scholarly journals Steroid-induced psychosis in a child with croup: A case report

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110534
Author(s):  
Abdullrahman Alsalamah ◽  
Saud Alsahali
Keyword(s):  
Emergency Department ◽  
Single Dose ◽  
Case Report ◽  
Adverse Effects ◽  
Pediatric Population ◽  
Psychiatric History ◽  
Psychiatric Disturbances ◽  
Rare Side Effect ◽  
Abnormal Behaviors ◽  
Respiratory Complaints

Corticosteroids are effective for the treatment of many chronic and acute diseases but have many well-known adverse effects, which limit their use in some conditions. Steroid-induced psychosis is a rare side effect especially in the pediatric population. Although the estimated incidence of steroid-induced psychosis in adults is approximately 6%, it is rarely reported in the pediatric population. Moreover, it is poorly characterized and described in the literature. We report the case of a 4-year-old boy with no known medical or psychiatric history who presented to the emergency department with respiratory complaints. After observation and monitoring, the patient was diagnosed as having croup. A single dose of 8 mg dexamethasone was started intravenously. Within 3 h after the injection, the patient experienced psychiatric disturbances, including abnormal behaviors, anxiety, disorientation, decreased speech, and sleep disturbance. During the first 48 h of admission, the symptoms improved gradually, without using further medication during the rest of his hospital stay.

scholarly journals Bowel perforation after single-dose activated charcoal

CJEM ◽  
2006 ◽  
Vol 8 (05) ◽  
pp. 358-360 ◽  
Author(s):  
Jason P. Green ◽  
William McCauley
Keyword(s):  
Emergency Department ◽  
Single Dose ◽  
Case Report ◽  
Adverse Effects ◽  
Drug Overdose ◽  
Activated Charcoal ◽  
Literature Search ◽  
Bowel Perforation ◽  
Gastrointestinal Decontamination

ABSTRACT Patients presenting to the emergency department (ED) after medication overdose are often given activated charcoal initially for gastrointestinal decontamination. Complications of charcoal are rare, but do occur. The following case describes a patient with pre-existing undiagnosed diverticular disease who developed sigmoid perforation after a single dose of activated charcoal, given without cathartic for a drug overdose. A literature search revealed no other cases of bowel perforation associated with single-dose activated charcoal. This case report discusses adverse effects associated with activated charcoal and the role of cathartics in gastrointestinal decontamination.

Can low-dose propranolol induce a manic syndrome? Case report of an unexpected side effect

2013 ◽  
Vol 25 (3) ◽  
pp. 184-186 ◽  
Author(s):  
Mahin Eslami Shahrbabaki ◽  
Fariborz Estilaee ◽  
Amir Eslami Shahrbabaki
Keyword(s):  
Single Dose ◽  
Case Report ◽  
Side Effects ◽  
Panic Disorder ◽  
Side Effect ◽  
Adrenergic Receptor ◽  
Low Dose ◽  
Manic Symptoms ◽  
Rare Side Effect ◽  
Adrenergic Antagonists

ObjectivesPropranolol, the first discovered b-adrenergic receptor antagonist, has been prescribed by physicians in various fields for more than three decades. It has been applied for treating psychiatric disorders including schizophrenia, mania and anxiety disorders, as well as for controlling withdrawal symptoms or other side effects.MethodsWe describe the case of an 11-year-old boy with bipolar-I disorder comorbid with panic disorder who developed manic symptoms with a single dose of 10 mg of propranolol.Results and ConclusionAlthough depression is a better-known side effect of b-adrenergic antagonists, clinicians should take mania as a rare side effect into consideration as well.

scholarly journals The Possibility of the Second Generation Antipsychotic-Olanzapine to Cause Severe Akathisia in a Drug Naive Patient -A Case Report

2020 ◽  
Vol 5 (1) ◽  
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Rating Scale ◽  
Psychiatric History ◽  
Naive Patient ◽  
The Family ◽  
Drug Naïve ◽  
Second Generation Antipsychotic ◽  
Severe Anxiety ◽  
Drug Naive Patient

Here we are presenting this case of 26 years old gentleman with no past psychiatric history who presented initially to the emergency department with anxiety and depressive symptoms in the context of ongoing stressors, diagnosed as a case of severe anxiety and started on neuroleptic medication. A few days later, it was reported by the family that the patient was moving around and only sit for a few minutes before starting to move again in response to an urge to keep moving. Barnes Akathisia-Rating Scale was administered and indicated severe akathisia. The patient started on Mirtazapine 15 mg and Propranolol 20 mg twice daily, and he dramatically improved in a few days.

