Acute pulmonary edema: Report of a case with autopsy

A case is presented which offers detailed clinical and electrocardiographic study of the nature and causation of attacks of acute pulmonary edema. Autopsy findings substantiate the clinical diagnosis and are further verification of the accepted theory of the cause of this syndrome.     

Dieulafoy＇s lesion： A case series study

AIM: Dieulafoy's lesion (DL) accounts for 1-5.8% of cases of acute upper gastrointestinal bleeding (GIB). Its mortality is high, approaching 20%, despite recent advances In endoscopic therapy. We aimed to report our experience in the treatment of DL. METHODS: A retrospective case study of all patients with DL between January 1993 and January 2003 was done. Characteristics, treatment methods, success rates and 30-d mortality of the patients were analyzed. RESULTS: Thirty-six patients were noted to have DL in the study period. Thirty-three records were available for assessment in which 35 DL were identified. The median age of the patients was 67 years with male to female ratio of 5.6:1. Significant comorbidities existed in 69% of the patients. Eighty-nine percent of the DL was found at first endoscopy, three DL at laparotomy. Significant coexistent endoscopic findings existed in 23%. Hemostasis was achieved in 88% by using adrenaline injection, or in combination with heater probe application at first endoscopy. Four cases had re-bleeding, all were successfully treated endoscopically. The 30-d mortality rate was 23%. CONCLUSION: Successful endoscopic hemostasis could be achieved in 100% of cases of DL. The overall mortality may still remain high, mainly due to the comorbidities and age of these patients.     

Acute myocarditis with Toxoplasma gondii. A case report in a newborn

Acute myocarditis with Toxoplasma Gondii in immunocompetent patients is rare and the paediatric cases touch old children. These myocarditis lead sometimes cardiac insufficiency and sometimes mimic a myocardial infarction. The evolution is often favorable, even when there is no pest-destroying treatment. We report a case of myocarditis toxoplasma Gondii with which has occurred in a 11 month and half old infant, whose evolution was favorable with a symptomatic and pest-destroying treatment. The interest of this observation is related to the scarcity of acute myocarditis caused by toxplasmosis in infant without immunoinsufficiency.     

Acute necrotizing eosinophilic myocarditis presenting as ST-elevation myocardial infarction: a case report

Eosinophilic myocarditis (EM) is a rare disease. The spectrum of clinical presentation is wide and it is often fatal if left untreated. We report a case of eosinophilic myocarditis manifesting as ST-elevation myocardial infarction (STEMI) with cardiogenic shock treated successfully with steroids. This diagnosis should always be considered in patients with an acute coronary syndrome and normal coronary arteries, especially in the presence of a history of allergies, asthma or peripheral eosinophilia.     

Acute hyperparathyroidism with systemic calcinosis. Report of a case

A patient with a huge mediastinal parathyroid adenoma had an acute hypercalcemic crisis. The patient exemplifies the many pitfalls in diagnosis and management of this unusual complication. Postoperatively the patient further developed severe calciphylaxis with calcinosis cutis and systemic and pulmonary calcinosis, a most rare condition.     

Acute staphylococcic valvulitis with vegetations of rheumatic type: Report of a case

A case of staphylococcic pyemia is presented which showed many rheumatic, some small bacterial, and some transitional forms of vegetations on the mitral valve. It is suggested that vegetations of rheumatic type may be produced by staphylococci.     

Acute hemorrhage from right-colonic hemangiomas: Report of a case

Summary and Conclusion A rare case of severe rectal bleeding beginning in adult life is reported. A diffuse, cavernous hemangioma of the right transverse colon was visualized by superior mesenteric arteriography and the diagnosis was confirmed by peroperative colonoscopy carried out through a colotomy. The patient was treated by right hemicolectomy. the diagnostic value of selective abdominal arteriography in patients who have severe rectal bleeding is demonstrated.     

