Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Aug 1999
Review Case Reports[Imported Anopheles: in the luggage or from the airplane? A case of severe autochthonous malaria tropica near an airport].
A 67-year-old woman was admitted with pyrexia of unknown cause preceded by transitory peripheral pareses. She had not been to any malaria-infested regions. Within 4 days a "sepsis syndrome" developed with acute respiratory and renal failure. ⋯ The source of the malaria could not be identified. "Baggage malaria" is more likely than the bite of a mosquito expelled from the "plane's undercarriage" well as it approached Frankfurt airport (the patient lived under one of the approach sectors, 30 km from the airport). As there are no screening procedures, imported malaria should be thought of in case of fever of unknown cause without history of foreign travel; a blood smear should be done.
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Dtsch. Med. Wochenschr. · Aug 1999
Review Case Reports[Dissection of the ramus interventricularis anterior in blunt chest trauma].
A 57-year-old man suffered a blunt trauma to his chest when the car he was driving collided head-on with a stationary lorry. He had worn his seat belt and the air-bag had inflated on impact. He was admitted to hospital because of severe left chest pain that started 45 min after the accident. Admission physical examination indicated stable cardiopulmonary status in a fully conscious person with no obvious physical signs, in particular no contusion or other injury to the chest or fractures. ⋯ The possibility of severe injury of the heart and other organs even after primarily blunt chest trauma demands careful follow-up monitoring and, if indicated, extensive noninvasive as well as invasive diagnosis and treatment.
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Nosocomial pneumonia in patients in an intensive care unit (ICU) are a great problem as a cause of increased morbidity and mortality as well as the resulting high cost of treatment. This study was aimed at determining the incidence of nosocomial pneumonia and the risk factors for its occurrence in patients with severe neurological disease. ⋯ These data (incidence, relative risk) can, by taking into consideration various aspects of specialist and hospital hygienic practices, contribute to a continuing optimization of the prevention and treatment of disease.
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Dtsch. Med. Wochenschr. · Jul 1999
Case Reports[Extra-intestinal manifestations and complications in chronic active ulcerative colitis in childhood and adolescence].
A 18-year-old girl suffered from chronic active ulcerative colitis for ten years with growth retardation, primary amenorrhoea and osteopenia, so that total colectomy had been discussed as a possible treatment option. However, clinical remission was reached using a medication with budesonide (9 mg), mesalazine (3 g) and azathioprine (100 mg) when a painful ulcer occurred at the right lower leg. ⋯ Drug therapy with azathioprine can be regarded as a treatment option in pediatric patients with chronic active inflammatory bowel disease. It can be concluded from this case report that faced with controversial therapeutic options in adolescent patients the decision mainly depends on the clinical experience of the physician than on the results of controlled clinical trials.