scholarly journals A Cluster of Neurobrucellosis at King Hussein Medical Center, Jordan - A Comprehensive Analysis And Review.

2020 ◽  
pp. 349-358
Author(s):  
Al Dhomour Aktham ◽  
Al Shyyab Awni ◽  
Al Etan Shaher ◽  
Al Adamat Mohammed ◽  
Amin Bani Salamah ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Medical Center ◽  
Systemic Disease ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Close Monitoring ◽  
Animal Products ◽  
Fluid Analysis ◽  
Clinical Presentations ◽  
Low Glucose

In this retrospective review, we describe the neurological clinical manifestations in five cases diagnosed with neurobrucellosis over two years between 2018 and 2020, and the application of different proposed criteria for establishing the diagnosis and treatment of neurobrucellosis. All cases were confirmed to have brucellosis with laboratory tests, and all were living in Jordan, which is considered part of a highly endemic area within the Middle East. The neurobrucellosis proposed criteria was applied, which requires signs and symptoms consistent with neurobrucellosis, presence of anti-Brucella antibodies in cerebrospinal fluid and serum with or without isolation of Brucella species in CSF and serum, cerebrospinal fluid analysis shows: lymphocytosis, high protein level, and low glucose level and radiological findings on MRI or CT. In all five cases, we have confirmed direct contact with animals or animal products either as a consumer or as a farmworker. Their signs and symptoms were consistent with brucellosis. In all cases, haematological and CSF results, in addition to imaging findings using magnetic resonance and computed tomography, were highly coherent with neurobrucellosis. Neurobrucellosis can present with different clinical manifestations, either as a sole site of infection like acute or subacute meningitis or myelitis, or in context of a multi variable systemic disease. In patients with unusual neurological clinical presentations, and those with persistent chronic symptoms like headache, malaise, or depression, neurobrucellosis should be highly suspected, especially in endemic areas. Such patients must have a prolonged course of antibiotics between 6 to 18 months with close monitoring of their serum and CSF examination

scholarly journals Porencephalic Cyst in an Adult - A Rare Pathology

2021 ◽  
Vol 10 (12) ◽  
pp. 918-919
Author(s):  
Shreya Tapadia ◽  
Suresh Vasant Phatak ◽  
Harshith Gowda K.B ◽  
Asish Pavanan
Keyword(s):  
Cerebrospinal Fluid ◽  
White Matter ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Sudden Onset ◽  
Brain Parenchyma ◽  
Motor Deficits ◽  
Cystic Degeneration ◽  
Lateral Side ◽  
Porencephalic Cyst

Porencephalic cyst is a rare entity in adults with limited cases reported so far. It is usually congenital and seen in neonates. Here, we report a 25-year-old male who presented with post-ictal confusion following an episode of sudden onset of generalised tonic clonic seizure. He was diagnosed to have large cerebrospinal fluid (CSF) density cystic lesion in the right parieto-occipital region communicating with occipital horn on right side side of porencephaly. Porencephaly is an uncommon congenital disorder that occurs due to cystic degeneration and encephalomalacia leading to porencephalic cyst formation.1 They are considered to occur most commonly from focal encephalomalacia due to a localised cerebral insult during early gestation, 2 while the other aetiologies include trauma, infection, antenatal intraparenchymal haemorrhage and perinatal cerebral ischemia.3 If the insult occurs in late third trimester it can lead to gliosis. Porencephalic cysts are typically lined by white matter of brain parenchyma.2 They differ widely in their location and size while the clinical manifestations and presentations range from being asymptomatic to extremely impaired mental function. Generally, the signs and symptoms of porencephaly become apparent in the first year of life. The earliest manifestation being spasticity and seizures. As the age increases there is a delay in development of milestones presenting as language impairment, disability in intellect and motor deficits. Clinically head circumference measurement varies from being normal or small to an enlarged head in cases of synechiae formation that creates a one-way valve effect leading to progressive enlargement of the cyst and expansion of skull or there may be hydrocephalus.4 Radiologically the diagnosis depends on demonstrating a well-defined CSF-filled space occupying lesion lined by white matter and communicating with ventricles on computed tomography (CT) scan or magnetic resonance imaging (MRI) of brain. The prognosis of porencephaly depends on the location and extent of the cyst.5 If the cyst is very large it can cause mass effect in the form of scalloping of adjacent bone, buckling of brain parenchyma, midline shift to contra lateral side and hydrocephalus. On MRI, brain cyst appears well defined and lined by white matter with or without gliosis. Cerebrospinal fluid is the content which is shown as hypointense on T1 and hyperintense on T2.

