Swiss medical weekly
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Swiss medical weekly · Dec 1998
Case Reports[Chronic meningococcemia--a rare, but characteristic disease picture].
Chronic meningococcaemia is a rare clinical manifestation of invasive infection by Neisseria meningitidis. The clinical signs and symptoms are recurrent fever, skin rash, arthralgias and headache. This constellation is rather typical and may enable the clinician to establish the diagnosis. ⋯ Positive cultures may be obtained by needle aspiration or skin biopsy. There are a few reports on patients with deficiency of late complement components or immunoglobulin deficiency. We report on two patients with the typical findings of chronic meningococcaemia.
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As a rule the indication for sedation should be broad. Any child who is, or could be, frightened by an intervention should have the benefit of sedation. Correspondingly, an analgesic should be chosen if the intervention is painful. ⋯ Despite all efforts a small proportion of patients show an inadequate response to the chosen medication. In young children and in sick children the specific physiological and anatomical features will overtax the therapist. In such cases the help and advice of a specialist trained in paediatric anaesthesia can and should be sought.
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In many epidemiological pain studies, women more frequently report more intense, frequent and long-lasting or chronic transient pain than men. In our retrospective study including hospitalised patients referred to a pain centre, prevalence of headaches, musculoskeletal pain and somatoform pain was observed in women, as described in the literature. ⋯ Drug treatments were adapted to pain aetiologies, which accounted for the observed differences. In hospitalised patients the significant differences observed in intensity, pain control and treatment reflect the heterogeneity of pain aetiologies rather than gender differences.