The Netherlands journal of medicine
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Review Case Reports
Nature's high-voltage injuries: sometimes a deadly consequence.
A patient is described who presented with the clinical picture of respiratory failure, persistent comatose state and myocardial injury after being struck by lightning. The discussion reviews the management of lightning injuries with emphasis on cardiovascular and neurological complications.
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We describe 2 case reports dealing with accidental hypothermia in which continuous veno-venous haemofiltration and dialysis (CVVHD) in combination with hyperinfusion with heated crystalloids was used as a rewarming technique. In this way it also is possible to correct metabolic disturbances, even during cardiopulmonary resuscitation.
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Pyomyositis is an abscess-forming infection of large skeletal muscles, usually with Staphylococcus aureus. Although it is common in the tropics and relatively rare in temperate climates, imported cases due to growing global mobility may be expected to increase its incidence outside tropical regions. Early diagnosis and correct management are imperative in this potentially fatal disorder, and require a high degree of clinical suspicion. A case report is presented demonstrating typical aspects of diagnosis and treatment.
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A 31-year-old male patient is reported who presented with neurological symptoms. He developed a urinary tract infection and an Addisonian crisis. This was due to adrenomyeloneuropathy, a form of X-linked adrenoleukodystrophy and characterized by accumulation of very-long-chain fatty acids in the adrenal cortex and nervous tissues.