1/15. Unusual injury pattern in a case of postmortem animal depredation by a domestic German shepherd.A case is presented of a 38-year-old woman with skeletization of the head, neck, and collar region and a circumscribed 26-cm x 19-cm defect on the left chest with sole removal of the heart through the opened pericardium but undamaged mediastinum and lungs. The injuries showed V-shaped puncture wounds and superficial claw-induced scratches adjacent to the wound margins that have been described as typical for postmortem animal depredation of carnivore origin and derived from postmortem animal damage by the woman's domestic German shepherd. The circumscribed destruction of the left chest with unusual opening of the pericardium is explained by the physiognomy of the muzzle of the German shepherd and differs from previous reports. Any case presented as postmortem animal mutilation should be viewed with skepticism and undergo a full autopsy.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
2/15. Pathologic features of fatal shark attacks.To examine the pattern of injuries in cases of fatal shark attack in South Australian waters, the authors examined the files of their institution for all cases of shark attack in which full autopsies had been performed over the past 25 years, from 1974 to 1998. Of the seven deaths attributed to shark attack during this period, full autopsies were performed in only two cases. In the remaining five cases, bodies either had not been found or were incomplete. Case 1 was a 27-year-old male surfer who had been attacked by a shark. At autopsy, the main areas of injury involved the right thigh, which displayed characteristic teeth marks, extensive soft tissue damage, and incision of the femoral artery. There were also incised wounds of the right wrist. Bony injury was minimal, and no shark teeth were recovered. Case 2 was a 26-year-old male diver who had been attacked by a shark. At autopsy, the main areas of injury involved the left thigh and lower leg, which displayed characteristic teeth marks, extensive soft tissue damage, and incised wounds of the femoral artery and vein. There was also soft tissue trauma to the left wrist, with transection of the radial artery and vein. Bony injury was minimal, and no shark teeth were recovered. In both cases, death resulted from exsanguination following a similar pattern of soft tissue and vascular damage to a leg and arm. This type of injury is in keeping with predator attack from underneath or behind, with the most severe injuries involving one leg. Less severe injuries to the arms may have occurred during the ensuing struggle. Reconstruction of the damaged limb in case 2 by sewing together skin, soft tissue, and muscle bundles not only revealed that no soft tissue was missing but also gave a clearer picture of the pattern of teeth marks, direction of the attack, and species of predator.- - - - - - - - - - ranking = 240.5331144562keywords = behind (Clic here for more details about this article) |
3/15. Envenomation by the billygoat plum stinging caterpillar (Thosea penthima).We report the first case of envenomation by the billygoat plum stinging caterpillar, Thosea penthima Turner (Limacodidae). The sting, on the forearm, caused immediate burning pain and local wheal formation. Pain radiated up the arm and there was severe "crushing" chest pain lasting four hours. The local pain persisted for 10 hours and required opiate analgesia.- - - - - - - - - - ranking = 0.5keywords = chest (Clic here for more details about this article) |
4/15. Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. How to remove a tick.A short cut review was carried out to establish whether there was any evidence to decide between the various described methods of tick removal. Altogether 40 papers were found using the reported search, of which two presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.- - - - - - - - - - ranking = 2keywords = chest (Clic here for more details about this article) |
5/15. Fatal envenomation by jellyfish causing Irukandji syndrome.We report the first of two recent deaths from Irukandji syndrome. A 58-year-old male tourist was stung on the face and chest by an unidentified jellyfish in shallow water off the Whitsunday islands, queensland. He developed muscle cramps, sweating, anxiety, nausea and hypertension, and died 30 hours later from intracerebral haemorrhage.- - - - - - - - - - ranking = 0.5keywords = chest (Clic here for more details about this article) |
6/15. endocarditis due to staphylococcus aureus after minor dog bite.Living in a society of animal lovers, the dangers are often not always apparent. Injury from bites and scratches is an occupational hazard for those people who work with animals. Despite the high risk of secondary wound infection as a result of an animal bite, many patients do not receive treatment with an antimicrobial medication. This report describes a case of a previously fit and well 66-year-old female dog handler who, after an apparently minor dog bite to the hand, developed fulminant acute staphylococcus aureus endocarditis and life-threatening aortic regurgitation. This article discusses the microbiology behind dog bites and highlights the need for proper wound hygiene and consideration of prophylactic broad-spectrum antibiotics to prevent potentially fatal outcomes as a result of what initially seem to be minor injuries.- - - - - - - - - - ranking = 240.5331144562keywords = behind (Clic here for more details about this article) |
7/15. Acute myocardial infarction in a professional diver after jellyfish sting.To our knowledge, acute myocardial infarction after jellyfish envenomation has not been reported previously. We describe a previously healthy 45-year-old male diver who had an acute inferior myocardial infarction with right ventricular involvement after a jellyfish sting on his left forearm while diving in the Gulf Sea. The patient had a normal controlled ascent after the incident. He had no risk factors for coronary artery disease, and cardiac catheterization revealed normal coronary arteries. Acute myocardial infarction should be considered in patients who experience chest pain or have hemodynamic compromise after jellyfish envenomation.- - - - - - - - - - ranking = 0.5keywords = chest (Clic here for more details about this article) |
8/15. replantation of an amputated upper lip.Soft tissue defects of the face are a difficult reconstructive problem. replantation of large amputated segments of the face has been rarely successful and has lagged well behind extremity trauma due in part to the relative rarity of these defects. Presented is a case of successful microvascular replantation of half of the upper lip after a dog bite.- - - - - - - - - - ranking = 240.5331144562keywords = behind (Clic here for more details about this article) |
9/15. Cardiac involvement in a patient with clinical and serological evidence of African tick-bite fever.BACKGROUND: myocarditis and pericarditis are rare complications of rickettsiosis, usually associated with rickettsia rickettsii and R. conorii. African tick-bite fever (ATBF) is generally considered as a benign disease and no cases of myocardial involvement due to Rickettsia africae, the agent of ATBF, have yet been described. CASE PRESENTATION: The patient, that travelled in an endemic area, presented typical inoculation eschars, and a seroconversion against R. africae, was admitted for chest pains and increased cardiac enzymes in the context of an acute myocarditis. CONCLUSION: Our findings suggest that ATBF, that usually presents a benign course, may be complicated by an acute myocarditis.- - - - - - - - - - ranking = 0.5keywords = chest (Clic here for more details about this article) |
10/15. Acute myocardial infarction in a young man caused by centipede sting.It is known that insects can cause various clinical effects such as myocardial ischaemia and hypotension from vasospasm and the myocardial toxic effects of the venom and anaphylaxis. Although myocardial ischaemia resulting from centipede sting has been reported once before, myocardial injury has not. In this report, the authors present the case of a 20 year old male patient bitten by a centipede and admitted to the emergency room with chest pain, abnormal electrocardiographic findings, and increased cardiac enzymes (cardiac troponin t) suggesting acute myocardial infarction.- - - - - - - - - - ranking = 0.5keywords = chest (Clic here for more details about this article) |
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