1/3. myiasis in a pregnant woman and an effective, sterile method of surgical extraction.BACKGROUND: Cutaneous myiasis caused by Dermatobia hominis involves the infestation of tissue with dipterous fly larvae and is common in many tropical and subtropical areas. We describe a patient in her sixth month of pregnancy who returned from belize with myiasis detected in the right popliteal fossa. Multiple surgical techniques have been described in the past outlining various ways to extract the botfly larva. No single standardized technique for surgical extraction of larvae has been adopted. OBJECTIVE: To describe a highly effective, sterile method of extraction used in a pregnant patient with botfly infestation. methods: A combination of injection with plain 1% lidocaine, sterile occlusion with polymyxin b sulfate ointment and a cruciform incision was used to extract the larva. RESULTS: The botfly larva was easily and completely extracted without remnants of the larval body being left in the skin. CONCLUSION: The sterile technique we describe allows for quick and easy extraction of the larva without risk of secondary infection or need for antibiotics. This method is especially appropriate for pregnant patients or those with medical conditions precluding a completely competent immune response to potential secondary infection.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
2/3. Ultrasound in the diagnosis of roundworms in gallbladder and common bile duct. Report of four cases.Four patients who complained of symptoms and signs compatible with biliary tract disease and in whom the diagnosis of gallbladder (three cases) and common bile duct ascariasis (one case) was made sonographically are reported. In two patients with gallbladder ascariasis, cholecystectomy corroborated the presence of the round-worms, and was curative. The third patient was a pregnant woman (32nd gestational week) who took piperazine citrate, and a second sonogram performed 29 days later was completely normal. The fourth patient with common bile duct ascariasis underwent choledochotomy with extraction of one ascaris lumbricoides from the common duct, and a T tube was left in place for 15 days. All patients received antiparasitics and had a favorable outcome. ultrasonography is an important noninvasive diagnostic procedure in the work-up of these patients, who usually describe a clinical picture suggesting gallstone disease: this is especially true in the presence of pregnancy.- - - - - - - - - - ranking = 0.14285714285714keywords = extraction (Clic here for more details about this article) |
3/3. Postpartal endomyometritis in a case of unknown tertian malaria.A 28-year-old woman developed puerperal endomyometritis and tertian malaria simultaneously. She delivered her child by vacuum extraction during week 41 of pregnancy in September 1994. The peripartal period was uneventful. Nine days post partum the patient was readmitted to hospital with fever and pain in the area of the episiotomy. On day 13 post partum a hysterectomy was performed because of suspected abscess-forming endomyometritis. Two days after the hysterectomy the patient developed septic temperatures, which persisted for 10 days. Tertian malaria due to plasmodium vivax was found to be the cause of fever. The patient had been in indonesia without anti-malarial prophylaxis in 1991. Two years later she travelled to ghana, having taken mefloquine as prophylaxis. malaria was obviously caused by reactivated hypnozoites in the liver, although the patient had never had an episode of fever associated with malaria before. This case proves that tertian malaria may "recur" even without previous manifestation, years after a stay in a region endemic for malaria.- - - - - - - - - - ranking = 0.14285714285714keywords = extraction (Clic here for more details about this article) |