for routine kyphoplasty for a compression fracture of L1 and L2. Pre-operative electrocardiogram (EKG) revealed a normal sinus rhythm and no abnormalities. Her intra-operative course was complicated by severe hypotension. A post operative EKG revealed ST elevation in inferior and lateral leads with ST changes. She underwent a left heart catheterization that revealed normal coronary arteries and an ejection fraction of 70%.
Nosocomial infections (NIs) are one of the most common complications that occur in ICU patients and confer an increased relative risk of 3.5 for mortality. These types of infections may affect from 5 to 35% of patients who are admitted to ICU’s. Guidelines for Environmental Infection Control in Health-Care Facilities by the CDC, and the Healthcare Infection Control Practices Advisory Committee [HICPAC] guidelines have become standard. These recommendations have been tested in clinical trials of routine infection control surveillance.
A 46 year-old Hispanic female with no past medical history, and no history of trauma presented to the hospital with complaints of shortness of breath worsening gradually over past two months. The patient’s physical examination was remarkable for diminished heart sounds at auscultation. A complete blood count chemistry was within normal limit. Collagen vascular profi le was negative. A chest x-ray revealed enlarged cardiac shilloute suggestive of pericardial effusion. A computed tomography (CT) scan of chest showed massive pericardial effusion.
A 25 year-old Hispanic gentleman without any significant past medical history, presented to the emergency department with a 3 hour history of sudden onset shortness of breath and acute progressive quadriparesis. He specifically denied any recent viral infection, recent travel or illicit drug use. He worked as a "chef" in a local restaurant. On initial physical examination, the patient was a slender male in moderate-to-severe respiratory distress. Blood pressure was 160/90 mmHg, heart rate 150 bpm, respiratory rate 32/minute, temperature 38.5 oC and oxygen saturation by pulse oximetry of 98%.
Myxomas are the most common type of primary cardiac tumors, comprising 30-50% of the total in most pathological series. The incidence of atrial myxomas ranges between 0.5 and 1 per million of population/year.
Purpose. To describe the successful endovascular treatment using direct carotid artery access in a high risk elderly patient with symptomatic internal carotid artery stenosis. Case Report. A 98 year-old man who was independent and lived alone was admitted to our hospital for symptoms of progressive weakness, associated with disorientation and difficulty with speech. Duplex carotid ultrasound was performed which revealed a totally occluded right internal carotid artery and high grade stenosis of the left internal carotid artery.
Pellet embolization to the pulmonary artery from a shotgun injury is a rare event. Our current experience with this entity is described. We reviewed the literature of Bullet Embolization with emphasis on management. We believe that shotgun pellet pulmonary artery embolism should be regarded as a separate entity from bullet embolism. The mechanism of injury and its sequelae, leading to complication is very much subtle compared to bullet embolism per se.
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CRITICAL CARE AND SHOCK is published by The Indonesian Foundation of Critical Care Medicine and indexed in Embase and in the Sociedad Iberoamericana de Información Cientifica (SIIC). CRITICAL CARE AND SHOCK (ISSN 1410-7767) is the official journal of the Asia Pacific Association of Critical Care Medicine, Indonesian Society of Critical Care Medicine, Philippine Society of Critical Care Medicine and Society of Intensive Care Medicine (Singapore), Korean Society of Critical Care Medicine, Chinese Society of Critical Care Medicine, and is published Quarterly by The Indonesian Foundation of Critical Care Medicine.