The American journal of emergency medicine
-
A case of carbon monoxide (CO) poisoning with severe myonecrosis and acute renal failure (ARF) is presented with extremely high values of CPK but with preservation of myocardial tissue. A discussion of the broad effects of CO intoxication is undertaken with a review of the pertinent literature. Diagnostic and therapeutic mainstays are presented with some pitfalls and alternatives to their implementation. Computed tomography of affected muscles is presented as an alternative to muscle biopsy, and a unique modality of noninvasive diagnosis of myonecrosis.
-
Review Case Reports
Aortic dissection presenting as superior vena cava syndrome.
Aortic dissection usually presents with chest pain, abnormal pulses, and a widened mediastinum on chest radiograph. It is rarely associated with the superior vena cava syndrome (SVCS), which more commonly occurs in the setting of malignant disease. A patient who had SVCS as a result of a painless aortic dissection is presented and compared with other previously reported cases of simultaneous SVCS and aortic dissection.
-
Eikenella corrodens, a fastidious, slow-growing, gram-negative, facultative anaerobic bacillus may be encountered in wounds exposed to human saliva, especially human bites and head and neck infections. An unusual case of a mixed flora E corrodens and Streptococcus septic arthritis with adjacent osteomyelitis secondary to saliva contamination from licking an intravenous (i.v.) needle is presented. A literature search showed 53 previous cases of E corrodens infections in i.v. drug users. ⋯ Recommendations for treatment include penicillin or ampicillin. Tetracycline is recommended in the penicillin-allergic patient. This is the first case that draws attention to the connection between E corrodens, i.v. drug use, and septic arthritis and osteomyelitis.
-
To improve the prognosis in patients with acute myocardial infarction (AMI) if treatment by early instituting treatment, we initiated a media campaign during 1 year with the intention to reduce delay times and increase ambulance use in patients with acute chest pain. This article describes the outcome during 3 years after the campaign was finished. ⋯ Ambulance use was not affected during or after the campaign. It can be concluded that a media campaign resulted in a reduction of delay times not only during the campaign, but also during 3 years after its performance, whereas ambulance use was not affected.