scholarly journals Acute Pesticide Poisoning in Children: A Review of 50 Cases

2018 ◽  
Vol 12 (6) ◽  
pp. 27-31
Author(s):  
Fatma Khalsi ◽  
◽  
Ines Trablesi ◽  
Imen Belhadj ◽  
Nozha Brahmi ◽  
...  
Keyword(s):  
Gastric Lavage ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Lavage Fluid ◽  
The Body ◽  
Pesticide Poisoning ◽  
Early Management ◽  
Clinical Presentations ◽  
Major Factors ◽  
Poisoning In Children

Background: Pesticide poisoning is very common in Tunisia. Various factors are involved in the analysis of the clinical presentations and the severity of this condition. Major factors are the chemical nature of the pesticides and the quantity entered the body. Methods: This is a retrospective study, reporting the pediatric cases that presented to us with signs and symptoms of pesticide poisoning. Fifty cases pesticide poisoning were admitted to the hospital between January 2013 and October 2016. Results: A total of 50 pediatric cases were included in this study with the mean age of 3 years and 4months. The poisoning was accidental in 49 cases and self-inflicted in one, with the mode being oral (N=45), respiratory (N=2) and cutaneous (N=3). The average duration of hospital care for these patients was 2 hours and 30 minutes (range: 30 min-24 hr). The clinical manifestations of poisoning noted were due to muscarinic and nicotinic receptors inhibition. Upon clinical examination, 29 patients had no pesticide in the gastric lavage fluid and urine and demonstrated no abnormal cholinesterase activity. The therapeutic management was mainly symptomatic with antidote medications prescribed (atropine and oxime). All patients had favorable outcomes and no death occurred. Conclusion: This study demonstrated the frequency of pesticide poisoning in a pediatric setting and the importance of early management. Optimal therapeutic approaches were evaluated, demonstrating that prevention still remains the best solution in such cases.

Spinal Lesions and Cerebrospinal Fluid

2016 ◽  
pp. 279-296
Author(s):  
Christopher H. Hawkes ◽  
Kapil D. Sethi ◽  
Thomas R. Swift
Keyword(s):  
Cerebrospinal Fluid ◽  
Dural Arteriovenous Fistula ◽  
Cell Protein ◽  
Spinal Dural Arteriovenous Fistula ◽  
Protein Ratio ◽  
Protein Levels ◽  
Fluid Analysis ◽  
Low Glucose ◽  
Specific Disorders ◽  
Lesion Localization

This chapter expounds on the major lesions of the spinal cord, whether from within the cord or from outside it, with particular emphasis on syringomyelia. Points from the history and examination that aid lesion localization are detailed, together with tips that might lead to a speedy diagnosis. Diagnostic clues for specific disorders are listed, such as spinal dural arteriovenous fistula and claudication. Detail is supplied on infectious myelopathies, in particular recurrent myelopathy and recurrent meningitis. Clues are given that would allow rapid interpretation of cerebrospinal fluid analysis, including high or low cell–protein ratio, cell and protein levels, chronic polymorphonuclear reaction, eosinophilia, and low glucose. The causes of a dry spinal tap are also outlined.

scholarly journals Smart Check - COVID-19 triage system: evaluation of the impact on the screening time and identification of clinical manifestations of SARS-CoV-2 infection in a public health service.

