Ketamine in the management of generalised cephalic tetanus

2007 ◽  
Vol 122 (12) ◽  
pp. 1389-1391 ◽  
Author(s):  
O Obanor ◽  
H O Osazuwa ◽  
J E O Amadasun

AbstractBackground:Tetanus is a fatal infection caused by the neurotoxin tetanospasmin released by the vegetative spores of Clostridium tetani. The high mortality rate is related to frequent tetanic fits with laryngeal spasm and airway obstruction. Numerous anticonvulsants are in use, with varying efficacy in controlling fits. This case report highlights the use of ketamine as adjunctive therapy in the management of tetanus.Case report:A 20-year-old woman was admitted with a history of recurrent left ear pain, with bloody, purulent discharge, following a self-inflicted injury. She developed tetanic spasms 24 hours after admission. She had received no immunisations. A tracheostomy was established to relieve airway obstruction, and ketamine was added to the medication when breakthrough seizures were refractory to diazepam.Conclusion:Ketamine is of proven safety as an anaesthetic agent, especially in cases in which an anaesthetist is not readily available. Its effectiveness in this case, in combination with diazepam, warrants further evaluation.

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daniel Ardian Soeselo ◽  
Wirawan Hambali ◽  
Sandy Theresia

Abstract Background In patients who are critically ill with COVID-19, multiple extrapulmonary manifestations of the disease have been observed, including gastrointestinal manifestations. Case presentation We present a case of a 65 year old man with severe COVID-19 pneumonia that developed hypercoagulation and peritonitis. Emergent laparotomy was performed and we found bowel necrosis in two sites. Conclusions Although rare, the presentation of COVID-19 with bowel necrosis requires emergency treatments, and it has high mortality rate.


Author(s):  
Ankitha Peetha ◽  
Nahida Farheen Shaik ◽  
Spandana Ayela

Myocardial infarction can be complicated by Ventricular septal rupture which is a rare fatal grim mechanical complication of MI which is a surgical emergency due to its incredibly high mortality rate. We depict a case of Anterior wall MI which was complicated by Ventricular septal rupture post fibrinolytic therapy.


2020 ◽  
Vol 6 (1) ◽  
pp. 45-48
Author(s):  
Sonam Gyamtsho

Introduction: Infants and children are very prone to air way obstruction due to smaller and immature air ways. There are multiple causes of upper airway obstruction in infants like infections, congenital lesions and rarely tumours of the upper airway. However, angiofibrolipoma, a rare variant of lipoma causing intermittent respiratory distress in an infant has not been reported until now. Objective: To report a very rare case of angiofibrolipoma arising from the soft palate in an infant. Case report: Two and half months old female child reported to the department of otolaryngology with a history of intermittent airway obstruction since one month of age. After evaluation she was found to have a fleshy polypoidal mass above the laryngeal inlet arising from soft palate causing airway compromise. She underwent surgical excison with bipolar cautery under general anaesthesia. Conclusion: Few cases of angiofibrolipoma has been reported in adults but none has been reported in children. This is to report a case of angiofibrolipoma in child causing airway obstruction.


2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
N. Houari ◽  
S. Touzani ◽  
H. Salhi ◽  
M.-Y. Alaoui Lamrani ◽  
K. Ibnmajdoub ◽  
...  

Background. Catecholamine-induced cardiogenic shock is a rare manifestation of paragangliomas. The high mortality rate of this condition makes the immediate, multidisciplinary approach mandatory. Case Report. We report a case of an 18-year-old woman with a retroperitoneal secreting paraganglioma, complicated with a cardiogenic shock and an acute adrenergic myocarditis, requiring hemodynamic support and emergency arterial embolization prior to surgical excision, with a favorable outcome. Conclusion. Paraganglioma-induced myocarditis is rare but can be dramatic. Management requires appropriate and immediate hemodynamic support. Embolization may be an alternative to stabilize the patient prior to surgery.


2012 ◽  
Vol 127 (S1) ◽  
pp. S39-S41 ◽  
Author(s):  
G Sim ◽  
F Lannigan

AbstractObjective:We report lateral sinus thrombosis occurring as a rare complication following a routine and uneventful otological procedure.Case report:Lateral sinus thrombosis is a rare but known complication of otitis media. It has not been documented as a complication of routine otological surgery. We present a case of this rare complication following a myringoplasty. We also discuss the presentation, investigation and treatment of lateral sinus thrombosis. It is essential to be able to recognise and treat this rare complication early, due to its high mortality rate.Conclusion:Lateral sinus thrombosis is a rare but potentially life-threatening complication. It is therefore essential for clinicians to be able to recognise and treat this condition early.


