scholarly journals Fatal accidental lipid overdose with intravenous composite lipid emulsion in a premature newborn: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maliha Badr ◽  
Marion Goulard ◽  
Bénédicte Theret ◽  
Agathe Roubertie ◽  
Stéphanie Badiou ◽  
...  
Keyword(s):  
Exchange Transfusion ◽  
Lipid Emulsion ◽  
Infusion Pump ◽  
Serum Triglyceride ◽  
Multiple Organ ◽  
Serum Triglyceride Level ◽  
Case Presentation ◽  
Pump Flow Rate ◽  
Life Threatening ◽  
High Frequency Oscillatory

Abstract Background Tenfold or more overdose of a drug or preparation is a dreadful adverse event in neonatology, often due to an error in programming the infusion pump flow rate. Lipid overdose is exceptional in this context and has never been reported during the administration of a composite intravenous lipid emulsion (ILE). Case presentation Twenty-four hours after birth, a 30 weeks’ gestation infant with a birthweight of 930 g inadvertently received 28 ml of a composite ILE over 4 h. The ILE contained 50% medium-chain triglycerides and 50% soybean oil, corresponding to 6 g/kg of lipids (25 mg/kg/min). The patient developed acute respiratory distress with echocardiographic markers of pulmonary hypertension and was treated with inhaled nitric oxide and high-frequency oscillatory ventilation. Serum triglyceride level peaked at 51.4 g/L, 17 h after the lipid overload. Triple-volume exchange transfusion was performed twice, decreasing the triglyceride concentration to < 10 g/L. The infant’s condition remained critical, with persistent bleeding and shock despite supportive treatment and peritoneal dialysis. Death occurred 69 h after the overdose in a context of refractory lactic acidosis. Conclusions Massive ILE overdose is life-threatening in the early neonatal period, particularly in premature and hypotrophic infants. This case highlights the vigilance required when ILEs are administered separately from other parenteral intakes. Exchange transfusion should be considered at the first signs of clinical or biological worsening to avoid progression to multiple organ failure.

scholarly journals A case of tamoxifen-induced hypertriglyceridemia monitoring the changes in lipoprotein fractions over time

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hayato Isobe ◽  
Masashi Shimoda ◽  
Yuki Kan ◽  
Fuminori Tatsumi ◽  
Yukino Katakura ◽  
...  
Keyword(s):  
Lipolytic Activity ◽  
Lipoprotein Metabolism ◽  
Serum Triglyceride ◽  
Lipoprotein Fraction ◽  
Serum Triglyceride Level ◽  
Nonalcoholic Fatty Liver ◽  
Estrogen Receptor Modulators ◽  
Before And After ◽  
Life Threatening ◽  
Life Threatening Complication

Abstract Background Tamoxifen, which is one of the selective estrogen receptor modulators (SERMs), can bring out life-threatening complication, e.g. hypertriglyceridemia-induced acute pancreatitis, although it is rare. We precisely report changes in lipoprotein metabolism before and after tamoxifen discontinuation because there have been few reports of it. Case presentation 47-year-old premenopausal woman with dyslipidemia, type 2 diabetes, nonalcoholic fatty liver disease and chronic kidney disease was prescribed tamoxifen as adjuvant therapy after operation of breast cancer. She experienced severe tamoxifen-induced hypertriglyceridemia several months after dosing tamoxifen. Before cessation of tamoxifen, lipoprotein fraction test revealed marked stagnation of VLDL and IDL metabolisms, resulting in severe hypertriglyceridemia (serum triglyceride level was 1881 mg/dL). Seven days after tamoxifen withdrawal, lipoprotein fraction test showed that the metabolisms of endogenous lipoproteins were changed drastically. Conclusions From these results, we confirmed that tamoxifen certainly changes lipoprotein metabolism through suppression of post-heparin lipolytic activity. It is very important to evaluate the balance between benefit and risk before dosing tamoxifen and survey lipid profiles constantly during treatment to avoid life-threatening complication when prescription of tamoxifen is planned.

scholarly journals Invasive liver abscess caused by hypervirulent Klebsiella pneumoniae: case report and literature review

