Post-malaria neurological syndrome manifesting as new onset psychosis with generalized encephalopathy: an analysis of two cases in children

2021 ◽  
pp. 004947552110553
Author(s):  
Neha Agarwal
Keyword(s):  
Clinical Improvement ◽  
Specific Treatment ◽  
Complete Recovery ◽  
The Other ◽  
Malaria Parasitaemia ◽  
Neurological Syndrome ◽  
Psychiatric Manifestations ◽  
Post Infectious ◽  
New Onset

Post-malaria neurological syndrome(PMNS) is a rare heterogenous syndrome heralded by the appearance of new neurological or psychiatric manifestations emerging in the post-infectious phase after clearance of malaria parasitaemia. Most cases of PMNS have been described in adults. Only seven cases have been reported in children. We describe two further cases of possible PMNS who presented with prominent psychiatric manifestations evolving into generalized encephalopathy after complete recovery from malaria. Both patients were treated with antivirals and antibiotics without clinical improvement. One patient received pulse corticosteroids and had a remarkable and rapid clinical improvement. The other recovered without specific treatment.

scholarly journals A young man presenting with encephalopathy and seizures secondary to SARS-CoV-2

2021 ◽  
Vol 14 (3) ◽  
pp. e240576
Author(s):  
Bilal Athar Jalil ◽  
Mohsin Ijaz ◽  
Amir Maqbul Khan ◽  
Thomas Glenn Ledbetter
Keyword(s):  
Respiratory Illness ◽  
Viral Meningitis ◽  
The Other ◽  
New Disease ◽  
Unique Case ◽  
Multisystem Involvement ◽  
Disease Associations ◽  
Viral Illness ◽  
Structural Brain ◽  
New Onset

COVID-19 has now emerged from a respiratory illness to a systemic viral illness with multisystem involvement. There is still a lot to learn about this illness as new disease associations with COVID-19 emerge consistently. We present a unique case of a neurological manifestation of a patient with structural brain disease who was COVID-19 positive and developed mental status changes, new-onset seizures and findings suggestive of viral meningitis on lumbar puncture. We also review the literature and discuss our case in the context of the other cases reported. We highlight the value of considering seizures and encephalopathy as one of the presenting features of COVID-19 disease.

scholarly journals Bipolar Dislocation of the Clavicle: A Report of Two Cases with Different Injury Patterns and a Literature Review

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Ichiro Okano ◽  
Takatoshi Sawada ◽  
Katsunori Inagaki
Keyword(s):  
Literature Review ◽  
Treatment Strategy ◽  
Acromioclavicular Joint ◽  
Treatment Approach ◽  
Specific Treatment ◽  
Sternoclavicular Joint ◽  
The Other ◽  
Anterior Dislocation ◽  
Injury Patterns ◽  
Rare Injury

Bipolar dislocation of the clavicle is a rare injury that is defined as a concomitant dislocation of the ipsilateral acromioclavicular joint and sternoclavicular joint. This injury is also described as a floating clavicle. Although this injury has been known for nearly two centuries, knowledge about it is limited and the treatment strategy remains controversial. Bipolar dislocation includes several combinations of both joints’ injury types. We reported two patients with bipolar dislocation of the clavicle: one with an anterior dislocation and the other with a posterior dislocation of the sternoclavicular joint. After reviewing the currently available literature, we discussed these cases to highlight the necessity of a specific treatment approach that is modified based on the pattern of each joint’s lesion.

Secondary Procedures Following Iliac Branch Device Treatment of Aneurysms Involving the Iliac Bifurcation: The pELVIS Registry

2017 ◽  
Vol 24 (3) ◽  
pp. 405-410 ◽  
Author(s):  
Konstantinos P. Donas ◽  
Mirjam Inchingolo ◽  
Piergiorgio Cao ◽  
Carlo Pratesi ◽  
Giovanni Pratesi ◽  
...  
Keyword(s):  
Specific Treatment ◽  
The Other ◽  
Type I ◽  
Iliac Arteries ◽  
Type I Endoleak ◽  
Secondary Procedures ◽  
Sealing Zone ◽  
Crossover Bypass ◽  
Iliac Bifurcation