2011 ◽  
Vol 2011 ◽  
pp. 1-2 ◽  
Author(s):  
M. A. Alhaji ◽  
U. Abdulhafiz ◽  
C. I. Atuanya ◽  
F. L. Bukar

A case report of cephalic tetanus in a 2-year-old girl who was not immunized against tetanus following suppurative otitis media (SOM) is presented. This case is reported because of the rarity of cephalic tetanus associated with high mortality, to highlight the risk of cephalic tetanus as sequelae of SOM and the need for proper aural care and prompt treatment of SOM. Primary immunization of all eligible children as well as booster vaccination at appropriate time as an effective management strategy for tetanus is emphasized.


2020 ◽  
Vol 8 (C) ◽  
pp. 121-124
Author(s):  
Darmadi Darmadi ◽  
Riska Habriel Ruslie ◽  
Carolus Trianda Samosir

BACKGROUND: Gallstone ileus (GI) is a mechanical obstruction in the intestinal lumen due to gallstones. Its prevalence is very low, but it possesses a high mortality rate. It is commonly found in older female population. CASE REPORT: We reported a case of GI in a 61-year-old Chinese female, who presented with acute onset of abdominal pain, nausea, and intermittent vomiting. On water-soluble contrast follow-through examination, she showed total bowel obstruction on the level of terminal ileum due to suspected gallstone. Exploratory laparotomy with procedure of enterolithotomy and stone removal by milking the bowel distal to the stone were performed. Post-operative course was uneventful, but the patient was discharged at post-operative day 8. Furthermore, the patient underwent cholecystectomy and fistula repair in the following days (two-stage surgery). She was followed up in the clinic for 12 months and the patient remained asymptomatic. CONCLUSION: GI is a rare medical condition with a high mortality rate, commonly affecting females and elder population. It must be considered in a patient with bowel obstruction, especially with a history of cholelithiasis. Many clinicians prefer enterolithotomy alone, followed by cholecystectomy at later date, because of its lower morbidity and report high spontaneous fistula closure.


2015 ◽  
Vol 7 (2) ◽  
pp. 81-82
Author(s):  
Rabindra Kumar Khatua

ABSTRACT We present a case of a 10 years old child who swallowed a live fish, which resulted in severe upper airway obstruction. The child presented to the casuality with severe airway obstruction with a history of accidental slippage of a live Koi fish into the throat. He was restless, dysphasic, dyspneic, typically placing his hands in front of his neck. On physical examination, there was suprasternal retraction and bilateral decreased breath sound. Direct laryngoscopy was done and fish was removed from hypopharynx as an emergency procedure. We outline our emergency airway management strategies and focus our discussion on the technique used to remove the impacted fish from the upper airway, which was paramount for the successful outcome of this case. How to cite this article Khatua RK. Fish in Hypopharynx: A Rare Case Report. Int J Otorhinolaryngol Clin 2015;7(2):81-82.


2019 ◽  
pp. 43-47
Author(s):  
Juliana C Ferreira ◽  
Maria Lucia B Santos ◽  
Marcia A Souza ◽  
Gisele M Silva ◽  
Ana Cristina S Monteiro ◽  
...  

Toxic epidermal necrolysis is a rare and severe skin reaction with a high mortality rate. This case report describes a case of toxic epidermal necrolysis in a 7-year-old patient caused by an adverse drug reaction.


2020 ◽  
pp. 194187442095784
Author(s):  
Rizwan Sabir ◽  
McNeill Kirkpatrick ◽  
Jonathan Watts ◽  
Jindong Xu

Cavernous sinus thrombosis (CST) is rare and can present with various nonspecific symptoms. The high mortality rate of this disease is largely due to delayed recognition and treatment. We report a case who presented with unrelenting headache and was diagnosed with temporal arteritis (TA) but did not respond to steroids. Imaging helped make the CST diagnosis and the patient responded well to treatment. This case reiterates the importance of early recognition and treatment of CST, and reminds physicians to include CST as an essential differential diagnosis of TA.


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