2021 ◽  
Author(s):  
Fernando Anschau ◽  
Paulo Worm ◽  
Luciane Kopittke ◽  
Luis Humberto de Mello Villwock ◽  
Marcos Luiggi Lemos Sartori ◽  
...  
Keyword(s):  
Wide Spectrum ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Control Analysis ◽  
Evaluation Tool ◽  
Clinical Presentations ◽  
Before And After ◽  
Loss Of Appetite ◽  
The Impact ◽  
Triage Time

Introduction: Most patients with COVID-19 have mild or moderate manifestations, however, there is a wide spectrum of clinical presentations and even more severe repercussions that require high diagnostic suspicion. Vital sign acquisition and monitoring are crucial for detecting and responding to patients with COVID-19. Objective: Thus, we conducted this study to demonstrate the impact of using a tool called Smart Check on the triage time of patients with suspected COVID-19 and to identify the main initial clinical manifestations in these cases. Methodology: We assessed triage times before and after the use of Smart Check in 11,466 patients. In this group, we identified 211 patients for the identification of COVID-19 clinical manifestations in a case-control analysis. Results: Smart Check was able to decrease the triage time by 33 seconds on average, with 75% of the exams being performed within 5 minutes, whereas with the usual protocol these steps were performed within 6 minutes. A range of clinical presentations made up the COVID-19 initial manifestations. Those with the highest frequency were dry cough (46.8%), fever (41.3%), dyspnea (35.8%), and headache (32.1%). Loss of appetite, fever, and ageusia were the manifestations that had a statistically significant association with the SARS-CoV-2 presence. Conclusions: Smart Check, a simple clinical evaluation tool, along with the targeted use of rapid PCR testing, can optimize triage time for patients with and without COVID-19. In triage centers, a number of initial signs and symptoms should be cause for SARS-CoV-2 infection suspicion, in particular the association of respiratory, neurological, and gastrointestinal manifestations. Keywords: new coronavirus, COVID-19, triage, clinical manifestations

scholarly journals Epidemiological aspects of centipede (Scolopendromorphae: Chilopoda) bites registered in Greater S. Paulo, SP, Brazil

1998 ◽  
Vol 32 (6) ◽  
pp. 514-518 ◽  
Author(s):  
Irene Knysak ◽  
Rosana Martins ◽  
Carlos R. Bertim
Keyword(s):  
Urban Areas ◽  
Rainy Season ◽  
Medical Center ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Reproductive Period ◽  
The Body ◽  
Basic Knowledge ◽  
Venomous Animals ◽  
Hands And Feet

INTRODUCTION: The lack of basic knowledge on venomous arthropods and the benignity of the clinical manifestations contribute to the centipede bite victims' not being taken to a treatment reference center, leading to underestimation of the number of cases and minimizing the possibility of a broader epidemiological view. An inventory of the centipede bite occurrences in Greater S. Paulo, Brazil, and the therapeutic methods employed, by the main Brazilian medical center for the notification of poisoning by venomous animals, is presented. METHOD: All patient cards of the period 1980-1989 have been checked as to place, month and time of occurrence; sex, age, affected part of the body, signs and symptoms have been observed, as well as the therapeutic methods employed. The centipedes that caused the accidents were identified at the Arthropods Laboratory. RESULTS: It was registered 216 accidents, with a 69% predominance of the Greater S. Paulo and in only 63% of the cases (136) was the agent brought in by the victim for identification. The genera most frequently represented were Cryptops (58%), Otostigmus (33%) and Scolopendra (4%). Of the 136 cases, 87% showed erythema, edema, hemorrhage, burns, cephalalgia, and intense pain. There was a predominance of accidents in the warm rainy season, in the morning and for females between 21 and 60 years of age. Hands and feet were the parts of the body most affected. The benign evolution of the clinical picture (54%) made therapeutical treatment unnecessary. Only the victims of Scolopendra and Otostigmus (46%) were medicated with anesthetics (51%), analgesics (25%), antihistamines and cortisone (24%). CONCLUSION: The reproductive period of the centipedes, associated with their sinanthropic habits, contributes to the greater incidence of accidents in urban areas in the warm rainy season. Only patients bitten by Scolopendra and Otostigmus require therapeutical treatment.

