Southern medical journal
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Southern medical journal · Sep 1997
Case ReportsTongue involvement in a patient with granulomatous myositis.
A 64-year-old woman had difficulty swallowing and talking, weakness of the tongue, and progressive muscle weakness that was proven to be caused by a granulomatous myopathy. This case resembled a motor neuron disease, indicating that granulomatous myopathy should be considered in patients with similar presentations, since it is a treatable condition with a more benign prognosis.
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Southern medical journal · Sep 1997
Review Case ReportsMethemoglobinemia caused by benzocaine topical spray.
Acute methemoglobinemia is a medical emergency that can rapidly become fatal. A substantial number of drugs, including topical preparations, can precipitate this condition. I report a rare example of severe, acute methemoglobinemia caused by oropharyngeal anesthesia with topical benzocaine spray for orogastric intubation. The pathophysiology, diagnosis, and treatment of methemoglobinemia are reviewed briefly.
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Southern medical journal · Sep 1997
Case ReportsRespiratory depression in a child unintentionally exposed to transdermal fentanyl patch.
A 2-year-old boy was found unresponsive after sleeping in bed with his grandmother. After the patient was intubated and ventilated, paramedics discovered a transdermal fentanyl patch on the victim's back. Removal of the patch and treatment with naloxone resolved symptoms. This is the first reported case of secondary exposure to a fentanyl patch causing clinically significant respiratory depression in the pediatric population, and it emphasizes a new hazard of such drug use.
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Southern medical journal · Sep 1997
Clostridium difficile infection in obstetric and gynecologic patients.
We reviewed hospital records of women on the obstetrics and gynecologic services with a diagnosis of antibiotic-associated diarrhea, pseudomembranous colitis, or Clostridium difficile infection to better characterize the incidence and course of women with C difficile infection. Cases were included if there was identification of C difficile by culture or toxin or endoscopic verification of pseudomembranous colitis. Between January 1985 and June 1995, there were 74,120 admissions to the obstetrics and gynecology services at two tertiary level hospitals. ⋯ Antimicrobial agents given before infection included cephalexin, cefoxitin, imipenem, ciprofloxacin, trimethoprim/sulfamethoxazole, ampicillin, gentamicin, and clindamycin. All patients were treated successfully with inpatient antimicrobial agents-15 with metronidazole and 3 with vancomycin. There was one possible recurrence.
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Southern medical journal · Sep 1997
Review Case ReportsIsolated colonic neurofibroma manifested by massive lower gastrointestinal bleeding and intussusception.
We report a case of rare solitary neurofibroma of the transverse colon in a patient without neurofibromatosis. The patient was found to have an intussuscepting tumor prolapsing transanally, with massive lower gastrointestinal bleeding. This case represents only the second documented report of an isolated colonic neurofibroma.