1/6. Pseudomembranous tracheobronchitis caused by methicillin-resistant staphylococcus aureus.We report a case of severe tracheobronchitis caused by methicillin-resistant staphylococcus aureus in a man exhibiting symptoms of upper airway obstruction after infection with influenza. bronchoscopy revealed diffuse pseudomembrane formation throughout the trachea and bilateral bronchi, which were nearly obstructed. In this case, it was helpful to perform bronchoscopy, protected brushing and tracheotomy immediately in order to avoid choking.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
2/6. A potential propensity for failure secondary to clot embolism in neonatal ECMO.OBJECTIVE: To report a single case of oxygenator failure caused by clot embolism originating from the bladder; and to discuss some preventative options. CASE REPORT: A 2.5 kg neonate with a diagnosis of influenza A received veno-arterial (V-A) extracorporeal membrane oxygenation (ECMO) for cardiorespiratory support. Halfway through treatment, she underwent an elective circuit change for numerous clots in her circuit. The patient continued to consume vast quantities of platelets and developed a fatal oxygenator failure after 18 days. DISCUSSION: Amongst the factors influencing the outcome in events of a sudden unexpected oxygenator failure are the severity of patient illness, the size of the clot relative to the size of the oxygenator, the availability of a previously primed circuit and the ease and speed of priming a new oxygenator. CONCLUSION: There is a need for improvement in the design of small oxygenators and ECMO circuits. Adjustment of the coagulation parameters and lowering the tolerance towards clots in the circuit by electively changing them may reduce the incidence of sudden unexpected oxygenator failure. However, using a slightly larger Medos oxygenator may gain valuable time needed to arrange an oxygenator/circuit change.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
3/6. The use of extracorporeal life support in the treatment of influenza-associated myositis/rhabdomyolysis.A 13-year-old girl presented to the emergency department with fatigue, headaches and muscle stiffness after returning from a family camping trip. Within 24 h, she was transferred to ICU with general oedema and low saturations, where she had a cardio-respiratory arrest and was placed on veno-arterial extracorporeal membrane oxygenation (ECMO). The patient was successfully supported with ECMO for profound myocardial dysfunction and haemofiltration for rhabdomyolysis and acute renal failure. patients who present with profound myocardial dysfunction and myoglobinuria as a consequence of viral infection can be successfully supported with ECMO.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
4/6. Fatal case of influenza pneumonia with suprainfection by multiple bacteria and herpes simplex virus.A case of influenza pneumonia is described in which death occurred from persistence of the influenza infection and suprainfection with two bacteria, Staphylococcus aureus and escherichia coli, and another virus, herpes simplex. Of additional interest were the observations that this overwhelming illness developed in a previously healthy person, that typical influenza virus particles were present in antemortem lung tissue, and that the patient died despite 6 days of extracorporeal membrane oxygenation and corticosteroids.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
5/6. labyrinthitis ossificans.Three cases with postinflammatory inner ear sequelae are presented to illustrate unusual histopathologic changes. endolymphatic hydrops without changes in the perilymphatic system was present in one ear following "influenza" meningitis and labyrinthitis ossificans in the contralateral ear. The characteristic histopathological changes of the temporal bones with hematogenic bacterial infection were an extensive labyrinthine ossification associated with a generalized sclerotic change of the whole periotic bone. Bony fixation of the stapedial footplate occurred with the generalized inflammatory process of the otic capsule. Severe and diffuse labyrinthitis ossificans occurred in one case due to tympanogenic inflammation spreading through the round window membrane in the course of suppurative otitis media. A general immunosuppression leading to fatal termination was the apparent factor predisposing to the inner ear complication.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
6/6. Recurrent Goodpasture's syndrome.A 49-year-old woman had three distinct episodes of pulmonary hemorrhage over a 11-year period separated by symptom-free intervals of 6 and 5 years. The first and third episodes were associated with mild glomerulonephritis and linear deposition of IgG along glomerular/tubular basement membranes. The first episode was associated with a rising influenza A2 titer. Investigation of the third episode revealed circulating antiglomerular basement membrane antibodies detected by radioimmunoassay but not by indirect immunofluorescence. Antilung basement membrane antibodies were detected by both direct and indirect immunofluorescence. Recovery from each hemorrhage followed blood transfusion and oxygen therapy. This case demonstrates that (1) Goodpasture's syndrome, predominantly manifest by pulmonary hemorrhage, may have circulating antibodies with greater affinity for lung membrane compared with glomerular basement membrane, and (2) the antiglomerular basement membrane antibody response is not necessarily an acute self-limited event but may be a chronic or recurrent phenomenon.- - - - - - - - - - ranking = 6keywords = membrane (Clic here for more details about this article) |