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  • 1
    ISSN: 1439-0973
    Keywords: Key WordsAbsidia corymbifera ; Mucormycosis ; Acute myeloid leukemia ; Neutropenia ; Vasculitis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary An 18-year-old woman was admitted to hospital because of subcutaneous hematoma and fever of unknown origin. Acute myeloid leukemia was diagnosed and empirical antimicrobial treatment and induction chemotherapy were started. After initial defervescence, fever relapsed 21 days after the onset of neutropenia. The CT scan of the lung was consistent with an invasive fungal infection. Treatment with amphotericin B was started and antimicrobial treatment was continued with liposomal amphotericin B because of an increase in creatinine later. The fever persisted and the patient suddenly developed progressive neurological symptoms. CT scan of the head suggested cerebral infarction and angiography of the extra- and intracranial arteries showed signs of vasculitis. Six days after the onset of neurological symptoms cerebral death was diagnosed. Autopsy revealed non-septate, irregularly branched hyphae in various histologic sections including brain. Absidia corymbifera could be isolated from lung tissue confirming the diagnosis of disseminated mucormycosis. In this case, angiographic findings suggested severe cerebral vasculitis which was in fact caused by thromboembolic dissemination of fungal hyphae. This case underlines the fact that cerebral symptoms in febrile neutropenic patients are highly indicative for fungal infections of the brain.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1433-0474
    Keywords: Schlüsselwörter ; Zentrales anticholinerges Syndrom ; Engelstrompete ; Datura suaveolens ; Skopolaminvergiftung ; Alkaloidintoxikation ; Key words ; Central anticholinergic syndrome ; Angel’s trumpet ; Datura suaveolens ; Scopolamine-poisoning ; Alkaloid-intoxication
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Reports of accidental alkaloid-intoxications with plants of the nightshade family, in particular Datura-species are well known in pediatric care. The intentional abuse as a hallucinogenic drug in adolescents became more frequent in recent years. Two patients, a 14- resp. 16-year old boy were admitted to the intensive care units of our hospitals because of a severe central anticholinergic syndrome after ingestion of tea from Angel’s Trumpet blossoms for experimental reasons. Patient’s history in the first somnolent patient was not available at the time of admission, a routine immunological drug screening of the patient’s urine had been negative. Discussion: Prominent central nervous symptoms as unconsciousness or hallucinations in adolescents without further explanation should suggest a special toxicological analysis for tropan-alcaloids e.g. scopolamine because of increasing abuse of plants containing the drug.
    Notes: Zusammenfassung Akzidentelle Intoxikationen von Nachtschattengewächsen bei Kindern sind bereits häufiger beschrieben worden. In jüngster Zeit nimmt der bewußte Mißbrauch insbesondere von Daturaarten als Rauschmittel bei Heranwachsenden deutlich zu. Wir berichten über 2 14 bzw. 16jährige Jugendliche, die aus Experimentierfreudigkeit einen Tee aus Engelstrompetenblüten getrunken hatten und sich wegen eines ausgeprägten zentralen anticholinergen Syndroms auf unseren Intensivstationen behandeln lassen mußten. Im ersten Fall, einem somnolenten Patienten, war zunächst keine Anamnese verfügbar, ein immunologisches Drogen-Screening im Urin blieb ohne richtungsweisendes Ergebnis. Diskussion: Auch bei im Vordergrund stehender Bewußtseinstrübung oder paranoid-halluzinatorischen Symptomen sollte insbesondere bei Jugendlichen an eine Ingestion von Tropanalkaloiden bzw. eine Skopolaminintoxikation durch Ziergewächse wie Engelstrompete oder Stechapfel gedacht und gezielt danach gesucht werden.
    Type of Medium: Electronic Resource
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