scholarly journals Intractable Headache in a Patient with Carcinoma Breast: Infiltrative or Infective - A Diagnostic Challenge

2019 ◽  
Vol 16 (3) ◽  
pp. 72-75
Author(s):  
Pradeep Kumar Maurya ◽  
Saumya Shukla ◽  
Ashutosh Tiwari ◽  
Dinkar Kul Shreshtha ◽  
Ajai Kumar Singh
Keyword(s):  
Cerebrospinal Fluid ◽  
False Negative ◽  
Clinical Manifestations ◽  
Carcinomatous Meningitis ◽  
Malignant Cells ◽  
Chronic Meningitis ◽  
Diagnostic Challenge ◽  
Negative Results ◽  
Fluid Analysis ◽  
False Negative Results

Chronic meningitis is the inflammation of meanings having varied clinical manifestations and diverse etiologies. Among them tuberculosis continues to be an important cause of chronic meningitis. To achieve the etiological diagnosis, examination of cerebrospinal fluid is mandatory. Carcinomatous meningitis, another rare cause of chronic meningitis is caused by infiltration of leptomeninges by malignant cells. Diagnostics old standard of carcinomatous meningitis is to demonstrate malignant cells in the cerebrospinaluid. In cerebrospinal fluid negative cases with high degree of suspicion, various biomarkers may assist to arrive at diagnosis. However examination of single sample, delayed processing and low volume cerebrospinal fluid analysis may give rise to false negative results. Were port a patient of breast carcinoma presenting with intractable headache misdiagnosed as tuberculosis meningitis. Definitive diagnosis of carcinomatous meningitis was established by repeated lumbar puncture and large volume of cerebrospinal fluid was sent for immediate processing. Our case emphasizes the importance of the above parameters of cerebrospinal fluid study to maximize the diagnostic accuracy and efficiency.

scholarly journals Guillain-Barré syndrome associated with COVID-19 disease

2020 ◽  
Vol 13 (9) ◽  
pp. e237215 ◽  
Author(s):  
Sindhuja Korem ◽  
Haresh Gandhi ◽  
Decerie Baculi Dayag
Keyword(s):  
Cerebrospinal Fluid ◽  
Clinical Course ◽  
Clinical Manifestations ◽  
Guillain Barre Syndrome ◽  
Upper Respiratory Tract ◽  
Cerebrospinal Fluid Analysis ◽  
Fluid Analysis ◽  
Guillain Barré Syndrome ◽  
Upper Respiratory ◽  
Guillain Barré

Clinical manifestations of COVID-19 are known to be variable with growing evidence of nervous system involvement. In this case report, we describe the symptoms of a patient infected with SARS-CoV-2 whose clinical course was complicated with Guillain-Barré syndrome (GBS). We present a case of a 58-year-old woman who was initially diagnosed with COVID-19 pneumonia due to symptoms of fever and cough. Two weeks later, after the resolution of upper respiratory tract symptoms, she developed symmetric ascending quadriparesis and paresthesias. The diagnosis of GBS was made through cerebrospinal fluid analysis and she was successfully treated with intravenous immunoglobulin administration.

scholarly journals Comparative analysis between the profile of cerebrospinal liquid (CSF) and clinical evolution in patients with bacterial meningitis

2021 ◽  
Author(s):  
Clara Kimie Miyahira ◽  
Vania Maria Sabadoto Brienze
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Bacterial Meningitis ◽  
Medical Records ◽  
Signs And Symptoms ◽  
Cerebrospinal Fluid Analysis ◽  
Fluid Analysis ◽  
Serious Infection ◽  
Cerebrospinal Fluid Examination ◽  
The Central Nervous System

