The American journal of emergency medicine
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Case Reports
Probable parenteral and oral contrast-induced Steven Johnson syndrome/toxic epidermal necrolysis: A case report.
We report a case of contrast-inducted Steven Johnson Syndrome (SJS)/Toxic Epidermal Necrolysis (TEN). The patient had received parenteral iopamidol and oral iohexol five days prior. The patient's chief complaint at the Emergency Department (ED) presentation was shortness of breath and blisters throughout body. ⋯ Complete metabolic panel was normal with serum creatinine 0.77 mg/dL. The patient was initially treated with diphenhydramine, methylprednisolone, ondansetron, sodium chloride, lorazepam and oxycodone-acetaminophen. Hemotology/Oncology and Trauma/Burn consult identified possible SJS/TEN and the patient was transferred to another facility for dermatologic/burn follow up.
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Congenital hypothyroidism is rare and is screened for in the United States during the newborn period in order to prevent a treatable cognitive delay. Myxedema coma is a complication due to severe hypothyroidism resulting from failure of homeostatic processes, causing altered mental status, generalized edema, and vital sign abnormalities. Treatment of myxedema coma consists of supportive care and hormone replacement. We describe a case of congenital hypothyroidism presenting as myxedema coma in an immigrant teenager.
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Letter Multicenter Study
Community-based study of cannabis hyperemesis syndrome.
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There are 5000-10,000 snake envenomations annually in the United States. Fortunately, few are fatal. In this study we review the epidemiology of fatal snakebites. ⋯ Death following envenomation from a native U.S. snake is unlikely, particularly if medical attention is sought promptly. Rattlesnake envenomations are more likely to be fatal than bites from other species. Intentionally engaging with a venomous snake raises the risk of incurring a fatal bite, as does concurrent alcohol or drug use. Age less than 12 years old does not appear to be a risk factor for a fatal outcome, while elderly patients may have a slightly increased risk of death.