Background: Skin reactions and musculoskeletal injuries caused by intramuscular injection are an increased risk for skin and soft tissue infections and may culminate in sepsis. Objective: To describe the history of an...Background: Skin reactions and musculoskeletal injuries caused by intramuscular injection are an increased risk for skin and soft tissue infections and may culminate in sepsis. Objective: To describe the history of an elderly patient who developed a lesion in her right arm after home administration of intramuscular iron injection in this arm and its outcome. Methods: This is a case report of a patient who participated in a study in an intensive care unit. Results: This study describes a 65-year-old patient with multiple comorbidities who was admitted to the hospital complaining of pain for two months and difficulty in moving her right shoulder associated with skin and soft tissue infections in her right arm after intramuscular iron administration by a relative for the treatment of multifactorial anemia and refractory melena. The patient worsened her general condition and was transferred to the intensive care unit. Despite the therapy instituted, the patient developed sepsis of cutaneous origin, multiple organ dysfunction, and death. Conclusions: The administration of intramuscular medication requires the participation of qualified professionals, such as nurses, mainly within the scope of the Brazilian public health system which commonly comprises patients in a context of vulnerability.展开更多
Tuberculosis is one of the 10 leading causes of death in the world. Its symptoms include fever, malaise, weakness, weight loss, chest pain, cough, expectoration, shortness of breath and sepsis, which is its most frequ...Tuberculosis is one of the 10 leading causes of death in the world. Its symptoms include fever, malaise, weakness, weight loss, chest pain, cough, expectoration, shortness of breath and sepsis, which is its most frequent complication. Due to these symptoms, many patients with tuberculosis require admission to the Intensive Care Unit, where they usually are placed on mechanical ventilation. Tuberculosis is more prevalent in the population in situations of social and economic vulnerability. The main factors that interfere with adherence to treatment and the prognosis of these patients are the patient’s support network and their socioeconomic status. We present the following report of a long-time smoker patient, with chronic kidney disease and previous treatment for tuberculosis, who was brought to the emergency room due to lowering of the sensorium, and was immediately placed on mechanical ventilation. The tests suggested sepsis with a respiratory focus, so a search for Alcohol-Acid-Resistant Bacillus was carried out, with a positive result. The patient was transferred to the Intensive Care Unit due to tachycardia and acute respiratory failure. The patient was a smoker with a high tobacco load, chronic kidney disease, in addition to precarious economic, educational and self-care conditions. This report shows that patients with tuberculosis and its complications can be stabilized through known pharmacological treatment. However, the most effective measure to interrupt the transmission of the disease remains the early diagnosis and the provision of adequate treatment, with guidelines aimed at the cessation of harmful habits, such as smoking.展开更多
Lymphomas are neoplastic transformations that affect lymphoid cells. Diffuse large B-cell non-Hodgkin’s lymphoma has a high degree of cell proliferation, accounting for 30% of all lymphomas. Lung cancer is the leadin...Lymphomas are neoplastic transformations that affect lymphoid cells. Diffuse large B-cell non-Hodgkin’s lymphoma has a high degree of cell proliferation, accounting for 30% of all lymphomas. Lung cancer is the leading cause of death worldwide and the recommended treatment is chemotherapy. Among the main complications resulting from non-Hodgkin’s lymphoma, lung cancer and chemotherapy used in their treatment, we can mention sepsis, acute kidney injury and febrile neutropenia. Febrile neutropenia can occur by suppressing the production of neutrophils. Sepsis, a widespread infection, is the main cause of acute kidney injury, which can also be caused by hydroelectrolytic complications or by nephrotoxicity. This is a report of a smoking patient with metastatic lung cancer who sought care due to progressive dysphagia, cough with chest pain, fever, and lower airways critical obstruction due to mediastinal lymphadenopathy, being diagnosed with diffuse large B-cell non-Hodgkin’s lymphoma. The patient evolved to death because of a significant worsening of the ventilatory pattern of multifactorial cause, mainly due to sepsis, acute kidney injury, and febrile neutropenia. The patient had mostly classic characteristics of her comorbidities, however, the overlapping of interrelated comorbidities led to the outcome of death. What is unusual about the present case report is that the patient’s characteristics, such as age, sex, and ethnicity, are opposite to those described as risk factors for diffuse large B-cell non-Hodgkin’s lymphoma.展开更多