Background: Bacterial meningitis is a serious infection that occurs in the Central Nervous System, which presents important morbidity and mortality, mainly in children. The main bacterial agents causing meningitis in the community are Haemophilus influenzae, Neisseria meningitidis and Streptococcus pneumoniae. Specific signs and symptoms suggest meningitis and cerebrospinal fluid analysis is the main exam leading to diagnosis. Objectives: To analyze the behavior of cerebrospinal fluid during the evolution of the patient with bacterial meningitis. Methods: A retrospective study revised the medical records of patients with bacterial meningitis confirmed by cerebrospinal fluid examination in the Base Hospital of São José do Rio Preto from January 1996 to December 2002. Results: in the 63 Patients, there were 18 cases (28.6%) of S. pneumoniae, 20 cases (31.7%) of H. influenzae, 12 cases (19%) of N.meningitides B and 13 (20.6%) cases of N. meningitidis C. In the 18 patients with pneumococcus, 10 (55.6%) were discharged and 8 (44.4%) died. In the 20 patients with HIB, only 3 (15%) died, there was no death patients with meningococcus B and C. Conclusion: There was no difference statistics in the cerebrospinal fluid of the patients who were discharged and those who died.

scholarly journals Severe Ocular Surface abnormalities in a child and Ectodermal Dysplasia: A Case Report.

2019 ◽  
Vol 7 (7) ◽  
pp. 2845
Author(s):  
Shailender Minhas ◽  
Rajeev Tuli ◽  
Gaurav Sharma
Keyword(s):  
Case Report ◽  
Ectodermal Dysplasia ◽  
Systemic Disease ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Abnormal Development ◽  
Body Sensation ◽  
Younger Age ◽  
The Family

Ectodermal Dysplasia is a disorder that occurs due to abnormal development of at least two major ectodermal derivatives in the developing embryo. Author report the case of a 10 year old male child who was referred to our department with complaints of absent sweating, foreign body sensation and watering in both eyes for past few months. The family history could be traced to four generations and there was an observed trend of increase in severity of signs and symptoms occurring at younger age.  The purpose of this case report is to create awareness in the Ophthalmic community about the diagnosis and clinical manifestations of the disorder. This case highlights the role of multidisciplinary approach for management of systemic disease, genetic evolution of affected individual and carriers and genetic counseling.

scholarly journals Multiple Brain Abscesses Caused by Fusobacterium nucleatum Treated Conservatively

2003 ◽  
Vol 30 (3) ◽  
pp. 266-268 ◽  
Author(s):  
Josef G. Heckmann ◽  
Christoph J.G. Lang ◽  
Heinz Hartl ◽  
Bernd Tomandl
Keyword(s):  
Cerebrospinal Fluid ◽  
Fusobacterium Nucleatum ◽  
Signs And Symptoms ◽  
Brain Dysfunction ◽  
Neck Stiffness ◽  
Fluid Analysis ◽  
Brain Abscesses ◽  
Brain Ct Scan ◽  
Diffuse Brain

Background:Multiple brain abscesses are serious neurological problems with high mortality and disabling morbidity. The frequency is rising as a result of AIDS and the increasing number of immunocompromised patients.Case study:A 59-year-old woman developed signs and symptoms of diffuse brain dysfunction including fever and neck stiffness. A brain CT scan demonstrated nine contrast-enhancing ring-shaped lesions. Analysis of the cerebrospinal fluid using PCR-technique revealed DNA of Fusobacterium nucleatum. Conservative treatment with antibiotics was successful. The patient recovered with only mild cognitive deficits.Results:The experience of our patient and the review of the literature indicate that multiple brain abscesses due to Fusobacterium nucleatum are rare. The most probable source is oral infection.Conclusion:Multiple brain abscesses may be caused by Fusobacterium nucleatum. Cerebrospinal fluid analysis using PCR technique is helpful with diagnosis. Conservative management can be successful.

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