[ XXXX . A case report].

@entity3326 @entity1 @entity2011 @entity2003 @entity11896 @entity51470 @entity1133 @entity146 @entity5720 @entity772 @entity1833 @entity177 @entity5925 @entity1767 @entity592 @entity9153
A lethal case of @entity3326 in a 42-year-old @entity1 with a history of @entity146 under treatment with @entity1767 is reported. The @entity1 , hospitalized many times in the past for @entity146 treatment, was then admitted for treatment of a relapse of the disease during a exceedingly hot period. The @entity1 complained of @entity1833 and stomach ache. It was necessary to increase the dose of @entity1767 to 2 mg, 3 times a day, and to give a single dose of @entity51470 100 mg. All tests proved normal except for @entity9153 274 U/l and @entity1133 14 mg/dl. On hospital day 2, went into @entity772 with high temperature, diaphoresis, @entity2011 , leucocytosis (WBC count 15,440 U/mm3), @entity1133 7 mg/dl, LDH 425 U/l, Na 114 mEq/l, K 2.5 mEq/l. The rapid improvement following hypertonic saline treatment encouraged a diagnosis of @entity11896 . On hospital day 7, continuing with the @entity1767 treatment, the @entity1 developed a high temperature and deterioration torpor. On hospital day 9, the @entity1 went back into @entity772 with temperature over 40 degrees C (104 degrees F), with fine myoclonia most visible on the face, and @entity2003 . The @entity9153 , rose from 5,169 to 28,060 U/l in less than 24 hours; the serum myoglobin rose to 41,000 ug/l. On day hospital 11 developed @entity177 . The picture deteriorated and @entity592 was no longer of use in controlling the fever. Then with a fever of over 42 degrees (108 degrees F) and the @entity9153 at 50,000 the @entity1 died. The autopsy demonstrated @entity5925 , a picture of widespread aspecific shock in all organs and picture of myoglobin-induced @entity5720 .