2020 ◽  
Author(s):  
Xiao-Guang Xiao ◽  
Zhao-Hong Mu ◽  
Qing-Dong Li ◽  
Yong-Li Zhang
Keyword(s):  
Literature Review ◽  
Klebsiella Pneumoniae ◽  
Liver Abscess ◽  
Pathogenic Bacteria ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction ◽  
Antimicrobial Drugs ◽  
Case Presentation ◽  
Life Threatening

Abstract Background: Klebsiella pneumoniae is a common pathogenic bacteria that cause infectious diseases, Klebsiella pneumoniae invasive liver abscess syndrome is a rare disease, which often caused by hypervirulent Klebsiella pneumoniae(hvKP), the hvKP patients with sepsis may have life-threatening multiple organ dysfunction and visual sequelae.Case presentation: We report a case of Klebsiella pneumoniae invasive liver abscess syndrome caused by hvKP, the patient was treated with long-term antibiotic treatment, along with controlling blood sugar with Insulin, and the patient was eventually discharged from the hospital. Case analysis and literature review were performed to improve the understanding of invasive liver abscess caused by hvKP.Conclusions Patients with hvKP invasive liver abscess are in relatively severe conditions and often have poor visual prognosis. Appropriate antimicrobial drugs should be administered to prevent complications and improve prognosis.

scholarly journals Multi-Site Infections Caused by Methicillin-Resistant Staphylococcus Aureus in a Six-Year Old Girl: A Rare Case Report

2021 ◽  
Author(s):  
pei xiao ◽  
Jing Liu ◽  
Xue Yang ◽  
Yixue Wang ◽  
Weiming Chen ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Pediatric Patients ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Multiple Organ ◽  
Case Presentation ◽  
Methicillin Resistant ◽  
Interdisciplinary Approaches ◽  
Rare Case Report ◽  
Life Threatening ◽  
Mrsa Infection

Abstract Background Community-associated Methicillin-resistant Staphylococcus aureus (CA-MRSA) is an emerging pathogen that leads to severe outcomes, especially in pediatric patients with multiple site infections. Case presentation: We report a case of a multiple organ and life-threatening infection caused by CA-MRSA in a 6-year-old girl who manifested sepsis, myelitis, purulent arthritis, purulent meningitis, hydropericardium, pneumonia, and empyema. The girl exhibited good response to the combination therapy of linezolid and rifampicin after treatment with vancomycin failed due to delay in achieving target serum concentration. We performed pleural effusion and hydropericardium effusion drainage and treated left lower limb infection using interdisciplinary approaches. Conclusion This case highlights the need to be aware of CA-MRSA infection, which requires accurate diagnosis, identification of site infection, appropriate antibiotic treatment, and surgical debridement.

“Spleen Baby”: A Case Presentation of Pyruvate Kinase Deficiency in an Amish Neonate

2016 ◽  
Vol 35 (6) ◽  
pp. 375-380
Author(s):  
Pamela S. Hackman
Keyword(s):  
Pyruvate Kinase ◽  
Blood Cells ◽  
Exchange Transfusion ◽  
Autosomal Recessive ◽  
Recessive Trait ◽  
Autosomal Recessive Trait ◽  
Case Presentation ◽  
Pyruvate Kinase Deficiency ◽  
Life Threatening ◽  
Severe Hyperbilirubinemia

AbstractPyruvate kinase deficiency (PKD) is an autosomal recessive trait in which there is a lack of the enzyme pyruvate kinase. Because of this lack of pyruvate kinase, red blood cells are broken down more freely, thereby causing hemolytic anemia. The degree to which the hemolysis occurs varies from mild-to-severe to life-threatening neonatal anemia and kernicterus necessitating an exchange transfusion. The purpose of this article is to introduce the reader to PKD through a case presentation of severe hyperbilirubinemia necessitating the need for an exchange transfusion. This article also includes the prevalence, clinical features and diagnosis, treatment, and nursing considerations in caring for this type of infant.

scholarly journals Aggressive infantile myofibromatosis with intestinal involvement

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Tristan Römer ◽  
Norbert Wagner ◽  
Till Braunschweig ◽  
Robert Meyer ◽  
Miriam Elbracht ◽  
...  
Keyword(s):  
Kinase Inhibitor ◽  
Molecular Genetic ◽  
Molecular Genetic Analysis ◽  
Multiple Organ ◽  
Molecular Defect ◽  
Infantile Myofibromatosis ◽  
Case Presentation ◽  
Intestinal Involvement ◽  
Life Threatening ◽  
Fluctuating Course

