Splenic Hematoma as a First Manifestation of Cytomegalovirus Infection

Splenic rupture is rare but life threatening complication of mononucleosis syndrome. It has been suggested that subcapsular splenic hematoma formation precedes rupture. The case of 44-year-old, previously healthy, male with splenic hematoma occurring after rising of heavy cargo is reported. Mononucleosis syndrome was suggested based on routine laboratory tests (elevated white blood cell count with predominance of lymphocytes and raised serum transaminases) and CMV infection was confirmed by serological test. Nonoperative management was used since the patient was hemodynamically stable with no further signs of splenic rupture. The same approach has been used in growing number of cases of patients with spontaneous splenic rupture in mononucleosis syndrome. Importance of considering splenic hematoma and/or rupture if abdominal pain occurs in the course of mononucleosis syndrome is outlined as well as importance of routine laboratory tests in suspecting mononucleosis syndrome in otherwise clinically silent patient

Prognostic Values of IL-6, IL-8, and IL-10 in Acute Pancreatitis

Goals: The prognostic importance of interleukin-6 (IL-6), IL-8, and IL-10 in the prediction of acute pancreatitis severity. Background: Early assessment of severity in acute pancreatitis could help the patients who are at risk of developing complications. Unfortunately, the used prognostic scoring systems generally are only moderately accurate in assessing disease severity. Study: We studied 117 consecutive patients with a diagnosis of acute pancreatitis admitted to our hospital during the past 2 years. Laboratory parameters and cytokines were analyzed from serum taken routinely on admission. Severity criteria were noted for each patient using Ranson, Glasgow, and APACHE II scoring systems. Local and systemic complications, developed during a follow-up period, were classified by Atlanta criteria. Results: IL-6 was the only parameter that statistically significantly predicted complicated acute pancreatitis (P<0.05). IL-8 and IL-10 and the 3 prognostic scoring systems used did not properly assess complicated versus noncomplicated acute pancreatitis. Conclusions: Our prospective study supported the potential importance of IL-6 in the early assessment of complicated acute pancreatitis, but also suggested that pancreatitis classified as complicated in a large number of patients could not be correctly predicted with the Ranson, Glasgow, and APACHE II scoring systems

Accidental plant poisoning with Colchicum autumnale: report of two cases

Colchicine poisoning is a rare but serious and potentially fatal event, which results from food poisoning or overdose with drugs containing colchicine, with no currently available antidote. We report two cases of plant poisoning with Colchicum autumnale, in which the patients had identical initial symptoms but developed extremely different clinical courses. One patient recovered after only moderate gastroenteritis and liver injury, whereas the other died of rapid progressive multiple organ failure 52 h after the plant ingestion. We recommend that all patients suspected of colchicine intoxication due to its unpredictable outcome should be managed according to the principles of intensive care, irrespective of the actual degree of poisoning

Accidental plant poisoning with Colchicum autumnale: report of two cases

Colchicine poisoning is a rare but serious and potentially fatal event, which results from food poisoning or overdose with drugs containing colchicine, with no currently available antidote. We report two cases of plant poisoning with Colchicum autumnale, in which the patients had identical initial symptoms but developed extremely different clinical courses. One patient recovered after only moderate gastroenteritis and liver injury, whereas the other died of rapid progressive multiple organ failure 52 h after the plant ingestion. We recommend that all patients suspected of colchicine intoxication due to its unpredictable outcome should be managed according to the principles of intensive care, irrespective of the actual degree of poisoning