Purpose: To evaluate the incidence and reasons for secondary procedures in patients treated with iliac branch devices (IBDs) for isolated iliac aneurysm or aortoiliac aneurysms involving the iliac bifurcation. Methods: Between January 2005 and December 2015, 575 surgical-high-risk patients (mean age 72.0±8.4 years; 558 men) with isolated iliac aneurysms (n=79) or aortoiliac aneurysms involving the iliac bifurcation (n=496) were treated with placement of 650 ZBIS or Gore IBDs (75 bilateral) in 6 European centers. The primary outcome was procedure-related reinterventions for occlusion or high-grade (>70%) stenosis of the bridging device, occlusion of the ipsilateral common or external iliac artery (EIA), type I/III endoleak, rupture, or infection following IBD implantation. Clinical and radiological data were analyzed based on preset definitions of comorbidities, aneurysm morphology, intraoperative variables, and follow-up strategies. Results: Nine (1.6%) reinterventions were performed within 30 days for occlusion or endoleak. Among 10 (1.5%) occluded EIAs ipsilateral to a deployed IBD, 6 underwent a reintervention with additional stent placement after thrombolysis (n=4) or a femorofemoral or iliofemoral crossover bypass (n=2). Three of 14 patients with early type I endoleak had a reintervention for an insufficient proximal sealing zone (stent-grafts in 2 common iliac arteries and 1 bifurcated endograft). Mean clinical and radiological follow-up were 32.6±9.9 and 29.8±21.1 months, respectively. Forty-two (7.3%) patients underwent reinterventions in the follow-up period. The overall postoperative reintervention rate was 8.9%. Both external and common iliac segments occluded in 30 (4.6%) IBDs; 2 patients had a crossover bypass and 14 were treated with endovascular techniques. In the other 14 patients, no specific treatment was performed. Seven (1.2%) patients with isolated EIA occlusion were treated during follow-up. Nineteen of the overall 28 patients with type I endoleak underwent endovascular repair. The other 9 were under radiological surveillance due to less significant (<5 mm) sac increase. No reintervention was performed to recanalize 11 (1.6%) occluded internal iliac arteries. Conclusion: Midterm experience with placement of IBDs is associated with a low incidence of secondary procedures due to type I endoleaks and occlusions. The main reasons for reinterventions seem to be short proximal sealing zone and poor conformability of the ZBIS device in elongated EIAs.

AUREOMYCIN IN THE TREATMENT OF EXPERIMENTAL AND CLINICAL INFECTIONS WITH H. INFLUENZAE, TYPE B

PEDIATRICS ◽  
1950 ◽  
Vol 5 (2) ◽  
pp. 267-275
Author(s):  
CAROLINE A. CHANDLER ◽  
HORACE L. HODES
Keyword(s):  
Body Weight ◽  
Clinical Improvement ◽  
Complete Recovery ◽  
Spinal Fluid ◽  
Response To Treatment ◽  
Type B ◽  
Adequate Treatment ◽  
Residual Damage ◽  
Toxic Reactions

Aureomycin, in doses of 20 mg./kg. body weight, was as effective in the treatment of mice infected with H. influenzae, type B, as streptomycin and dihydrostreptomycin, and more effective than polymyxin or Q-19. Two infants with H. influenzae, type B, meningitis were treated successfully with aureomycin and sulfadiazine. Spinal fluid cultures became negative and marked clinical improvement occurred within 48 hours. Both patients went on to complete recovery. Three children were treated with aureomycin alone. Although their response to treatment was not so rapid as that of the infants treated with aureomycin and sulfadiazine, rccovery was assured within four to seven days and subsequently there were no evidences of residual damage. No serious toxic reactions to aureomycin were apparent. A sixth patient, desperately ill on admission, succumbed within 36 hours in spite of adequate treatment with combined aureomycin and sulfadiazine.

scholarly journals Rate of reversion of hepatosplenic schistosomiasis after specific therapy

1986 ◽  
Vol 19 (2) ◽  
pp. 69-73 ◽  
Author(s):  
Reynaldo Dietze ◽  
Aluizio Prata
Keyword(s):  
Clinical Improvement ◽  
Endemic Area ◽  
Surgical Intervention ◽  
Specific Treatment ◽  
Previous Treatment ◽  
Clinical Form ◽  
Specific Therapy ◽  
Liver Nodules ◽  
History Of ◽  
Hepatosplenic Schistosomiasis

