Asunto(s)
Colecistitis/virología , Hepatitis A , Enfermedad Aguda , Niño , Colecistitis/diagnóstico , Femenino , Hepatitis A/diagnóstico , HumanosRESUMEN
BACKGROUND: The malmignatte Latrodectus mactans tredecimguttatus, commonly known as a black widow spider, can be found in the Mediterranean region. Its bite is a cause of a rarely seen syndrome called latrodectism. CASE REPORT: During a visit to Corsica, a 13-year-old boy developed abrupt severe abdominal pain and spasmodic muscular contractions, headache and vomiting. The patient was restless and experienced hallucinations including distressing visions of death. His high blood pressure (154/100 mmHg) returned to normal within 3 days. Clinical examination revealed dyspnea and facial edema associated with blepharoconjunctivitis and hyperreflexia, together with a scattered erythema and pruritus. These changes took place within minutes, after a probable black widow spider bite. The abdominal and neuropsychiatric symptoms disappeared after 5 days. Treatment with calcium gluconate, paracetamol, phloroglucinol and hydroxyzine had no effect, but diazepam decreased the acuteness of the symptoms. Anti-venom serum was not used. CONCLUSION: Diagnosis of latrodectism must be based on clinical and epidemiological data. Erroneously diagnosing surgical acute abdomen, renal colic, meningitis, tetanus or opioid withdrawal would entail incorrect treatment.
Asunto(s)
Araña Viuda Negra , Picaduras de Arañas/diagnóstico , Adolescente , Animales , Humanos , Masculino , Picaduras de Arañas/fisiopatologíaRESUMEN
BACKGROUND: The hypoglossia-hypodactylia syndrome, a combination of limb hypogenesis and micrognathia is exceptionally associated with glossopalatine ankylosis and cleft palate. CASE REPORT: A twin girl from monochorionic pregnancy had hypoglossia and micrognathia with anterior maxillo-mandibular fusion, glossopalatine ankylosis and cleft palate. Her left foot was amputated distal to the talus and calcaneous; her right foot had only one phallange. The second phallange of the second finger was hypoplastic on her right hand. There was no abnormality on left hand. Her sister was unaffected. The maxillo-mandibular fusion was divided on second day. The infant was able to suckle on the tenth day. Episodes of airway obstruction occurred on cardiorespiratory recording and the patient was further monitored at home. CONCLUSION: This case suggests that the hemodynamic disorders due to multiple vascular connections from monochorionic pregnancies may have induced ischemic lesions of hypoglossia-hypodactylia. Other malformations and signs of brain stem dysfunction should be detected.
Asunto(s)
Anomalías Múltiples , Anquilosis/complicaciones , Fisura del Paladar/complicaciones , Sinostosis/complicaciones , Enfermedades en Gemelos , Femenino , Glotis/fisiopatología , Humanos , Recién Nacido , Mandíbula/anomalías , Maxilar/anomalías , Hueso Paladar/fisiopatología , SíndromeRESUMEN
BACKGROUND: Chronic administration of theophylline can be used for treating asthma; it may represent a severe risk when some other drugs are prescribed by unaware physicians. CASE REPORT: A 4 yr-8-mo-old boy was admitted suffering from status epilepticus which occurred 3 hours after vomiting. This patient had asthma and was given sustained-release formulation of theophylline and, independently by another physician, two anti-H1 drugs: ketotifen and mequitazine. Serum theophylline concentration measured 9 hours after the onset of vomiting was 28 micrograms/ml; the calculated concentrations were 45.3 +/- 4, 40.2 +/- 4 and 33.4 +/- 4 micrograms/ml after the last administration of theophylline, the onset of vomiting and the onset of seizures, respectively. The patient was given IV fluids plus clonazepam and recovered completely. CONCLUSION: Severe poisoning can be seen with moderately increased blood levels of theophylline when this drug is chronically administered. Association of other drugs such as anti-H1 could represent an additional risk.
Asunto(s)
Asma/complicaciones , Estado Epiléptico/etiología , Asma/tratamiento farmacológico , Broncodilatadores/administración & dosificación , Broncodilatadores/uso terapéutico , Preescolar , Quimioterapia Combinada , Humanos , Cetotifen/administración & dosificación , Cetotifen/uso terapéutico , Masculino , Fenotiazinas/administración & dosificación , Fenotiazinas/uso terapéutico , Estado Epiléptico/inducido químicamente , Teofilina/administración & dosificación , Teofilina/uso terapéuticoRESUMEN
We report the case of a 13 year-old white teenager who was referred for chronic bone pain. Physical examination showed a swelling of the anterior part of the neck and biological findings clearly evoked a primary hyperparathyroidism. The surgical treatment was successful and confirmed the diagnosis of parathyroid adenoma. Primary hyperparathyroidism being unusual in childhood, the eventuality of a multiple endocrine neoplasia is discussed.