Case 2-2011 — A 30-Year-Old Woman with Shock after Treatment of a Furuncle  

Oleh:

Moellering, Robert C. ; Abbott, Gerald F. ; Ferraro, Mary Jane

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The New England Journal of Medicine (keterangan: ada di Proquest) vol. 364 no. 03 (Jan. 2011), page 266-275.
Topik: Allergies to Medications.

Ketersediaan

Perpustakaan FK Nomor Panggil: N08.K.2011.01 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Dr. Ari Brettman (Medicine): A 30-year-old woman was transferred to this hospital because of hypotension and respiratory failure. The patient had been well until 4 days before admission, when she slipped and fell in her home, after which she reported severe posterior thoracic pain that radiated to the anterior chest and lower back and did not respond to acetaminophen. Two days later, she went to an urgent care clinic affiliated with this hospital. She rated the pain at 10 on a scale of 0 to 10, with 10 indicating the most severe pain; she reported that the pain increased with movement and breathing. She reported mildly decreased appetite, without nausea, vomiting, or weakness. On examination, she appeared comfortable; the temperature was 36.6°C, the blood pressure 102/59 mm Hg, the pulse 100 beats per minute, the respiratory rate 18 breaths per minute, and the oxygen saturation 98% while she was breathing ambient air. The thoracic paraspinal muscles were tender, with spasm; the remainder of the examination was normal. Radiographs of the chest and thoracic spine were normal. Ketorolac tromethamine was administered intramuscularly. The patient went home, with instructions to return if the pain did not resolve. The next day, she went to another hospital because of persistent pain. Cyclobenzaprine and oxycodone with acetaminophen were prescribed, and she returned home. On the day of admission, at approximately 8:30 p.m., a friend found her at home, unresponsive and moaning. Emergency medical services personnel were called, and the patient was taken to the other hospital by ambulance. Naloxone was administered en route, with minimal response.

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