Adrenal Crisis, by Dr Nilesh Patel -Also known as acute adrenal insufficiency or Addisonian crisis -No universally accepted definition. Proposed Definition: Acute deterioration in health status associated with hypotension (SBP < 100) or relative hypotension (drop in 20 mmHg from […]
Having pus in your brain is a problem no matter how you cut it, but finding it in there can be a challenge. While the classic triad is usually fever, headache and a focal neuro deficit, this isn’t always present. Dave Traficante (@davetraf) just published a pretty cool case of bifrontal brain abscesses in the International Journal of Emergency Medicine of a gentlemen with this very problem. Interestingly, he didn’t have any focal neuro deficits, but he did have a very flat affect and could care less of the pus accumulating in his brain which coincided with the frontal lobe location of his abscesses.
Correct, we don’t have terlipressin in the US, yet… Hopefully, sometime in the not so far off future we’ll have the chance to play around with it. Essentially it’s a synthetic analog of vasopressin which we are more familiar with. There’s some written about its use in variceal bleeds and here is a cool little study from Egypt using it for refractory septic shock.