scholarly journals Differentiating stroke, transient ischemic attack, or hemiplegic migraine in a teenager: a case report

2021 ◽  
Vol 15 (2) ◽  
pp. 1-5
Author(s):  
Monika Ciechanowska ◽  
Jan Stachurski
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Transient Ischemic Attack ◽  
Pediatric Population ◽  
Young Patients ◽  
Diagnostic Process ◽  
First Episode ◽  
Hemiplegic Migraine ◽  
Ischemic Attack ◽  
The Right

Background: The symptoms of stroke in the pediatric population are less evaluated than in adults. Although certain indicators are characteristic of stroke – acute drooping of the mouth corners, hemiparesis, and headache – they are not pathognomonic. Other diseases may manifest with similar symptoms, such as the first episode of hemiplegic migraine, and should be differentiated from stroke at an emergency department. Aim of the study: We present the differential diagnosis between stroke, transient ischemic attack, and first episode of hemiplegic migraine in a teenager with alarming focal symptoms. Case report: We present a case of 15-year-old patient with acute headache, drooping of the right mouth corners, and hemiparesis of the right upper and lower limb. He was brought by ambulance to the emergency department under suspicion of a stroke. A series of diagnostic tests performed at the Emergency Department did not reveal any vascular incident. Further diagnosis was performed at the Neurology Department. The patient was discharged from the hospital with a suspicion of first attack of hemiplegic migraine or transient ischemic attack. Conclusions: Differentiating stroke from other conditions in young patients is a significant challenge. The stroke diagnostic process in children requires further research to support accurate diagnosis and, if necessary, treatment as rapidly as possible.

Seborrheic dermatitis: Could be a rare side effect of nortriptyline?

2011 ◽  
Vol 26 (S2) ◽  
pp. 1050-1050
Author(s):  
A. Mehdizadeh Zare Anari ◽  
A. Ghaffarinejad
Keyword(s):  
Side Effects ◽  
Major Depression ◽  
Adverse Effects ◽  
Depressive Episode ◽  
Seborrheic Dermatitis ◽  
Psychiatric History ◽  
Major Depression Disorder ◽  
Anticholinergic Effects ◽  
Rare Side Effect ◽  
Depression Disorder

In Iran, although new antidepressants are available, nortriptyline is widely used because of being economical and accessible.Physicians prescribe it for psychiatric disorders, especially in hospitalized or outpatients with depression.Clinicians know its common side effects, for example anticholinergic effects, but such as other drugs it has rare adverse effects.Here, we present a 27 years old woman with major depression disorder who has been treated with nortriptyline/75 mg/day. After a week she came back with seborrheic dermatitis, the diagnosis was confirmed by a dermatologist. Lesions disappear when she discontinued the drug. In her past psychiatric history we found similar lesions in previous depressive episode and using same drug 5 years ago Which are treated only after stop using nortriptylin. She has no lesions in episode intervals.Although, uncommon skin effects such as uriticaria and angioedema had been reported but this is the first patient with confirmed seborrehic dermatitis.

Case Report: When all claims that it is necrotizing fasciitis but Point of care ultrasound (POCUS) proves the opposite!

POCUS Journal ◽  
2018 ◽  
Vol 3 (1) ◽  
pp. 13-14
Author(s):  
Hadiel Kaiyasah, MD, MRCS (Glasgow), ABHS-GS ◽  
Maryam Al Ali, MBBS
Keyword(s):  
Emergency Department ◽  
Critical Care ◽  
Case Report ◽  
Soft Tissue ◽  
Necrotizing Fasciitis ◽  
Soft Tissue Infection ◽  
Critical Care Unit ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Soft Tissue Infections

Soft tissue ultrasound (ST-USS) has been shown to be of utmost importance in assessing patients with soft tissue infections in the emergency department or critical care unit. It aids in guiding the management of soft tissue infection based on the sonographic findings.

Acute Dystonia after a Single Dose of Intravenous Metoclopramide during Elective Cesarean Section: A Case Report.

