J Emerg Med
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Case Reports
Instability of gait as an extrapulmonary sequela in acute Legionella pneumonia: a case report.
Legionnaires disease is a potentially fatal infection often associated with permanent pulmonary fibrosis in survivors. Although neurological complications are not infrequent, chronic peripheral neuropathy in the absence of pulmonary abnormalities is an uncommon consequence of Legionnaires disease. ⋯ The outcome of this case confirms that the early exudative phase of ARDS in the absence of bronchial dilatation on chest CT scan is not always related to pulmonary fibrosis in survivors at follow-up. It also demonstrates that peripheral neuropathy can persist despite tailored treatment.
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Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is an uncommon but serious hypersensitivity drug reaction most frequently associated with antiepileptics. Clinical manifestations include rash, fever, and visceral organ involvement, most commonly hepatitis. The mortality rate associated with DRESS syndrome is approximately 10%, the majority due to fulminant liver failure. ⋯ Given the significant mortality related to DRESS syndrome, ED staff should have a low threshold for suspecting the condition in patients who present with unusual complaints and skin findings after starting any antiepileptic drug. Early diagnosis and prompt treatment with corticosteroids is imperative.
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It has been estimated that up to one-quarter of spinal cord injuries may be significantly worsened during extrication or early treatment after a motor vehicle accident. ⋯ In this study, no decrease in neck movement occurred for certain extrication events that included protection and assistance by the paramedics. Future work should further investigate this finding.