RESUMEN
BACKGROUND: Mercury poisoning presents a variety of clinical pictures depending on chemical structure, amount absorbed, total mercury burden, and individual factors. Distant skin lesions, after subcutaneous injection of metallic mercury, have not been previously described. CASE REPORT: We present a homicidal, subcutaneous injection of mercury resulting in widespread skin lesions, remote from the radiologically visible mercury. The lesions appeared at 40 days and began to clear at 6 months after the injection.
Asunto(s)
Intoxicación del Sistema Nervioso por Mercurio/complicaciones , Intoxicación del Sistema Nervioso por Mercurio/diagnóstico , Enfermedades de la Piel/inducido químicamente , Adulto , Fibrosis/inducido químicamente , Fibrosis/patología , Fibrosis/cirugía , Antebrazo/diagnóstico por imagen , Reacción a Cuerpo Extraño/etiología , Reacción a Cuerpo Extraño/patología , Mano/diagnóstico por imagen , Humanos , Inyecciones Subcutáneas , Masculino , Mercurio/administración & dosificación , Mercurio/sangre , Mercurio/orina , Intoxicación del Sistema Nervioso por Mercurio/terapia , Radiografía , Enfermedades de la Piel/diagnóstico , Enfermedades de la Piel/terapia , Espectrofotometría Atómica , Resultado del TratamientoRESUMEN
From January 1984 to May 1994, 17 of 239 children under 15 years old stung by Tityus serrulatus (15.1%) or Tityus bahiensis (84.9%) presented severe envenoming. Of these 17 patients (1-11 years old; median = 2 yr) 14 were stung by T. serrulatus and three by T. bahiensis. All of them received scorpion antivenom i.v. at times ranging from 45 min. to 5 h after the accident (median = 2 h). On admission, the main clinical manifestations and laboratory and electrocardiographic changes were: vomiting (17), diaphoresis (15), tachycardia (14), prostration (10), tachypnea (8), arterial hypertension (7), arterial hypotension (5), tremors (5), hypothermia (4), hyperglycemia (17), leukocytosis (16/16), hypokalemia (13/17), increased CK-MB enzyme activity (> 6% of the total CK, 11/12), hyperamylasemia (11/14), sinusal tachycardia (16/17) and a myocardial infarction-like pattern (11/17). Six patients stung by T. serrulatus had depressed left ventricular systolic function assessed by means of echocardiography. Of these, five presented pulmonary edema and four had shock. A child aged two-years old presented severe respiratory failure and died 65 h after being stung by T. serrulatus. Severe envenomations caused by T. serrulatus were 26.2 times more frequent than those caused by T. bahiensis (p < 0.001).
Asunto(s)
Picaduras de Escorpión , Animales , Brasil , Niño , Preescolar , Humanos , Lactante , Picaduras de Escorpión/diagnóstico , Picaduras de Escorpión/fisiopatología , EscorpionesRESUMEN
Type and frequency of early reactions (ER) were studied in 24 children aging 2-14 years victims of snake bites who received pretreatment with histamine antagonists H1 (dextrochlorfeniramine) and H2 (cimetidine or ranitidine) and hydrocortisone from 1989 to 1993. None of them had atopy nor received any type of anti-venoms(AV) and antitoxins before. Of 24 children, 15 received bothropic AV (ER in 5), 7 crotalic AV (ER in 5), 1 crotalic plus crotalic-bothropic AV, and 1 elapidic AV (ER in 1). In 3 children severe early reactions were observed and they were classified as severe crotalic accident. Results suggest that pre-treatment did not offer safety protection at the appearance of early reactions.