Southern medical journal
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Southern medical journal · Jul 2009
Case ReportsNitazoxanide and probiotics for the treatment of recurrent Clostridium difficile infection in a peritoneal dialysis patient.
Nitazoxanide has been proven to be efficacious for the treatment of Clostridium difficile infection (CDI), but data is limited in peritoneal dialysis (PD) patients. This report details the successful utilization of nitazoxanide and probiotics to treat multirecurrent CDI in a PD patient. ⋯ During her admission, the patient developed CDI and was started on a 6-week regimen of nitazoxanide and probiotics to assist in re-establishing the colonic flora. The regimen was well tolerated and the patient remained disease free at follow up, four months later.
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Southern medical journal · Jul 2009
Case ReportsPericardial involvement as a rare manifestation of hypereosinophilic syndrome.
A 56-year-old female with idiopathic hypereosinophilic syndrome who presented with chest tightness, dyspnea and new-onset atrial fibrillation is reported. Work up revealed significant peripheral eosinophilia, pericarditis, and a pericardial effusion with tamponade physiology. ⋯ After initial stabilization, pericardial effusion reaccumulated with persistence of marked eosinophilia. A diagnosis of idiopathic hypereosinophilic syndrome was made, and she was started on prednisone with a dramatic resolution of her clinical symptoms.
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Southern medical journal · Jun 2009
Case ReportsProne ventilation in a United States Marine with acute respiratory distress syndrome and an open abdominal injury.
A United States Marine with an open abdominal injury from a single gunshot wound to the chest and abdomen was placed in the prone position after suffering from acute respiratory distress syndrome (ARDS). Prone ventilation in traumatic injuries involving an open abdomen has been rarely reported or attempted because of the potentially fatal complication of bowel dehiscence. Improvement of gas exchange in patients with ARDS has been shown to occur with prone ventilation when conventional modes of ventilation have failed. The patient benefited from a sustained improvement in oxygenation hours after return to the supine position allowing for his rapid transport to a higher echelon of care and definitive management.