Severe scombroid poisoning and life-threatening hypotension

2021 ◽  
Vol 14 (4) ◽  
pp. e241507
Author(s):  
Shalika Basnayake Katugaha ◽  
Andrea Christine Carter ◽  
Shashank Desai ◽  
Pelayia Soto
Keyword(s):  
Health Department ◽  
Clinical Syndrome ◽  
Poison Control ◽  
State Health ◽  
St Depression ◽  
Heat Stable ◽  
Fish Poisoning ◽  
Life Threatening ◽  
Fish Ingestion ◽  
Histamine Response

Scombroid fish poisoning (SFP), the most common fish-related illness worldwide, is a histamine response caused by the heat stable toxin histamine. A healthy 48-year-old woman and co-author of this paper developed palpitations, tachycardia and hypotension 10 min after a tuna steak dinner. She subsequently developed numbness of her face, flushing, conjunctival erythema, abdominal pain, nausea, vomiting, diarrhoea, headache and chest pain. Her ECG revealed tachycardia with ST depression. Her hypotension did not respond to fluid resuscitation, and she required phenylephrine. Based on exposure history, clinical syndrome, exclusion of other diseases and consultation with poison control, a diagnosis of scombroid poisoning was established. The state health department was notified. The patient was weaned off vasopressors, dosed famotidine and discharged 43 hours after fish ingestion with no symptoms and normal ECG. SFP is an often misdiagnosed and underreported illness with the potential to cause life-threatening hypotension.

Haemophagocytic Lymphohistiocytosis (HLH) in a case of Enteric Fever

2016 ◽  
Vol 5 (03) ◽  
pp. 4882
Author(s):  
Vineeta Pande ◽  
Agarkhedkar S. R. ◽  
Ayank Tandon* ◽  
Aditya Agarwal
Keyword(s):  
Inflammatory Reaction ◽  
Enteric Fever ◽  
Infectious Agent ◽  
Clinical Syndrome ◽  
Haemophagocytic Lymphohistiocytosis ◽  
Life Threatening ◽  
Stimulation Of

HLH is an uncommon, life threatening clinical syndrome cause by a severe hyper inflammatory reaction triggered by an infectious agent. The characteristic symptoms of HLH are due to the persistent stimulation of lymphocytes and histiocytes, leading to hyper-cytokinemia. We report a case of HLH in enteric fever in a13 year old female presenting with fever, lymphadenopathy and pancytopenia due an infection caused by Salmonella.

scholarly journals Risk stratification in cardiogenic shock: a focus on the available evidence

2021 ◽  
Author(s):  
C. Sciaccaluga ◽  
G. E. Mandoli ◽  
N. Ghionzoli ◽  
F. Anselmi ◽  
C. Sorini Dini ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Cardiogenic Shock ◽  
Clinical Syndrome ◽  
Diagnostic Assessment ◽  
Prognostic Scores ◽  
Current Evidence ◽  
Efficient Resource ◽  
Threatening Condition ◽  
Life Threatening ◽  
Future Direction

AbstractCardiogenic shock is a clinical syndrome which is defined as the presence of primary cardiac disorder that results in hypotension together with signs of organ hypoperfusion in the state of normovolaemia or hypervolaemia. It represents a complex life-threatening condition, characterized by a high mortality rate, that requires urgent diagnostic assessment as well as treatment; therefore, it is of paramount important to advocate for a thorough risk stratification. In fact, the early identification of patients that could benefit the most from more aggressive and invasive approaches could facilitate a more efficient resource allocation. This review attempts to critically analyse the current evidence on prognosis in cardiogenic shock, focusing in particular on clinical, laboratoristic and echocardiographic prognostic parameters. Furthermore, it focuses also on the available prognostic scores, highlighting the strengths and the possible pitfalls. Finally, it provides insights into future direction that could be followed in order to ameliorate risk stratification in this delicate subset of patients.

scholarly journals Medical Specialties With Highest Percentages Of Complaints In The State Of Acre, Brazil

