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1.
Am J Case Rep ; 22: e928394, 2021 Jun 28.
Artículo en Inglés | MEDLINE | ID: mdl-34181635

RESUMEN

BACKGROUND Esophageal necrosis is a rare entity characterized by the presence of extensive circumferential necrosis of the esophagus. It generally affects older adults who have associated chronic pathologies and has a reported mortality rate of approximately 32%. Most patients with esophageal necrosis have a complex clinical course. CASE REPORT We present the case of a 37-year-old man with idiopathic chronic renal failure who presented to the Emergency Department with sudden esophageal necrosis and mediastinitis, associated with invasive candidiasis. Diagnosis was challenging owing to the rarity of the condition. The patient required intensive care management and multiple surgical procedures. CONCLUSIONS Esophageal necrosis is an uncommon pathology that can be fatal because of associated complications. Its pathophysiology is unclear, and its treatment is based on the control of local injury and signs and symptoms. Acute esophageal necrosis associated with invasive Candida sp. infection is even more infrequent, with only a few cases reported in the literature.


Asunto(s)
Candidiasis Invasiva , Mediastinitis , Adulto , Candidiasis Invasiva/complicaciones , Candidiasis Invasiva/diagnóstico , Esófago , Humanos , Masculino , Mediastinitis/diagnóstico , Necrosis
2.
Am J Case Rep ; 22: e928420, 2021 Jun 10.
Artículo en Inglés | MEDLINE | ID: mdl-34111056

RESUMEN

BACKGROUND Pesticides are commonly used in the agricultural industry. Overdose can be lethal due to its effects generating closure of the voltage-gated sodium channels in the axonal membranes. Most case reports of toxicity refer to skin exposure and there are very few that refer to effects due to its oral intake. CASE REPORT We report the case of an elderly woman with Alzheimer disease who accidentally swallowed 50 g of Lambda Cyhalothrin (GOLPE 5 M E®), a pyrethroid of medium toxicity containing a cyano group. It severely harmed the woman's health, causing severe central nervous system depression and refractory vasodilated shock requiring the use of vasopressors. Its management was challenging, requiring orotracheal intubation, vasopressors, and admission to the Intensive Care Unit (ICU). The emergency care team decided to use intravenous lipid emulsion, which clearly helped with the recovery and successful discharge of the patient. CONCLUSIONS The use of intravenous lipid emulsion for the treatment of pyrethroid poisoning can lead to successful outcomes, as described in this case report.


Asunto(s)
Enfermedad de Alzheimer , Sobredosis de Droga , Plaguicidas , Piretrinas , Anciano , Anciano de 80 o más Años , Enfermedad de Alzheimer/tratamiento farmacológico , Sobredosis de Droga/tratamiento farmacológico , Emulsiones Grasas Intravenosas/uso terapéutico , Femenino , Humanos , Piretrinas/uso terapéutico
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