文摘Background: Skin reactions and musculoskeletal injuries caused by intramuscular injection are an increased risk for skin and soft tissue infections and may culminate in sepsis. Objective: To describe the history of an elderly patient who developed a lesion in her right arm after home administration of intramuscular iron injection in this arm and its outcome. Methods: This is a case report of a patient who participated in a study in an intensive care unit. Results: This study describes a 65-year-old patient with multiple comorbidities who was admitted to the hospital complaining of pain for two months and difficulty in moving her right shoulder associated with skin and soft tissue infections in her right arm after intramuscular iron administration by a relative for the treatment of multifactorial anemia and refractory melena. The patient worsened her general condition and was transferred to the intensive care unit. Despite the therapy instituted, the patient developed sepsis of cutaneous origin, multiple organ dysfunction, and death. Conclusions: The administration of intramuscular medication requires the participation of qualified professionals, such as nurses, mainly within the scope of the Brazilian public health system which commonly comprises patients in a context of vulnerability.
文摘Tuberculosis is one of the 10 leading causes of death in the world. Its symptoms include fever, malaise, weakness, weight loss, chest pain, cough, expectoration, shortness of breath and sepsis, which is its most frequent complication. Due to these symptoms, many patients with tuberculosis require admission to the Intensive Care Unit, where they usually are placed on mechanical ventilation. Tuberculosis is more prevalent in the population in situations of social and economic vulnerability. The main factors that interfere with adherence to treatment and the prognosis of these patients are the patient’s support network and their socioeconomic status. We present the following report of a long-time smoker patient, with chronic kidney disease and previous treatment for tuberculosis, who was brought to the emergency room due to lowering of the sensorium, and was immediately placed on mechanical ventilation. The tests suggested sepsis with a respiratory focus, so a search for Alcohol-Acid-Resistant Bacillus was carried out, with a positive result. The patient was transferred to the Intensive Care Unit due to tachycardia and acute respiratory failure. The patient was a smoker with a high tobacco load, chronic kidney disease, in addition to precarious economic, educational and self-care conditions. This report shows that patients with tuberculosis and its complications can be stabilized through known pharmacological treatment. However, the most effective measure to interrupt the transmission of the disease remains the early diagnosis and the provision of adequate treatment, with guidelines aimed at the cessation of harmful habits, such as smoking.
文摘Lymphomas are neoplastic transformations that affect lymphoid cells. Diffuse large B-cell non-Hodgkin’s lymphoma has a high degree of cell proliferation, accounting for 30% of all lymphomas. Lung cancer is the leading cause of death worldwide and the recommended treatment is chemotherapy. Among the main complications resulting from non-Hodgkin’s lymphoma, lung cancer and chemotherapy used in their treatment, we can mention sepsis, acute kidney injury and febrile neutropenia. Febrile neutropenia can occur by suppressing the production of neutrophils. Sepsis, a widespread infection, is the main cause of acute kidney injury, which can also be caused by hydroelectrolytic complications or by nephrotoxicity. This is a report of a smoking patient with metastatic lung cancer who sought care due to progressive dysphagia, cough with chest pain, fever, and lower airways critical obstruction due to mediastinal lymphadenopathy, being diagnosed with diffuse large B-cell non-Hodgkin’s lymphoma. The patient evolved to death because of a significant worsening of the ventilatory pattern of multifactorial cause, mainly due to sepsis, acute kidney injury, and febrile neutropenia. The patient had mostly classic characteristics of her comorbidities, however, the overlapping of interrelated comorbidities led to the outcome of death. What is unusual about the present case report is that the patient’s characteristics, such as age, sex, and ethnicity, are opposite to those described as risk factors for diffuse large B-cell non-Hodgkin’s lymphoma.