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Danielle Levin
Keyword(s):  
Single Dose ◽  
Case Report ◽  
Cesarean Section ◽  
Epidural Anesthesia ◽  
Elective Cesarean Section ◽  
Single Administration ◽  
Dystonic Reaction ◽  
Elective Cesarean ◽  
Combined Spinal Epidural Anesthesia ◽  
Spinal Epidural

We would like to present the first report of severe acute dystonic reaction after a single administration of metoclopramide during cesarean section under combined spinal-epidural anesthesia.  During elective cesarean section, a 30-year-old female vomited four times and was treated with 10mg intravenous metoclopramide and 8mg intravenous ondansetron.  Nausea subsided with the antiemetic treatment, but two minutes later, patient had rapid eye blinking, uncontrollable head movement, and became unresponsive.  Bolus of 50mg intravenous diphenhydramine resolved the acute dystonic symptoms within seconds.  Patient was again oriented times three, with no recollection of symptoms, and remained symptom free for the rest of admission. 

scholarly journals Delayed-Type Hypersensitivity Reaction to Red Tattoo Ink Triggered by Ledipasvir/Sofosbuvir for Hepatitis C: A Case Report

2021 ◽  
pp. 379-383
Author(s):  
Meghan L. McPhie ◽  
Kevin Y.M. Ren ◽  
J. Michael Hendry ◽  
Sonja Molin ◽  
Thomas Herzinger
Keyword(s):  
Case Report ◽  
Hepatitis C ◽  
Adverse Effects ◽  
Hypersensitivity Reaction ◽  
Allergic Reaction ◽  
Delayed Type Hypersensitivity ◽  
Histological Features

Tattoos have become increasingly popular worldwide making adverse effects from tattoos a growing concern. In our report, we present a 51-year-old man who developed an unusual allergic reaction to the red ink portions of his tattoos that coincided with the initiation of ledipasvir/sofosbuvir treatment for his hepatitis C. Clinical and histological features were consistent with a delayed-type hypersensitivity reaction to red ink.

scholarly journals A141 SPONTANEOUS ESOPHAGEAL PERFORATION: AN UNREPORTED COMPLICATION OF LYMPHOCYTIC ESOPHAGITIS

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 128-129
Author(s):  
A LAGROTTERIA ◽  
A W Collins ◽  
A Someili ◽  
N Narula
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Case Report ◽  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Esophageal Perforation ◽  
Distal Esophagus ◽  
Chest Discomfort ◽  
History Of ◽  
Lymphocytic Esophagitis

Abstract Background Lymphocytic esophagitis is a new and rare clinicopathological entity. It is a histological pattern characterized by lymphocytic infiltrate without granulocytes. Its etiology and clinical significance remains unclear. The clinical manifestations are typically mild, with reflux and dysphagia the most commonly reported symptoms. Aims We describe a case report of spontaneous esophageal perforation associated with lymphocytic esophagitis. Methods Case report Results A previously well 31-year-old male presented to the emergency department with acute food impaction. His antecedent symptoms were acute chest discomfort and continuous odynophagia following his most recent meal, with persistent globus sensation. The patient had no reported history of allergies, atopy, rhinitis, or asthma. A previous history of non-progressive dysphagia was noted after resuscitation. Emergent endoscopy revealed no food bolus, but a deep 6 cm mucosal tear in the upper-mid esophagus extending 24 to 30 cm from the incisors. Chest computed tomography observed small volume pneumoperitoneum consistent with esophageal perforation. The patient’s recovery was uneventful; he was managed conservatively with broad-spectrum antibiotics, proton pump inhibitor therapy, and a soft-textured diet. Endoscopy was repeated 48 hours later and revealed considerable healing with only a residual 3-4cm linear laceration. Histology of biopsies taken from the mid and distal esophagus demonstrated marked infiltration of intraepithelial lymphocytes. There were no eosinophils or neutrophils identified, consistent with a diagnosis of lymphocytic esophagitis. Autoimmune indices including anti-nuclear antibodies and immunoglobulins were normal, ruling out a contributory autoimmune or connective tissue process. The patient was maintained on a proton pump inhibitor (pantoprazole 40 mg once daily) following discharge. Nearly six months following his presentation, the patient had a recurrence of symptoms prompting representation to the emergency department. He described acute onset chest discomfort while eating turkey. Computed tomography of the chest redemonstrated circumferential intramural gas in the distal esophagus and proximal stomach. Conclusions Esophageal perforation is a potentially life-threatening manifestation of what had been considered and described as a relatively benign condition. From isolated dysphagia to transmural perforation, this case significantly expands our current understanding of the clinical spectrum of lymphocytic esophagitis. Funding Agencies None

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