Acetazolamide in the resolution of cerebrospinal fluid cutaneous fistula after peridural analgesia: Case report1

AbstractBackgroundCerebrospinal fluid cutaneous fistula following spinal anaesthesia is a serious and rare complication which requires a prompt diagnosis. However, the treatment management is not well defined.Clinical caseFemale aged 50 with a stage IIB cervical carcinoma, who had a peridural catheter inserted at lumbar level. Three days after surgery she refers severe headache, which was corroborated by leakage of cerebrospinal fluid through the puncture. She was prescribed antibiotics and acetazolamide 250mg every 8hours for five days with a favourable outcome.ConclusionIn this case, management with acetazolamide and suture of the fistula inhibits cerebrospinal fluid leakage, without the need for a blood patch

Expression of TREM-1 in maternal leukocytes in preterm, prelabour rupture of the membranes

Studies have shown that triggering receptor expressed on myeloid cells-1 (TREM-1) is the mediator and activator of neutrophils and monocytes after stimulation with lipopolysaccharide (LPS), heat-inactivated Gram (−) bacteria, Gram (+) bacteria or fungi. Different studies have measured the expression of TREM-1 in patients with bacterial infections and critical states. The purpose of this study was to evaluate the expression of TREM-1 in circulating maternal leukocytes in premature rupture of the membranes (PRM). Two groups of patients were included in this case control study: pregnant women with PRM and healthy controls. All patients were free of any infection, including cervix and urinary tract. Although all patients expressed TREM-1 to some extent, there was no statistically significant difference in the expression of different cellularities in both groups; except for the mononuclear leukocytes (p < 0.05). In this study, TREM-1 was not altered in PRM