Acute pancreatitis associated with non-A-non-B hepatitis. Report of a case

A 33-year-old man, vaccinated against hepatitis B virus, working in an hemodialysis unit, pricked himself with a needle used in a patient. Four weeks later he developed acute hepatitis along with acute pancreatitis. The pancreatitis resolved, but the liver disease ran a chronic course. The diagnosis of hepatitis non-A-non-B (NANB) was made on the following criteria: (a) epidemiologic circumstances, (b) exclusion of other causes of acute and/or chronic liver disease, (c) chronic indolent course, and (d) compatible histological features. The diagnosis of acute pancreatitis was made with clinical, biological, and radiological data. We believe that the pancreatitis was related to the NANB viral infection, as they began simultaneously and other causes of pancreatitis were eliminated. Such an association has been reported mainly with hepatitis B and exceptionally with hepatitis A. It has also been observed in the course of fulminant NANB viral hepatitis, but we believe this to be the first case associated with a benign form of NANB.     

Acute rickettsial myocarditis. Description of a clinical case and review of the literature

A case of acute rickettsial myocarditis in a young patient is described. The Authors analyze the clinical features, discuss epidemiologic features and the necessity of treatment with tetracycline.     

A case of diphtheric myocarditis, Anatomoclinical study with histology of the conduction system]

Presentation of a case of diphteric myocarditis. The histological examination of the conduction system can explain the rhythm disturbances in the present case with the EKG characteristics of the sick sinus syndrome and the intraventricular conduction disturbances. The anatomical lesions are variables in their topography and age, explaining the variability of the troubles of the rhythm during the first weeks of the disease. The fibrotic scars and the ageing changes of the conduction system are probably the reason for the late constitution of AV block and sick sinus syndrome, years after the acute episode.     

A case of acute isolated (Fiedler's) myocarditis diagnosed by histopathological study with rapid unfortunate course]

A 65 year-old-man was admitted to our hospital complaining of orthopnea and precordial oppressive feeling. Chest roentgenogram revealed congestive heart failure. Electrocardiogram revealed acute myocardial infarction-like pattern. Serum enzymes (CPK, GOT, LDH) were slightly elevated, but serum antiviral antibodies were not elevated. Echocardiogram showed severe symmetrical left ventricular (LV) hypertrophy, but there was no abnormality of LV wall motion. He died of progressive heart failure and ventricular fibrillation on the second hospital day. A necropsy was performed within one hour of death. The heart was enlarged (690 g) with both left and right ventricular hypertrophy. The myocardium disclosed a diffuse infiltration predominantly of eosinophilic leucocytes. Histopathological study revealed giant cell formation and granulomatous lesions in the myocardium. There was no overt endocarditis or pericarditis. We concluded that the severe LV hypertrophy was due to myocardial inflammatory swelling. From these findings, we diagnosed this case as acute isolated (Fielder's) myocarditis.     

暴发性病毒性心肌炎1例

1病例资料 患者,男,36岁,因＂突发胸闷痛2d＂于2010-06-20收入广东省人民医院。患者入院前一天的中午12时无明显诱因突然出现胸闷,呈压榨样,持续性,后自行缓解,入院当天早晨6时许再次出现胸闷痛,同时伴全身冷汗,无向它处放射,无气促,无恶心、呕吐,无腹泻。     

Acute renal failure associated with mannitol intoxication. Report of a case

Mannitol intoxication has been reported as a potentially life-threatening complication when the agent is used unrestrictedly in patients with established renal failure. We report a case of mannitol intoxication in which acute oliguric renal failure occurred without a known predisposing factor other than the intravenous infusion of massive quantities of mannitol.     

Acute methanol poisoning: a case study.

Acute methanol poisoning produces severe anion gap metabolic acidosis caused by the toxic accumulation of metabolites, primarily formic acid. Formic acid produces serious neurologic sequelae. Therefore, an understanding of the mechanism of toxicity, treatment, and clinical course is essential in preventing permanent neurologic dysfunction. Prompt recognition and treatment are the keys to successful patient outcomes. This article presents a case report of a patient with severe methanol poisoning with clinical course, treatment, and outcome.