Dataset Information

Fatal cardiac injury sustained from an air gun: Case report with review of the literature.

ABSTRACT:

Introduction

Traditionally promoted as "toy guns," air guns have long been used by children and lack many regulatory guidelines compared to conventional firearms. However these weapons possess serious lethal potential and have led to numerous injuries and deaths.

Presentation of case

We describe a 21 year old man who sustained a penetrating cardiac wound from a pellet gun that led to cardiac tamponade and death. Post-mortem examination showed the pellet had penetrated the left ventricle and anterior esophagus with subsequent intraluminal migration into the stomach.

Discussion

Review of the literature identified 39 other cases of penetrating cardiac injuries from air guns. Sternotomy was the most frequently used surgical approach and the right and left ventricles were the most commonly affected chambers. Bullet embolization was the most frequently reported complication. Including our case, five deaths related to penetrating cardiac injury from air guns were identified.

Conclusions

This report highlights the seriousness of air guns and demonstrates a unique intra-thoracic injury.

SUBMITTER: Guenther T

PROVIDER: S-EPMC7229402 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Publications

Fatal cardiac injury sustained from an air gun: Case report with review of the literature.

Guenther Timothy T Chen Sarah S Wozniak Curtis C Leshikar David D

International journal of surgery case reports 20200511

<h4>Introduction</h4>Traditionally promoted as "toy guns," air guns have long been used by children and lack many regulatory guidelines compared to conventional firearms. However these weapons possess serious lethal potential and have led to numerous injuries and deaths.<h4>Presentation of case</h4>We describe a 21 year old man who sustained a penetrating cardiac wound from a pellet gun that led to cardiac tamponade and death. Post-mortem examination showed the pellet had penetrated the left ven ...[more]

PMID: 32417728

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Project description:BackgroundSystemic infections caused by the black yeast-like fungus Exophiala dermatitidis are rare, but are associated with high mortality especially in immunocompromised patients. We report the first case of E. dermatitidis fungemia in a premature extremely low birth weight (ELBW) neonate who succumbed despite antifungal therapy with liposomal amphotericin (AMB) and fluconazole. A systematic review of all fungemia cases due to E. dermatitidis was also conducted aiming for a better understanding of the risk factors, treatment strategies and outcomes.Case presentationA male, ELBW premature neonate, soon after his birth, developed bradycardia, apnoea and ultimately necrotizing enterocolitis with intestinal perforation requiring surgical intervention. Meanwhile, he had also multiple risk factors for developing bloodstream infection, such as intubation, mechanical ventilation, central venous catheter (CVC), parenteral nutrition, empirical and prolonged antibiotic use. His blood cultures were positive, firstly for Acinetobacter junii and then for Klebsiella pneumoniae together with E. dermatitidis while on fluconazole prophylaxis and antibiotic empiric therapy. Despite the treatment with broad spectrum antibiotics, liposomal AMB and fluconazole, the newborn succumbed. A literature review identified another 12 E. dermatitidis bloodstream infections, mainly in patients with hematologic malignancies and solid organ transplant recipients (61%), with overall mortality 38% despite CVC removal and antifungal therapy.ConclusionsDue to the rarity of E. dermatitidis infections, little is known about the characteristics of this yeast, the identification methods and the optimal therapy. Identification by common biochemical tests was problematic requiring molecular identification. Resolution of neonatal fungemia is difficult despite proper antifungal therapy especially in cases with multiple and severe risk factors like the present one. Therapeutic intervention may include CVC removal and treatment for at least 3 weeks with an azole (itraconazole or fluconazole after susceptibility testing) or AMB monotherapy but not echinocandins or AMB plus azole combination therapy.

Dataset Information

Fatal cardiac injury sustained from an air gun: Case report with review of the literature.

Introduction

Presentation of case

Discussion

Conclusions

Publications

Fatal cardiac injury sustained from an air gun: Case report with review of the literature.

Similar Datasets

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