Complications of ventilation tubes: - Dr. Nassem Talaat
Complications of ventilation tubes: - Dr. Nassem Talaat
Complications of ventilation tubes: - Dr. Nassem Talaat
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Local: - False membrane over the tonsil which is:<br />
- Unilateral -Yellow white or dirty gray.<br />
- Thick & firm , adherent & leaves a bleeding<br />
surface on removal & reforms rapidly<br />
- Often exceeds limits <strong>of</strong> the tonsils<br />
Enlarged tender cervical LN: Bull’s neck<br />
+ Clinical picture <strong>of</strong> laryngeal & nasal diphtheria<br />
Investigations : Throat swab: a: Direct smear b: Culture on loeffler’s serum<br />
<strong>Complications</strong> : due to effect <strong>of</strong> toxins<br />
A) Cardio vascular:<br />
1- Toxic myo carditis 2-vagal neuritis 3-acute heart failure<br />
B) Neurological (paralysis)<br />
1- S<strong>of</strong>t palate: earliest & most common.<br />
2- Occular paralysis: intrinsic more than extrinsic muscles.<br />
3- Laryngeal & pharyngeal muscles. 4- Diaphragm & inter costal muscles<br />
5- Peripheral neuritis.<br />
C) Respiratory :<br />
1- Laryngeal obstruction, lung collapse. 2-Peumonia , lung abscess<br />
2- Respiratory muscle paralysis & respiratory failure<br />
D) Renal: Toxic nephritis<br />
D.D membrane over tonsils<br />
1- Acute follicular tonsillitis 2- Diphtheria<br />
Onset Acute Gradual<br />
Fever high (39-40) low (38)<br />
Toxemia mild severe<br />
Face flushed pale<br />
Pulse full, rapid, proportionate weak rapid<br />
To fever Disproportionate<br />
Vomiting uncommon more common<br />
Exudation yellow spots dirty gray membrane<br />
confined to tonsils, exceeds the tonsils<br />
easily removed adherent<br />
No bleeding leaves bleeding surface<br />
Side bilateral unilateral<br />
Swab - ve for diphtheria + ve
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