Etilefrinhydrochloride tablet ingestion: successful therapy by endoscopic removal of tablet conglomerate

We report here on a case of etilefrinhydrochloride tablet intoxication in suicidal intention in a female adolescent. Tablet ingestion resulted in the formation of a tablet conglomerate in the stomach, which could neither be effectively treated with activated charcoal nor by gastric lavage. Endoscopic dissemination and removal of the fragments finally led to the elimination of the tables and the symptoms of intoxication resolved completely. The case presented here offers an explanation as to why the use of activated charcoal and/or a gastric lavage may not be successful in some cases of ingestion/intoxication. Endoscopic removal of ingested fragments of the toxic substance, such as etilefrinhydrochloride tablets, may be useful even hours following ingestion and should be considered when treatment with activated charcoal or gastric lavage fail to eliminate toxic substances in cases of tablet ingestion.

Cellulitis with compartment syndrome as a complication of varicella zoster infection

BACKGROUND

Varicella zoster infection (chickenpox) is a common and usually benign self limiting disease of childhood in non-vaccinated populations. Although varicella usually goes along with mild to moderate illness in immunocompetent patients, serious complications can arise. Varicella is highly infectious, with attack rates in susceptible individuals ranging from 61% to 100%.

PATIENT

This case describes a rare but life threatening complication of varicella zoster infection in a child.

CONCLUSIONS

High morbidity in non-vaccinated populations that led to rare cases of severe complications became a significant health burden all over the world. This aspect must be considered in the discussion about the importance and benefit of a population wide varicella vaccination programme as it was added to the childhood immunization schedule in Germany in 2004. The case described here might have been avoided by vaccination.

Seltener Fall einer epidemiologisch bedeutsamen Tuberkulose im Kindesalter

BACKGROUND

Tuberculosis is an infectious disease which is nearly forgotten in Germany because of its low incidence.

CASE REPORT

We report on a 14-year-old german girl who was disregarded when active case-finding of her uncle's active pulmonary tuberculosis was carried out three years before. As a result she herself developed a severe infectious pulmonary tuberculosis. The delay between onset of symptoms and diagnosis gives cause for concern and led to active tuberculosis in her brother and her girl friend as well. The lack of information about tuberculosis in population and delay of medical detection in this case led unnecessarily to the continuing chain of infection.

CONCLUSIONS

This case report shows that there are severe infectious courses of tuberculosis even in childhood which might get epidemiologically important. For earlier diagnosis and successful interruption of chains of infection tuberculosis in the German population even today has to be taken into account. Case detection through contact investigation of adults is of great importance in childhood and adolescence.

Gianotti-Crosti-Syndrom nach Impfungen bei einem Kleinkind

Gianotti-Crosti syndrome (GCS), first described by F. Gianotti in 1955, was originally reported to be associated with hepatitis B virus infection in children. The typical clinical picture allows diagnosis of GCS at first glance. The pathogenesis is still unknown. Besides HBV infection, a large number of infectious agents, mostly viruses, have been described as a trigger of GCS. Here we report the occurrence of GCS in an infant five days after the fourth immunization against poliomyelitis, DTPa, Hib, hepatitis B and Streptococcus pneumoniae. Our data and review of the literature suggest that GCS is rarely associated with immunizations, especially when performed with inactivated vaccines.