scholarly journals Unusual presentation of meningococcal meningitis in the elderly and utility of CSF PCR testing

2020 ◽  
Vol 2 (10) ◽  
Author(s):  
Elizabeth Ranson ◽  
Hannah Ship ◽  
Omai Garner ◽  
Shangxin Yang ◽  
Debika Bhattacharya
Keyword(s):  
Mental Status ◽  
Unusual Case ◽  
The Elderly ◽  
Altered Mental Status ◽  
Meningococcal Meningitis ◽  
Unusual Presentation ◽  
Nuchal Rigidity

We present an unusual case of a previously healthy 74-year-old man who presented with diffuse weakness, severe myalgias, petechial palmar rash and hypotension, but without fever, altered mental status, nuchal rigidity or headache, who was ultimately found through PCR testing to have meningococcal meningitis.

scholarly journals The Optimal Management of Acute Febrile Encephalopathy in the Aged Patient: A Systematic Review

2016 ◽  
Vol 2016 ◽  
pp. 1-13 ◽  
Author(s):  
Fereshte Sheybani ◽  
HamidReza Naderi ◽  
Sareh Sajjadi
Keyword(s):  
Systematic Review ◽  
Mental Status ◽  
The Elderly ◽  
Altered Mental Status ◽  
Cns Infection ◽  
Geriatric Syndrome ◽  
World Population ◽  
Main Process ◽  
Optimal Management ◽  
Language Restriction

The elderly comprise less than 13 percent of world population. Nonetheless, they represent nearly half of all hospitalized adults. Acute change in mental status from baseline is commonly seen among the elderly even when the main process does not involve the central nervous system. The term “geriatric syndrome” is used to capture those clinical conditions in older people that do not fit into discrete disease categories, including delirium, falls, frailty, dizziness, syncope, and urinary incontinence. Despite the growing number of elderly population, especially those who require hospitalization and the high burden of common infections accompanied by encephalopathy among them, there are several unresolved questions regarding the optimal management they deserve. The questions posed in this systematic review concern the need to rule out CNS infection in all elderly patients presented with fever and altered mental status in the routine management of febrile encephalopathy. In doing so, we sought to identify all potentially relevant articles using searches of web-based databases with no language restriction. Finally, we reviewed 93 research articles that were relevant to each part of our study. No prospective study was found to address how should AFE in the aged be optimally managed.

Altered Mental Status in the Elderly

1984 ◽  
Vol 11 (4) ◽  
pp. 653-665
Author(s):  
Bruce L. Miller ◽  
Stephen L. Read ◽  
Michael E. Mahler ◽  
D. Frank Benson
Keyword(s):  
Mental Status ◽  
The Elderly ◽  
Altered Mental Status

scholarly journals Altered mental status and complete heart block: an unusual presentation of aspirin toxicity

2013 ◽  
Vol 2013 (jun10 1) ◽  
pp. bcr2013010083-bcr2013010083 ◽  
Author(s):  
N. Aggarwal ◽  
Y. Kupfer ◽  
K. Chawla ◽  
S. Tessler
Keyword(s):  
Mental Status ◽  
Heart Block ◽  
Complete Heart Block ◽  
Altered Mental Status ◽  
Unusual Presentation

Altered mental status in the elderly

2016 ◽  
pp. 58-70
Author(s):  
Josh Joseph ◽  
Maura Kennedy
Keyword(s):  
Mental Status ◽  
The Elderly ◽  
Altered Mental Status

scholarly journals When a Seemingly Harmless Prescription Turns into Toxicity

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Zurab Azmaiparashvili ◽  
Kevin Bryan Lo ◽  
Nawal Habib ◽  
Annie Hsieh
Keyword(s):  
Renal Function ◽  
Differential Diagnosis ◽  
Herpes Zoster ◽  
Cognitive Function ◽  
Mental Status ◽  
Complete Resolution ◽  
Impaired Renal Function ◽  
Supportive Therapy ◽  
The Elderly ◽  
Altered Mental Status

Valacyclovir neurotoxicity is commonly seen in the elderly and those with impaired renal function. Differential diagnosis can be challenging as a myriad of medical conditions, including herpes zoster virus associated encephalitis, may present in a similar fashion. We present a case of a 71-year-old male who presented with altered mental status in the setting of recent herpes zoster eruption. His condition was attributed to valacyclovir neurotoxicity, and initiation of appropriate supportive therapy was met with complete resolution of symptoms and normalization of cognitive function.

An Unusual Case of Fever and Altered Mental Status

2020 ◽  
Vol 21 (3) ◽  
pp. B4 ◽  
Author(s):  
Patricia Guzman Rojas ◽  
Patricia Guzman Rojas ◽  
Laura Morton
Keyword(s):  
Mental Status ◽  
Unusual Case ◽  
Altered Mental Status

Altered mental status in the elderly

2014 ◽  
pp. 102-113
Author(s):  
Scott T. Wilber ◽  
Jin H. Han ◽  
Joseph H. Kahn ◽  
Jonathan S. Olshaker
Keyword(s):  
Mental Status ◽  
The Elderly ◽  
Altered Mental Status

scholarly journals Unforeseen Hodgkin Lymphoma Hidden behind Hypercalcemia

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Moutaz Ghrewati ◽  
Balraj Singh ◽  
Parminder Kaur ◽  
Michael Maroules
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Hodgkin Lymphoma ◽  
Mental Status ◽  
Cervical Lymph Node ◽  
Unusual Case ◽  
Case Reports ◽  
Altered Mental Status ◽  
Nodular Sclerosis ◽  
Timely Treatment

As one of the leading causes of hypercalcemia, malignancy is an essential consideration when patients present with such symptomology. While certain tumors are more known to cause hypercalcemia, it can occur with almost any type of cancer. Hodgkin lymphoma is an infrequent cause of hypercalcemia. Only a few case reports have been published in the literature to date. We report an unusual case of a 61-year-old female who presented with altered mental status, nausea, vomiting, and dizziness and was found to have multiple enlarged lymph nodes, and blood work showed hypercalcemia. Biopsy of the cervical lymph node showed Hodgkin lymphoma of the nodular sclerosis subtype. Our case aims to raise awareness of this rare but significant presentation of hypercalcemia and how timely treatment of calcium levels can facilitate the employment of available chemotherapeutic options.

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