Seventy patients with hepatosplenic schistosomiasis were treated with oxamniquine. The patients lived iti an endemic area and were evaluated 6, 18 and 24 months after treatment, during which time transmission in the area was interrupted. After treatment, clinical improvement occurred in 49 (70%) of the patients, as seen by reduction in visceromegaly and reversion of liver nodules. Reversion of hepatosplenic disease occurred in 28 (40%) patients and in liver nodularity in 26 (47.3%)patients after 24 months. Reversion of hepatosplenic disease was seen in 12 (21%) patients and liver nodules disappeared in 4 (8.5%) as early as 6 months after treatment. In general, hepatosplenomegaly reverses earlier than liver nodularity. Itis notable that reversion of hepatosplenic disease occurred in many individuals with a history ofprevious treatment and also in some with advanced age. In four cases this clinical form of the disease had existed for 20 years. Therefore, there must exist factors other than age and duration of the condition which determine the reversibility of this clinical form. Ourresults reinforce the concept that, in patients with hepatosplenic disease without esophageal hemorrhages, specific treatment shouldpreceed surgical intervention even in those with a history of previous treatment. At least 18 months should be allowed for the ejfects of treatment to be manifest.

Psychiatric Manifestations of Niemann-pick Type c Disease – Two Case Reports

2016 ◽  
Vol 33 (S1) ◽  
pp. 1-1 ◽  
Author(s):  
J. Rebelo ◽  
M. Oliveira ◽  
P. Nunes
Keyword(s):  
Metabolic Diseases ◽  
Psychiatric Symptoms ◽  
Case Reports ◽  
Clinical Manifestations ◽  
Specific Treatment ◽  
Autosomal Recessive Inheritance ◽  
Ataxic Gait ◽  
Type C ◽  
Niemann Pick ◽  
Psychiatric Manifestations

IntroductionNiemann-Pick type C disease (NPCD) is a rare metabolic illness, with autosomal recessive inheritance. NPCD has a heterogeneous presentation, with non-specific psychiatric symptoms, mostly affective and psychotic features and also cognitive deficits.Objectives and methodsWe present the case reports of two brothers with an adolescent-adult onset and discuss the evolution of their neuropsychiatric manifestations.ResultsThe patients have now 35 and 31 years old and the youngest was the first to develop clinical manifestations of the disease. From 16 years old, he developed unspecified neurological impairment with gait imbalance. In the next years, the neurologic manifestations exacerbated, with dysarthria, ataxic gait, and his academic performance declined. With 24 years old, he presented acute psychosis, with unstructured delusion and auditory hallucinations. The acute psychotic symptomatology remitted with olanzapine but he revealed social withdrawal, apathy and progressive cognitive decline that persist until now. His brother, whose diagnosis was made in the course of the family genetic study, developed the first signs of the NPCD with 19 years old. He presented neuropsychiatric compromise, with impaired learning, social isolation and insomnia. They are receiving specific treatment with miglustat and symptomatic treatment for the psychiatric manifestations.ConclusionsNPCD is a rare metabolic disease, with neuropsychiatric compromise. No general psychopathological profile has been associated to NPCD. Sometimes psychiatric symptoms dominate the initial clinical presentation, with neuro-visceral signs appearing later. An atypical psychiatric symptomatology should be extensively investigated in order to exclude organic causes, including metabolic diseases like NPCD.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Psychopathology of alcoholics during withdrawal and early abstinence

2000 ◽  
Vol 15 (8) ◽  
pp. 483-488 ◽  
Author(s):  
T Wetterling ◽  
K Junghanns
Keyword(s):  
Alcohol Withdrawal ◽  
Depressive Disorders ◽  
Specific Treatment ◽  
The Other ◽  
Depression And Anxiety ◽  
Symptom Profile ◽  
Co Morbidity ◽  
Icd 10 ◽  
Severe Psychopathology ◽  
The Impact

