The American journal of emergency medicine
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Case Reports
Enzymatic debridement as an effective treatment for combined flame and chemical burns caused by e-cigarettes.
Since its introduction on the market in 2007, the number of reports on injuries caused by the ignition or explosion of electronic nicotine delivery systems (ENDS) has increased significantly. Two male patients have been treated at our burn center, the for ENDS-related injuries. Their batteries came into contact with metal objects stored in their pants pockets, resulting in a short circuit and finally ignition. ⋯ Although enzymatic debridement is not generally recommended in the treatment of chemical burns, we successfully made use of this treatment option. Different authors advocate the use of mineral oils to irrigate or cover alkali burns, as contact between the chemical compounds and water can set off an exothermic reaction, leading to further injury. We believe that a hypertonic rinsing solution could be recommended as well in an emergency setting and we want to stress the importance of rapid removal of the chemical compounds in suspected chemical burns as well as swift debridement.
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Bacterial meningitis is a life-threatening condition that should be addressed as an emergency. The typical culprit microorganisms are targeted empirically with ceftriaxone and vancomycin, in the absence of an immunocompromised state. In this case report, however, we are describing a case of meningitis secondary to Weissella confusa, bacteria inherently resistant to the two drugs commonly used to empirically treat meningitis. ⋯ Other reported manifestations include post-operative osteomyelitis, thumb abscess, infected prosthetic joint, infected peritoneal fluid and peritonitis. To our knowledge, this is the first case of meningitis due to Weissella confusa in the literature. Therefore, we conclude that the isolation of Gram-positive coccobacilli resistant to vancomycin, especially in an immunocompromised host, should raise the suspicion of W. confusa.