N Engl J Med 1980,303(19):1098–1100.PubMedCrossRef 19. Powell VI, Grima K: Exchange transfusion for malaria and Babesia infection. Transfus Med Rev 2002, 16:239–250.PubMedCrossRef 20. Florescu D, Sordillo PP, Glyptis A, Zlatanic E, Smith B, Polsky B, selleck chemicals llc Sordillo E: Splenic infarction in human babesiosis: two cases and discussion”". Clin Infect Dis 2008, 46:e8–11.PubMedCrossRef 2) Competing see more interests The authors declare that they have no competing interests. 3) Authors’ contributions WT conducted the literature search, completed the chart review and authored the manuscript. DC served as a consultant for the patient, provided infectious disease input to his
care and to the manuscript and also edited the manuscript. TL provided initial patient care and patient information from the outside hospital, provided information about other patients treated for Babesiosis, and also served as an editor of the manuscript. SA edited the manuscript. EM was the attending physician caring for the patient, instigated the study, edited the manuscript, and oversaw the project from start until completion. All authors read and approved the final manuscript”
“Introduction Traumatic injuries
of the diaphragm remain an STI571 cost entity of difficult diagnosis despite having been recognised early in the history of surgery. Sennertus, in 1541, performed an autopsy in one patient who had died from herniation and strangulation of the colon through a diaphragmatic gap secondary to a gunshot wound received seven months earlier . However, these cases remain rare, and difficult to diagnose and care for. This has highlighted some of the aspects related to these lesions, especially when they are caused by blunt trauma and injuries of the right diaphragm [1, 2]. Case report We report the case of a man of 36 years of age, thrown
from a height of 12 meters and was referred to our centre. The patient arrived conscious and oriented, and we began manoeuvring the management of the patient with multiple injuries according to the guidelines of the ATLS (Advanced Trauma Life Support) recommended by the American College of Surgeons. The patient had an unstable pelvic fracture (type B2) with hemodynamic instability and respiratory failure. Patient’s Injury Docetaxel in vivo Severity Score (ISS) was 38. Pelvis and chest X-rays were performed which confirmed the pelvic fracture and pathological elevation of the right hemidiaphragm was observed (Figure 1). We proceeded to stabilise the pelvic fracture and replace fluids, improving hemodynamic status. The patient continued with respiratory failure. For this reason, a chest tube was placed and Computerised Tomography (CT) was performed (Figure 2), showing a ruptured right hemidiaphragm, including chest drain in the right hepatic lobe and occupation of the lesser sac by blood. The patient underwent surgery, finding a right hemidiaphragm transverse rupture with a hepatothorax and an intrahepatic thoracic tube.