Epidemiologic surveys show a high lifetime co-morbidity with psychiatric disorders (e.g., depression and anxiety) in alcoholics. However, alcoholics frequently complained about psychopathologic symptoms, particularly during alcohol withdrawal. There is some evidence that symptomatology decreases spontaneously with prolonged abstinence. Thus, the question arises whether high levels of psychopathology could be accounted for by withdrawal effects. This study was aimed at examining the impact of the alcohol withdrawal severity (assessed by the AWS scale) on psychopathologic symptoms. The psychopathologic profile of 110 alcoholics as measured by the Symptom Checklist-90 revised (SCL-90-R) was compared to that of 253 patients with adjustment, anxiety or depressive disorders (according to ICD-10 criteria). No relationship between the severity of alcohol withdrawal and psychopathology could be found which might hint at two different neurobiological processes underlying these phenomena. The comparison with patients suffering from depression or anxiety disorders revealed that the global symptom severity of alcoholics undergoing withdrawal was similar, but recovery was achieved more rapidly than in the other groups. On the other hand, the self-rated psychopathologic symptom profile of alcoholics was rather similar to that of patients with adjustment disorders. While about one-quarter of the alcoholics reported severe psychopathology on admission, only about 10% showed symptomatology at discharge about three weeks later, predominantly depression or anxiety. These results underline the notion that much of the psychopathology described by alcoholics decreases within 2–3 weeks after withdrawal without specific treatment.

Parvovirus B19 myocarditis in children: an observational study

2015 ◽  
Vol 101 (2) ◽  
pp. 177-180 ◽  
Author(s):  
Trisha V Vigneswaran ◽  
Julianne R Brown ◽  
Judith Breuer ◽  
Michael Burch
Keyword(s):  
Parvovirus B19 ◽  
Complete Recovery ◽  
Fulminant Myocarditis ◽  
Circulatory Support ◽  
Free Survival ◽  
St Segment Elevation ◽  
Viral Genomes ◽  
St Segment ◽  
Fractional Shortening ◽  
New Onset

BackgroundThe advent of PCR testing for the presence of viral genomes has led to the identification of parvovirus B19 (PVB19) as a causative agent of myocarditis.MethodsThe clinical presentation, course and outcome of children with PVB19 myocarditis was ascertained through a retrospective review. The PVB19 viral genome was detected by PCR from whole blood or endomyocardial biopsy specimens in patients presenting with new onset heart failure.ResultsSeventeen patients presented at a median age of 1.3 years (range: 0.4–15.4 years) in cardiac failure with a mean fractional shortening of 15±3%. Eleven patients required mechanical ventilation and intravenous inotropes and seven required extra-corporeal mechanical oxygenation. Four of the five deaths occurred in patients who had a short prodromal illness of less than 48 hours. All patients with ST segment elevation died (n=4). All non-fulminant cases survived. Event-free survival occurred in 11/17 (65%) patients. Five (29%) patients died and one patient underwent heart transplantation. Complete recovery of cardiac function occurred within a median of 12 months (range: 1–48) in five patients. There was incomplete recovery in five patients and one patient had persistent dilated cardiomyopathy.ConclusionsPVB19 can cause a devastating myocarditis in children. Children with fulminant myocarditis, ST segment changes or a short prodrome have the worst outcome. Transplantation may be considered, but is rarely required in the acute period if mechanical circulatory support is utilised. If the initial presentation is survived, recovery of the myocardium can occur even in those who had fulminant myocarditis.

Evaluation and Management of Syncope

2009 ◽  
Vol 2 (2) ◽  
pp. 65-77 ◽  
Author(s):  
Joanne L. Thanavaro
Keyword(s):  
Risk Stratification ◽  
Specific Treatment ◽  
Complete Recovery ◽  
Medical Problem ◽  
Cerebral Hypoperfusion ◽  
Loss Of Consciousness ◽  
Life Threatening ◽  
Transient Loss ◽  
Life Threatening Event ◽  
Postural Tone

Syncope is a transient loss of consciousness precipitated by cerebral hypoperfusion, which is associated with a brief absence of postural tone and usually followed by a complete recovery. This clinical condition is a common medical problem and may be attributed to a multitude of disease processes. Risk stratification identifies the safest setting for the initial evaluation as well as which patients are most likely to have a life-threatening event. Establishing the diagnosis of syncope is important so that specific treatment can be instituted to prevent future recurrences and eliminate the underlying predisposing disease. This article reviews the etiology, risk stratification, diagnosis, and therapeutic management of syncope.

Sign in / Sign up

Export Citation Format

Share Document