Southern medical journal
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Southern medical journal · Oct 1994
Review Case ReportsIsolated central nervous system mucormycosis.
Isolated central nervous system (CNS) mucormycosis is a rare but life-threatening infection. We report a case of bilateral frontal lobe mucormycosis in a previously healthy woman. Intravenous drug use was the most likely route of infection. ⋯ Treatment with amphotericin B was the only predictor of survival, reducing mortality from 92% to 41%. Isolated CNS mucormycosis should be considered in the differential diagnosis of brain abscesses, especially in intravenous drug users. Prompt initiation of therapy with amphotericin B may be life-saving.
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Southern medical journal · Aug 1994
Case ReportsPatient treated with antidote kit and hyperbaric oxygen survives cyanide poisoning.
A 54-year-old man deliberately drank a potassium-gold cyanide solution that contained approximately 1,650 mg of potassium cyanide. He survived after treatment with the Lilly antidote kit and hyperbaric oxygen.
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Medical records of 118 newborn infants with Down's syndrome were reviewed to document the types of congenital heart disease (CHD) in those having echocardiography. Of 102 infants having echocardiography, 49 (48%) had heart defects; 47 of these had trisomy 21 and 2 had unbalanced translocation karyotypes. ⋯ The most common heart malformation was an atrioventricular canal, followed in frequency by ventricular septal defect, atrial septal defect, patent ductus arteriosus, and tetralogy of Fallot. Benefits of echocardiography in such infants are early detection of CHD, with aggressive management to prevent future complications, and reassurance to parents if the infant does not have CHD.
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Southern medical journal · Jun 1994
Incidence of cervical spine injury in patients with gunshot wounds to the head.
Cervical spine immobilization is standard during the early stages of prehospital and hospital care of patients with blunt head injury. However, the need for cervical spine immobilization in patients with gunshot wounds to the head has not been addressed. To determine the incidence and types of cervical spine injury in this group, we retrospectively examined the records of 308 consecutive patients who had computed tomographic (CT) scans of the head to evaluate brain injury after gunshot wounds. ⋯ Of 52 patients with complete lateral x-ray films and wounds not limited to the calvaria, 5 (10%) had cervical spine or spinal cord injury. Of the 192 patients who had CT-proven intracranial injury, 86 (45%) required immediate intubation before x-ray films were obtained, and 67 (35%) died. We conclude that cervical spine immobilization may not be required during endotracheal intubation of brain-injured gunshot victims with wounds limited to the calvaria.