Productive cough severe necrotizing tracheobronchitis

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Unformatted text preview: ne formation Secondary bacterial infection Clifton Yu, MD Department of Pediatrics Walter Reed Army Medical Center 18 Bone Marrow Involvement occurs in severe cases Usually occurs on day 3 to 5 ANC less than 500 or a precipitous drop portends a high risk of sepsis and death Clifton Yu, MD Department of Pediatrics Walter Reed Army Medical Center 19 GI Tract Usually manifested by nausea and vomiting Generally transient and not severe Thought to be caused by cholinergic activity of mustard Delayed nausea and vomiting thought secondary to generalized cytotoxic activity and mucosal damage to GI tract Clifton Yu, MD Department of Pediatrics Walter Reed Army Medical Center 20 CNS Symptoms not usually prominent Common complaints in World War I were apathy, depression, and intellectual dullness 83% of hospitalized Iranians in one study had CNS complaints--usually mild and nonspecific Clifton Yu, MD Department of Pediatrics Walter Reed Army Medical Center 21 Treatment Decon, Decon, Decon !!! -only effective means of preventing or decreasing tissue damage -must be performed before entry into a clean MTF Remainder of treatment depends on the other organ systems involved Clifton Yu, MD Department of Pediatrics Walter Reed Army Medical Center 22 Skin Treat like a burn Erythema treated with soothing lotion, e.g. calamine Carefully unroof larger blisters Irrigation of denuded areas 3-4X daily Clifton Yu, MD Depar...
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