Abstract Background Infantile myofibromatosis (IM) is the most common cause of multiple fibrous tumors in infancy. Multicentric disease can be associated with life-threatening visceral lesions. Germline gain-of-function mutations in PDGFRB have been identified as the most common molecular defect in familial IM. Case presentation We here describe an infant with PDGFRB-driven IM with multiple tumors at different sites, including intestinal polyposis with hematochezia, necessitating temporary chemotherapy. Conclusions PDGFRB-driven IM is clinically challenging due to its fluctuating course and multiple organ involvement in the first years of life. Early molecular genetic analysis is necessary to consider tyrosine kinase inhibitor treatment in case of aggressive visceral lesions.

scholarly journals Perforation of the atrial wall and aortic sinus after closure of an atrial septal defect with an Atriasept occluder: a case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Zai-Qiang Zhang ◽  
Jia-Wang Ding
Keyword(s):  
Case Report ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Emergency Operation ◽  
Atrial Wall ◽  
Aortic Sinus ◽  
Case Presentation ◽  
Lethal Complications ◽  
Life Threatening

Abstract Background While the perforation of the atrial wall and aortic sinus after closure of an atrial septal defect (ASD) is rare, it’s life-threatening, with rapid progress and high mortality. To the best of our knowledge, 21 similar cases have been reported since 1976. Case presentation We report a 16-year-old male whose atrial septal defect (ASD) was closed using a 12-mm Amplatzer septal occluder (ASO). Atrial wall and aortic sinus perforation occurred 3 months after transcatheter closure, and the patient was discharged after emergency operation. He was discharged on the 12th postoperative day in good overall condition. Conclusions With this case report, we want to illustrate that although percutaneous closure of ASD is regarded as a routine procedure, we should not forget the potentially lethal complications, especially cardiac erosion. Therefore, we should carefully evaluate the risk of erosion before surgery, and careful lifelong follow-up is needed.

scholarly journals A fatal toxic shock-like syndrome post COVID-19 infection in a child

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Houda Ajmi ◽  
Wissem Besghaier ◽  
Wafa Kallala ◽  
Abdelhalim Trabelsi ◽  
Saoussan Abroug
Keyword(s):  
Ejection Fraction ◽  
Pediatric Intensive Care ◽  
Fresh Frozen Plasma ◽  
Multiple Organ ◽  
Clinical Feature ◽  
Fresh Frozen ◽  
Life Threatening ◽  
High Doses ◽  
Definition Of ◽  
High Level

Abstract Background Children affected by Coronavirus disease 2019 (COVID-19) showed various manifestations. Some of them were severe cases presenting with multi-system inflammatory syndrome (MIS-C) causing multiple organ dysfunction. Case presentation We report the case of a 12-year-old girl with recent COVID-19 infection who presented with persistent fever, abdominal pain and other symptoms that meet the definition of MIS-C. She had lymphopenia and a high level of inflammatory markers. She was admitted to pediatric intensive care unit since she rapidly developed refractory catecholamine-resistant shock with multiple organ failure. Echocardiography showed a small pericardial effusion with a normal ejection fraction (Ejection Fraction = 60%) and no valvular or coronary lesions. The child showed no signs of improvement even after receiving intravenous immunoglobulin, fresh frozen plasma, high doses of Vasopressors and corticosteroid. His outcome was fatal. Conclusion Pediatric patients affected by the new COVID-19 related syndrome may show severe life-threatening conditions similar to Kawasaki disease shock syndrome. Hypotension in these patients results from heart failure and the decreased cardiac output. We report a new severe clinical feature of SARS-CoV-2 infection in children in whom hypotension was the result of refractory vasoplegia.

scholarly journals Ondine’s curse, a fatal infarction diagnosed by polysomnography and saved by ventilation: a case report

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Hany Aref ◽  
Tamer Roushdy ◽  
Amr Zaki ◽  
Nevine El Nahas
Keyword(s):  
Case Report ◽  
Diagnostic Procedure ◽  
Cardiac Pacemaker ◽  
Brainstem Infarction ◽  
Case Presentation ◽  
Ondine’S Curse ◽  
Lateral Medullary Syndrome ◽  
Life Threatening ◽  
Ondine's Curse

