Acute pulmonary edema as a complication of urinary infection in pregnant women: a case report

Introduction: Urinary infection (UI) is the third most common pathology during pregnancy, affecting 10-12% of pregnant women in the first trimester. Thus, the prenatal care is important to reduce indicators of maternal-fetal mortality, promoting quality of life during pregnancy and postpartum. Objective: The aim of this study is to report the case of a pregnant woman with pyelonephritis, who evolved with acute pulmonary edema. Case report: The present study was elaborated according to the rules of CARE case report. This study was analyzed and approved by the Research Ethics Committee (CEP) according to a substantiated opinion number 4,375,418 and obtaining the patient's consent. The present study therefore highlights pyelonephritis as the most severe form of UI in pregnant women, associated with septic shock, with evolution to respiratory failure, resulting from acute pulmonary edema, and may be related to worse maternal-fetal prognoses. This clinical study contributes to the literature, emphasizing that, currently, all forms of UI during pregnancy should be considered as great potential for complications, and should be treated even in its asymptomatic form. Conclusion: It is evident the need for early intervention to minimize maternal-fetal losses, unnecessary interventions and to reduce costs in relation to additional treatments. The importance of rapid diagnosis and early treatment is emphasized in order to minimize or extinguish the damage. As well as promoting actions to encourage pregnant women to perform prenatal care.

POSACONAZOLE INDUCED PSEUDOHYPERALDOSTERONISM WITH CONCURRENT ACUTE PRIMARY ADRENAL INSUFFICIENCY-A CASE REPORT

In this covid 19 pandemic,there were increased incidence of Mucormycosis and thereby increase in usage of antifungals especially oral posaconazole which is more recently available in tablet form.There are already enough case reports of the incidence of new onset hypertension and hypokalemia with supressed renin and aldosterone which is termed as “Posaconazole induced pseudohyperaldosteronism”.We describe here about a similar case that presented with hypertensive urgency as Acute pulmonary edema with an associated primary adrenal insufciency.The potential mechanism include inhibition of 11 β HSD which degrades cortisol to cortisone,thereby increasing the levels of cortisol that stimulates Mineralocorticoid receptor.Also there is inhibition of steroidogenesis at the level of adrenal which in our patient presented with features of Acute adrenal insufciency.

Might life-threatening acute pulmonary edema occur after using recombinant tissue plasminogen activator? A case report

Background Recombinant tissue plasminogen activator (rt-pa) is the first-line drug for the treatment of acute ischemic stroke, and can lead to some complications.There were rare reports of death due to acute pulmonary edema during rt-pa thrombolysis treatment. Case presentation This study reports a 30-year-old man was diagnosed with acute ischemic stroke and underwent rt-pa thrombolytic therapy. Finally he died despite active rescue. Conclusions The autopsy revealed that he died of acute pulmonary edema. This case suggests that it is necessary to pay close attention to the changes of vital signs during thrombolysis and be aware of possibility of pulmonary edema during thrombolysis.