Risks and benefits of therapy with flumazenil (Anexate) in mixed drug intoxications.

Flumazenil, the first specific benzodiazepine (BZD) antagonist, is one of the most innovative drugs to become available within the last few years. Flumazenil is indicated for the reversal of the centrally depressant effects of BZDs, in BZD-induced anaesthesia, in BZD sedation in intensive care and in patients comatose after drug overdoses including BZDs. A conference of experts experienced in the treatment of mixed drug overdoses by various means, including flumazenil, was held in order to try to reach a consensus regarding the safe use of flumazenil in this indication.

Caustic intoxication.

After a retrospective study of 17 cases of caustic intoxication in the intensive care unit, the epidemiologic, pathophysiologic, clinic and therapeutic aspects are reviewed. The following procedure is suggested: early endoscopies, abstention of any gastric lavage, corticosteroids and empiric antibiotic therapy and the most early possible introduction of a parenteral nutrition.

[Case of acute poisoning by mercuric oxycyanide].

We report the case of a 25-year-old woman who voluntary swallowed mercuric oxycyanide and presented an anuric acute renal failure. The treatment was classically based upon the use of chelating agents and haemodialysis. Recovery of renal function was excellent.

Central nervous system complications of Mycoplasma pneumoniae.

Three cases of central nervous system complications of Mycoplasma pneumoniae infections are reported. There were several atypical findings: the first patient presented with an acute disseminated encephalitis with normal cerebrospinal fluid and hypogammaglobulinaemia. The second patient presented with a left sixth nerve palsy followed six weeks later by choreoathetoid movements and an acute psychosis.

[Infectious pulmonary and neurologic complications of Kaposi's sarcoma. Anatomo-clinical correlation with an ultrastructural study].

The authors report a case of generalised Kaposi sarcoma complicated by pulmonary cryptococcosis and cerebral toxoplasmosis. Clinical features were dominated by the cerebral condition. The infectious pathogenesis could be related to disturbances in immune defences.

Lithium in haematology: a case of acute intoxication.

A 74-year-old woman was treated by lithium carbonate 3 x 300 mg per day for drug-induced aplastic anemia. After 8 days, she suddenly developed severe impairment of consciousness with myoclonias and hypertonia which persisted during 10 days despite lithium withdrawal and sodium chloride infusion. Slight disorders of water and electrolyte metabolism, mild renal failure and the patient's age could have contributed to the development of intoxication.

Myopathy caused by polymyxin E: functional disorder of the cell membrane.

A myopathy caused by the activity of polymyxin E on the cell membrane was accompained by immunological manifestations. There were also disturbances of the central nervous system, contrasting with the absence of serious renal lesion.