Curēus
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Case Reports
Aggregatibacter actinomycetemcomitans Causing Empyema Necessitans and Pyomyositis in an Immunocompetent Patient.
Empyema necessitans is a relatively rare clinical entity in which the empyema extends through the parietal pleura into the adjacent soft tissue and musculature of the chest wall. It usually occurs due to inadequate treatment of a primary lung infection. Aggregatibacter (formerly Actinobacillus) actinomycetemcomitans is a facultative anaerobic gram-negative coccobacillus that is part of the normal oral flora. ⋯ It often coinfects with Actinomyces and is known to cause empyema necessitans. Cases of monomicrobial empyema necessitans due to Aggregatibacter actinomycetemcomitans in adults have rarely been reported with four such publications found on review of the literature. We present a patient with severe periodontitis who developed empyema necessitans due to Aggregatibacter actinomycetemcomitans likely from aspiration complicated by pyomyositis of the right triceps brachii and a left posterior thigh abscess.
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Thromboembolic events with coronavirus disease 2019 (COVID-19) infection, such as pulmonary embolism, have been described in recent literature as a manifestation in patients during their hospital admission. Our case report describes a delayed manifestation of bilateral pulmonary embolism in a patient who was discharged home. The patient is a 40-year-old COVID-19 positive male that presented to the emergency department eight days after his discharge with shortness of breath and diaphoresis. ⋯ Subsequently, the patient was started on heparin and transferred to a tertiary facility for thrombectomy. Pulmonary embolism is a manifestation of acute COVID-19 infection. It is important for clinicians to have an increased suspicion for pulmonary embolism in patients presenting with worsening dyspnea and hypoxia who were recently admitted for acute COVID-19 pneumonia. Patients that were hospitalized for acute presentation of COVID-19 infection should reasonably be considered for extended anticoagulant therapy after discharge.
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Aim Point-of-care ultrasound (POCUS) is a valuable tool in anesthesiology used for evaluating and managing cardiopulmonary pathology. Implications of this modality are extensive. Seamless integration into advanced cardiac life support (ACLS) has potential to improve resuscitation outcomes, and there is growing impetus for its implementation during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. ⋯ Conclusions Our initial data demonstrate the effectiveness of this approach to POCUS training. Performance is improved and learners are more likely to use POCUS in the future. The application of this method to larger sample sizes is an appropriate next step to demonstrate its utility.
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Coronavirus disease-2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and represents a potentially fatal disease. COVID-19 is associated with a hypercoagulable state leading to increased incidence of venous thromboembolism. Arterial thrombosis has been reported, but the prevalence is not known. Herein, we report an unusual presentation of a 77-year-old male who presented with dyspnea and pain in left leg and was found to have acute limb ischemia. Our case adds to the limited literature regarding arterial thrombosis in COVID-19.
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Review
The Association Between Cannabis Use and Schizophrenia: Causative or Curative? A Systematic Review.
Marijuana is one of the most abused substances in the world. Marijuana is getting legalized around the world. So, it is crucial to understand its effect on our mental health. ⋯ Even though CBD shows therapeutic effects and THC opposing effects, the data is minimal and low safety and efficacy warrants more research. The relation between cannabis and schizophrenia needs further investigation. We need more case-control studies and clinical trials with a larger population to get conclusive data.