Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Feb 2023
Case Reports[Extrapulmonary tuberculosis: a difficult therapeutic approach].
The 37 year old patient was admitted to hospital with persisting fever for 4 weeks. He had a history of weight loss, night sweat and cough. Antipyretic treatment with Paracetamol and up to ineffectiveness therapy with Ibuprofen was taken by the patient. ⋯ Toxic hepatitis is a possible severe complication of anti-Tb-treatment. A critical evaluation of patients' medication and soon initiation of anti -Tb-treatment is necessary. Especially in patients coming from high tb-incidence regions with history of poor general condition and persisting fever the diagnosis of extrapulmonary tuberculosis and bone marrow infiltration should be taken into account.
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The treatment of chronic wounds often poses a therapeutic challenge. Assessment of the pathogenesis of the wound, causative and symptomatic interventions are key. Concerning treatment-concepts the evaluation of comorbidities, pain management, the nutrition status of as well as the mobility of the patient are recommended.
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Vertigo has many different causal disorders, ranging from general dizziness and orthostatic regulation disorders to attacks of rotary vertigo. A targeted anamnesis and clinical examination can be used to narrow down the differential diagnosis. Questions about the type of dizziness, the duration and accompanying symptoms must be clarified. ⋯ But diagnostic imaging is also important. MRI can be used to confirm or rule out vascular causes (cerebral infarction or minor bleeding) and inflammatory lesions. Because the most serious misdiagnosis of dizziness is overlooking a stroke.