HNO
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Case Reports Comparative Study
[Pyoderma gangraenosum. Case report and comparison with necrotizing fasciitis].
The differential diagnosis of patients with ulcerative trachelophyma repeatedly causes difficulties. Particularly in view of the possibly fatal outcome, early differentiation between two clinical pictures is very important. Necrotizing fasciitis is often misdiagnosed or the diagnosis is delayed with a mortality rate of approximately 25-40%. ⋯ Pyoderma gangrenosum develops following an initial lesion with pustules and bullae in an ulceration with slight bleeding. Therapy consists of i.v. glucocorticoids (60-200 mg prednisolone/day) administered as early as possible. In complete contrast to the therapy for necrotizing fasciitis, surgical intervention should be strictly avoided in cases of pyoderma gangrenosum.
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Tracheal ruptures are most frequently the result of a blunt trauma to the thorax or of forced intubation. They represent a rare, but life-threatening complication that requires immediate help. ⋯ The present paper reports on three cases of tracheal ruptures after forced intubation which could be successfully managed by tracheostomy and subsequent reconstruction of the defects. The postoperative care of the patients is critically discussed.
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Appearance of an anticholinergic syndrome after treatment with drugs in therapeutic dosages is seldom reported in the literature. Based on a case report, the development and course of an anticholinergic syndrome after treatment with dimenhydrinate are described. The drug was given due to different symptoms such as vertigo and vomiting after surgery. The anticholinergic syndrome could successfully be treated with physostigmine.