RESUMEN
PURPOSE: We report a case of human rabies diagnosed by the metagenomics next-generation sequencing (mNGS). A 59-year-old man developed clinical rabies 20 days after he was bitten by dogs. Treatment included induction of coma initially; rabies vaccine was not administered. The patient was treated with propofol, midazolam, recombinant human interferon α2b, ribavirin, and amantadine. Penehyclidine was administrated to relieved the rabies induced pulmonary edema and the salivation. RESULTS: The patient's situation got worse on the 26th day after admition, and died on the 29th day finally. CONCLUSION: The mNGS might be a new choice for human rabies diagnosisï¼penehyclidine was effective in decreasing the rabies induced pulmonary edema and the salivation.
Asunto(s)
Edema Pulmonar , Rabia , Masculino , Humanos , Animales , Perros , Persona de Mediana Edad , Rabia/diagnóstico , Edema Pulmonar/tratamiento farmacológico , Amantadina/uso terapéutico , Ribavirina/uso terapéutico , Secuenciación de Nucleótidos de Alto Rendimiento , Sensibilidad y EspecificidadRESUMEN
OBJECTIVE: To report the outcome of a patient who developed aneurysm after a Deinagkistrodon acutus snakebite. CASE REPORT: A 65-year-old man, bitten by Deinagkistrodon acutus in his right forearm, came to our hospital 10 h after the bite. A pulsatile bulge was found on the right wrist at the third night, and spontaneous ruptured and hemorrhaged suddenly, an emergency surgery was arranged. A ruptured aneurysm of the radial artery was identified and the aneurysm was removed during the surgery. The patient underwent a total of six surgeries, regretfully, he was eventually discharged from the hospital with the right forearm amputated. CONCLUSION: A bite by the Deinagkistrodon acutus snake may be accompanied by aneurysm and spontaneous rupture, and vessel assessment is necessary in snakebite patients.
Asunto(s)
Aneurisma/etiología , Arteria Radial , Mordeduras de Serpientes/complicaciones , Anciano , Aneurisma/diagnóstico , Animales , Antebrazo , Humanos , MasculinoRESUMEN
OBJECTIVE: To report the outcome of a patient who developed pseudoaneurysms and compartment syndrome after a Deinagkistrodon acutus snakebite. CASE REPORT: A 61-year-old man, bitten by Deinagkistrodon acutus in his left forearm, came to the hospital eight hours after the bite. Despite the use of antivenom and supportive therapy, the patient developed compartment syndrome of the left forearm, the tissue pressure was elevated and fasciotomy was arranged. During the initial surgery, part of the necrotic tissues was removed. Moreover, two pseudoaneurysms of the ulnar artery were identified at the second debridement and the pseudoaneurysms were removed during this surgery. The patient went through a total of four surgeries, recovered and was eventually discharged from the hospital. CONCLUSION: A snake bite by Deinagkistrodon acutus may be accompanied by pseudoaneurysms and increased intracompartmental pressure.