10.3823/2510 ◽  
2017 ◽  
Vol 10 ◽  
Author(s):  
Dilza Teresinha Ambros Ribeiro ◽  
José Hiran Gallo ◽  
Guilhermina Rego
Keyword(s):  
General Practice ◽  
Medical Errors ◽  
Professional Training ◽  
Health Department ◽  
The State ◽  
Medical Council ◽  
State Health ◽  
Medical Specialties ◽  
Deductive Method ◽  
Regional Medical

Background: The present study had the objective of surveying the medical specialties most commonly involved in complaints reported to the Regional Medical Council (CRM) of the state of Acre, between the years 1993 and 2009. Method: Data were gathered from the CRM by means of a questionnaire. This yielded 121 complaints. A deductive method was applied, with quantitative analysis. The results indicated that the specialties most susceptible to “medical errors” were general practice and gynecology. Findings: The results indicated that the specialties most susceptible to “medical errors” were general practice and gynecology. Conclusion: It is hoped that these data will be useful to the State Health Department for justifying greater investments in these fields of scientific knowledge and for better professional training. Keywords: Acre; complaints; specialties; ethics.

The extraction of quality‐of‐care clinical indicators from State health department administrative databases

1999 ◽  
Vol 170 (9) ◽  
pp. 420-424 ◽  
Author(s):  
Jennifer W Majoor ◽  
Joseph E Ibrahim ◽  
Flavia M Cicuttini ◽  
John J McNeil ◽  
Neil W Boyce
Keyword(s):  
Quality Of Care ◽  
Health Department ◽  
Administrative Databases ◽  
State Health ◽  
State Health Department ◽  
Clinical Indicators

scholarly journals List of species in the genus Lutzomyia, França, 1924 (Psychodidae, Phlebotominae) from the State of Mato Grosso

2007 ◽  
Vol 40 (1) ◽  
pp. 11-14 ◽  
Author(s):  
Nanci Akemi Missawa ◽  
Giovana Belem Moreira Lima Maciel
Keyword(s):  
National Health ◽  
Vegetation Type ◽  
Health Department ◽  
Human Action ◽  
The State ◽  
Sand Fly ◽  
State Health ◽  
State Health Department ◽  
Mato Grosso ◽  
Forested Areas

This work had the objective of listing the sand fly species that occur in the State of Mato Grosso, Brazil. Data relating to entomological surveys conducted between 1996 and 2004 were obtained from the National Health Foundation and the State Health Department, and this was supplemented with information from research carried out in the state and from the specialized literature. There were records of 106 sand fly species belonging to the genus Lutzomyia. This is a rich and diversified fauna, with some species restricted to forested areas and others recorded throughout the state, independent of the vegetation type, and in areas modified by human action, with predominance of Lutzomyia whitmani.

scholarly journals Neurological Disturbances of Ciguatera Poisoning: Clinical Features and Pathophysiological Basis

Cells ◽  
2020 ◽  
Vol 9 (10) ◽  
pp. 2291
Author(s):  
Killian L’Herondelle ◽  
Matthieu Talagas ◽  
Olivier Mignen ◽  
Laurent Misery ◽  
Raphaele Le Garrec
Keyword(s):  
Clinical Features ◽  
Acute Phase ◽  
Specific Treatment ◽  
Clinical Syndrome ◽  
Histological Studies ◽  
Neurological Signs ◽  
Ciguatera Fish Poisoning ◽  
Fish Poisoning ◽  
Sensory Disturbances ◽  
Subtropical Fish

Ciguatera fish poisoning (CFP), the most prevalent seafood poisoning worldwide, is caused by the consumption of tropical and subtropical fish contaminated with potent neurotoxins called ciguatoxins (CTXs). Ciguatera is a complex clinical syndrome in which peripheral neurological signs predominate in the acute phase of the intoxication but also persist or reoccur long afterward. Their recognition is of particular importance in establishing the diagnosis, which is clinically-based and can be a challenge for physicians unfamiliar with CFP. To date, no specific treatment exists. Physiopathologically, the primary targets of CTXs are well identified, as are the secondary events that may contribute to CFP symptomatology. This review describes the clinical features, focusing on the sensory disturbances, and then reports on the neuronal targets and effects of CTXs, as well as the neurophysiological and histological studies that have contributed to existing knowledge of CFP neuropathophysiology at the molecular, neurocellular and nerve levels.

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