毒蛇咬伤致中毒性脑室炎致急性可逆性内源性脑积水、急性垂体出血、急性垂体功能减退、急性肾损伤、败血症、蜂窝织炎和DIC一例报告

K. Phyu Pyar, S. Win Hlaing, A. Aung, Zar Ni Htet Aung, N. L. Maung, K. Myat, L. Maung Maung, Y. Min Hein, L. Aung, Chan Pyae Aung, K. Lwin, Min Aung Hein, Moe Tun Zaw, M. Maung, A. Kyaw, Thein Soe Tun, W. Myint
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引用次数: 0

摘要

一个年轻的农民,十年级学生,在假期帮助他的祖父,被毒蛇咬伤后患上了无尿症。由于头痛,入院时进行头部非增强CT扫描,显示垂体小出血,脑室正常。后来,他有全身痉挛和第二次非增强CT扫描头显示一个小脑垂体出血和心室扩张。他还患有急性肾损伤、败血症、蜂窝组织炎和DIC。血清TSH、游离T3、游离T4水平较低;因此,进行了更换。脑脊液检查(蛋白、糖、细胞)包括培养均正常。给予肾脏替代治疗(血液透析)、血小板输注和抗生素治疗。当他从肾功能衰竭中恢复时,他有严重的多尿(每天尿量12升),用去氨加压素替代后明显改善。第三次非增强CT扫描头颅改善,第四次脑室正常,脑垂体出血缩小。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Venom Induced Toxic Ventriculitis Resulting in Acute Reversible Communicating Internal Hydrocephalus, Acute Pituitary Haemorrhage, Acute Hypopituitarism, Acute Kidney Injury, Septicaemia, Cellulitis and DIC Due to Viper Bite in a Young Farmer: A Case Report
A young farmer, tenth standard student, helping his grandfather during holiday, developed anuria after viper bite. Because of headache, non-enhanced CT scan head was done on admission which showed a small pituitary haemorrhage with normal ventricles. Later, he had generalized fits and second non-enhanced CT scan head was repeated which revealed a small pituitary haemorrhage with dilated ventricles. He also had acute kidney injury, septicaemia, cellulitis and DIC. The serum level of TSH, free T3 & free T4 were low; thus, replacement was done. Cerebrospinal fluid study (protein, sugar, cells) including culture was normal. Renal replacement therapy (haemodialysis), platelets transfusion and antibiotics were given. He had torrential polyuria (urine output 12 liter per day) when he recovered from renal failure and it improved dramatically with desmopressin replacement. There was improvement in third non-enhanced CT scan head and fourth one was consistent with normal ventricle and reduction in size of pituitary haemorrhage.
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