Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Jul 2020
Case Reports[Hepatolienal candidosis as a rare differential diagnosis of disseminated small parenchym lesions].
We report about a 17-year-old patient with the secondary malignancy of acute myeloid leukemia (AML). He developed fever of unclear origin during the hematopoietic stem cell transplantation.History We report about a 17-year-old patient with the secondary malignancy of acute myeloid leukemia (AML). He developed fever of unclear origin during the hematopoietic stem cell transplantation. ⋯ The case shows that in immunosuppressed patients, candidiasis must always be considered as a differential diagnosis with simultaneous parenchymal changes in the liver and/or spleen. In addition, in the screening situation, a suitable linear transducer should be used when asking about fungal lesions in the liver and spleen. Alternatively, if suspected hepato-lienal candidiasis could be diagnosed by a contrast-enhanced MRI of the upper abdomen/abdomen.
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Dtsch. Med. Wochenschr. · Jul 2020
Review Case Reports[Inflammatory Muscle Pain: Polymyalgia Rheumatica with or without Large Vessel Vasculitis].
Polymyalgia rheumatica (PMR) is characterized by rapidly evolving shoulder and pelvic girdle pain with fatigue, weight loss, night sweats and elevated CRP and ESR. Giant cell arteritis (GCA) can occur in PMR and vice versa. Headache and scalp tenderness are typical for GCA. ⋯ The prednisolone dose can be discontinued within 1 year in about 50 % of GCA patients. Additional treatment with tocilizumab allows to reduce flares and decrease glucocorticoid doses. Tocilizumab is particularly useful in patients with relapses and with increased risk of glucocorticoid side effects.
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The control and management of infection with the novel SARS-CoV-2 virus requires multidisciplinary work between specialists on all levels. This article aims to provide an overview of the current knowledge of COVID-19 from the view of infectious diseases physicians including all the uncertainties of our understanding of the pathogenesis and immunity.
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Dtsch. Med. Wochenschr. · Jul 2020
[Invasive Mechanical Ventilation Therapy in the Dying Process - Step by Step].
Invasive mechanical ventilation can be terminated by immediate (palliative) extubation or by gradual reduction of ventilation with the ventilation access left open (terminal weaning). Both procedures are ethically equivalent and can be performed in everyday life, so that individual patient factors and the experience of the treatment team are decisive. However, the primary goal is to ensure that the patient and relatives do not suffer. This article presents step by step which aspects are relevant: communication, adjust or stop monitoring, selection and implementation of the appropriate procedure, preparatory measures, recognition and treatment of distressing symptoms by means of drug or non-drug therapy options and last but not least accurate documentation.