Abstract Background Lateral medullary syndrome causing Ondine’s curse is a rare yet fatal brainstem infarction. Any patient presenting with lateral medulla infarction ought to be well observed and a polysomnography must be ordered for him. Case presentation A patient presenting with Ondine’s curse is dealt with through polysomnography as a diagnostic procedure that was followed by tracheostomy with portable ventilator and cardiac pacemaker as a therapeutic maneuver which ultimately preserved his life. Conclusion Lateral medullary syndrome infarct could be a life-threatening stroke if not diagnosed and managed properly.

scholarly journals Microbiome-Metabolomics Reveals Prebiotic Benefits of Fucoidan Supplementation in Mice

2021 ◽  
Vol 9 (5) ◽  
pp. 505
Author(s):  
Jingyi Yuan ◽  
Song Qin ◽  
Wenjun Li ◽  
Yubing Zhang ◽  
Yuting Wang ◽  
...  
Keyword(s):  
Lipid Metabolism ◽  
Triglyceride Level ◽  
Lactobacillus Reuteri ◽  
Binding Protein ◽  
Serum Triglyceride ◽  
Serum Triglyceride Level ◽  
Lipopolysaccharide Binding Protein ◽  
Lactobacillus Gasseri ◽  
Lactobacillus Animalis ◽  
Lipopolysaccharide Binding

Fucoidan is a kind of polysaccharide with antitumor and antioxidant properties, which is mainly isolated from brown algae. Although there are many reports about the prebiotic effects of polysaccharides on hosts, there are few reports about the effects of fucoidan on blood biochemical indexes, intestinal microbiome, and metabolic function on healthy hosts. We applied 16S rRNA gene amplicon sequencing and LC-MS/MS metabolomics to evaluate the changes in the gut microbiome and metabolite profiles of fucoidan treatment in mice over 10 weeks. Fucoidan treatment modulated lipid metabolism, including significantly decreasing serum triglyceride level in healthy mice. Fucoidan also significantly inhibited serum lipopolysaccharide-binding protein (LBP) concentration, a biomarker of endotoxemia. Correlation analysis further showed that Lactobacillus animalis populations that were enriched by fucoidan demonstrated significantly negative correlations with serum triglyceride level. The abundance of Lactobacillus gasseri and Lactobacillus reuteri, increased by fucoidan supplementation, demonstrated significantly negative correlation with lipopolysaccharide-binding protein levels. Lactobacillus gasseri also demonstrated significantly positive correlations with three tryptophan-related metabolites, including indoleacrylic acid, 3-indoleacrylic acid, and 5-hydroxytryptamine, which were all increased by fucoidan administration. Combined with the previous evidence, the results indicate that fucoidan exerts prebiotic effects, such as lipid metabolism suppression and metabolic endotoxemia suppression, by modulating the abundance of gut microbiota, such as Lactobacillus animalis, Lactobacillus gasseri, and Lactobacillus reuteri, as well as microbiota-dependent metabolites, such as tryptophan-related metabolites.

scholarly journals Two deaths due to explosion of cylinders of liquid petroleum gas

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nagendra Singh Sonwani ◽  
Navneet Ateriya ◽  
Arvind Kumar ◽  
Anil Kohli
Keyword(s):  
Blast Injuries ◽  
Air Conditioner ◽  
Liquefied Petroleum Gas ◽  
Case Presentation ◽  
Gas Cylinder ◽  
Liquid Petroleum Gas ◽  
Life Threatening ◽  
System Life ◽  
High Pressure Equipment ◽  
Coffee Machine

Abstract Background Cylinder blasts can inflict multi-system life-threatening injuries to one or many persons simultaneously if they are nearby. The explosion in high-pressure equipment produces injuries due to its varied effects. Cases have been reported where the blast occurred in balloon gas cylinder, oxyacetylene gas cylinder, oxygen cylinder, coffee machine, and compressor of a split air conditioner (AC). Most of the cases are accidental. The investigation into the blast circumstances is of utmost importance to find out the manner and device involved. Case presentation Here, we present a report of two cases where victims suffered blast injuries at the same location due to the explosion of two different capacity liquefied petroleum gas (LPG) domestic cylinder and died on the spot. Conclusion The investigation into the blast circumstances is of utmost importance to find out the manner and device involved. Malpractice involving use of cylinder to fill another one might be dangerous for the person involved and present in the vicinity. This practice should be discouraged by lay person.

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