Radiographically determined injuries to the lung parenchyma have a closer association with adverse outcome than chest-wall injuries but are often not diagnosed until 24 hours after injury. Therefore, clinical decision making, such as about the choice of surgery for long bone fractures, may be flawed if this information is used alone. A new thoracic trauma severity score may serve as an additional tool to improve the accuracy of the prediction of thoracic trauma-related complications.
Zoster is a frequent disease of adulthood with a distinct age-dependent increase after 60. In contrast during childhood or adolescence zoster only rarely occurs. Certain risk factors such as hematologic malignancies are associated with early appearance. The typical clinical manifestation is unilateral, equally involving thoracic dermatomes. A 16-year-old patient presented with zoster in bilateral asymmetrical distribution, with trigeminal and thoracic dermatomes simultaneously affected. Despite the clinical findings and the unusual localization, there was no history, clinical nor laboratory signs of an immune suppression or any other underlying disease. Careful follow-up examinations are necessary in order to recognize systemic, especially hematologic, malignancies.
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