Fatal Agranulocytosis and Fournier's Gangrene due to the Use of Metamizole

WOS: 000462243900025PubMed ID: 30328081

Tracheal Rupture: A Rare Complication of Endotracheal Intubation

WOS: 000489006800009PubMed ID: 31620698Clinicians can encounter various complications after endotracheal intubation as a result of patient anatomy, difficult intubation, and time and number of interventions performed. A life-threatening complication of intubation is iatrogenic tracheal rupture that leads to pulmonary air leak syndromes. In this case report, we present a 10-month-old patient who presented to the healthcare center with cyanosis and cough after foreign body aspiration and underwent endotracheal intubation for hypoxia. In our report, we aim to draw attention to tracheal rupture, a complication that was identified in bronchoscopy and found to be associated with repeated interventions and stylet use

Evaluation of foreign body aspiration cases in our pediatric intensive care unit: Single-center experience

WOS: 000471597800010PubMed ID: 31217709Aim: Foreign body aspiration is one of the common home accidents that requires urgent diagnosis and treatment, especially in children aged between 1 and 3 years. The type, location, and obstruction level of the aspirated material, age of the patient, and time of diagnosis influence the severity of the clinical picture. In our study, we aimed to evaluate patients who underwent bronchoscopy in our clinic with a diagnosis of foreign body aspiration in light of literature data. Material and Methods: The medical records of 87 patients who underwent rigid bronchoscopy with a prediagnosis of foreign body aspiration in cukurova University, Faculty of Medicine, between January 2016 and August 2018, and were followed up in the pediatric intensive care unit after the procedure were examined retrospectively. The subjects were evaluated in terms of age, sex, primary referal center, time of presentation, symptoms at presentation, physical examination findings, radiologic investigations, type and location of foreign body, and duration of stay in the intensive care unit. Results: A total of 87 patients were included in the study. Thirty-seven patients (42.5%) were female. The mean age was found as 33.73 +/- 39.44 (range, 5-202) months. The most common (74.7%) symptom at presentation was sudden onset of coughing. The foreign body aspirated was organic in 62.1% of patients. The most common foreign bodies aspirated were peanuts, with a rate of 19.5%. Four adolescent female patients underwent broncoscopy because they aspirated needles they held in their mouths while tying their headscarves. Interestingly, one patient aspirated a stone and one patient aspirated a parasite. The most frequent location of foreign body was the right main bronchus (n=27, 31%). Conclusion: In the diagnosis of foreign body aspiration, the most important step is maintaining a high index of suspicion. Foreign body aspiration should be considered in patients who present with cough, respiratory distress or cyanosis, unilaterally diminished breath sounds, ronchi or stridor on physical examination, and air trapping on chest X-ray. Bronchoscopy is life-saving in the presence of any suspicious history suggestive foreign body aspiration or refractory pneumonia, even if a physical examination and radiologic findings are normal, especially in high-risk children between 1-3 years old

Transfusion-Associated Acute Lung Injury following Donor Granulocyte Transfusion in Two Pediatric Patients

WOS: 000493544800011PubMed ID: 31673463Transfusion-associated acute lung injury (TRALI) is one of the complications seen due to transfusion. Hypoxemia and bilateral pulmonary infiltration in posteroanterior chest roentgenogram is seen in all cases during transfusion or within the first 6 hours; fever, hypotension, and pink frothy bleeding from endotracheal tube may also be seen. It can be seen following the administration of any blood product. The management strategies for TRALI include withholding the transfusion, positive pressure breathing support, and diuretics. There are few reported cases of TRALI occurring following donor granulocyte transfusion (DGT). In this article, we discuss two cases of TRALI following DGT transfusion

A case of brainstem encephalitis treated with plasmapheresis

WOS: 000429961400013Brain stem encephalitis is a rare disease, which can be triggered by infection, with an unclear etiology, in which infectious and autoimmune mechanisms are thought to play a role in the pathogenesis [1]. Major clinical symptoms are ataxia, muscle weakness and ocular and bulbar dysfunction [2]. Its etiology can vary from infection to autoimmune reasons. Listeria, enterovirus type 71 and Herpes simplex virus are the most common infectious causes. It may also be caused by neurobehcets, Bickerstaff's encephalitis, autoimmune diseases such as multiple sclerosis and paraneoplastic reasons [3-5]. With those in mind, the underlying etiology is unclear in most cases [2]. Treatment is based on etiology. Immunosuppressive treatment can be tried in brain stem encephalitis patients whose etiology can not be made clear [6]. In this case report, we present a case of brainstem encephalitis which did not respond to the present treatment and was treated with plasmapheresis

Polymorphism of hypoxia-inducible factor-1 α gene in pediatric acute respiratory distress syndrome

Objective: To examine if hypoxia-inducible factor-1 α (Hif-1 α ) polymorphisms are associated with pediatric acute respiratory distress syndrome (PARDS). Methods: Twenty two patients with PARDS and 11 non-PARDS controls were examined in pediatric intensive care unit in Cukurova University Balcali Hospital. Blood polymorphism was used to assess the Hif-1 α C1772T and G1790A polymorphisms of Hif-1 α gene, and differences in genotypes between the 2 groups were compared. Results: Hif-1 α C1772T polymorphism was observed only in one case of PARDS group but non-PARDS group didn’t show any C1772T polymorphism. Particularly, the difference in number of cases with Hif-1 α G1790A polymorphism was not significant between PARDS and non-PARDS groups. In addition, Hif-1 α G1790A polymorphism was significantly related to the distribution of lung opacities in children with PARDS (P<0.05). Conclusions: Our results indicate that Hif-1 α G1790A polymorphism is related to an increased susceptibility to pulmonary for PARDS children. The detection of G1790A polymorphism could help pediatricians to predict the extensity of PARDS early in lung tissue

Severe Troponin I Elevation and Myocardia Dysfunction in a Child with Scorpion Sting

WOS: 000449419100010Background Scorpion sting is a common medical problem and major cause of mortality and morbidity in many countries. The symptoms of envenomation are more severe in the pediatric population. The clinical manifestations of scorpion envenomation appear by activation of sympathetic and parasympathetic nervous system. Envenomation can cause multiorgan dysfunction and death. Case Presentation and Findings In this case report, we present a pediatric patient from Adana, Southeast Anatolia, with severe scorpion envenomation with Leiurus abdullahbayrami which is an especially dangerous species for children. Severe systolic dysfunction was detected by echocardiography. Troponin I levels elevated significantly and rapidly responded to three doses of antivenom therapy. Conclusion Early echocardiographic examination is an important procedure for patients with scorpion envenomation. Troponin I is a significant parameter to monitor the degree of cardiac injury. Antivenom therapy is the only recommended specific therapy for children with severe scorpion envenomation due to Leiurus abdullahbayrami. Abnormal echocardiography findings may require repeated doses of scorpion antivenom

Trientine-induced Rhabdomyolysis in an Adolescent with Wilson's Disease

WOS: 000496525900012PubMed ID: 31749561Background: Drugs are very important in the etiology of nontraumatic rhabdomyolysis. Case descriptions: A 16-year-old male patient with Wilson's disease was admitted for myoclonic contractions. Oral trientine was started for neurological problems and tremor on the hands due to D-penicillamine 1 month ago. Patient was oligoanuric, and his creatine kinase level was 15197 U/L. Rhabdomyolysis was associated with trientine, and trientine treatment was stopped. Hemodiafiltration was performed. The patient began to urinate on the 24th day. Conclusion: This is the first pediatric patient with rhabdomyolysis induced by trientine. Drugs used should be questioned carefully in patients with rhabdomyolysis