scholarly journals Secondary Intracranial Hypertension After Ciprofloxacin Treatment: A Case Report

2021 ◽  
pp. 1-3
Author(s):  
Pena Acevedo L ◽  
◽  
Rodriguez Pena S ◽  
Keyword(s):  
Visual Acuity ◽  
Intracranial Hypertension ◽  
Medical Literature ◽  
Index Finger ◽  
Traumatic Amputation ◽  
Sample Analysis ◽  
Ocular Pain ◽  
Cerebrospinal Fluid Analysis ◽  
Normal Visual Acuity ◽  
Fluid Analysis

A 30-year-old man developed secondary osteomyelitis after a traumatic amputation of his right index finger. The infection was treated with ciprofloxacin. Approximately 4 weeks after starting treatment, he complained of a progressive decrease in visual acuity, retro-ocular pain and bitemporal headache. A diagnosis of intracranial hypertension was established. Blood sample analysis, infectious profile, cerebrospinal fluid analysis, and neuroimaging were normal. Visual acuity and other symptoms progressively improved after stopping drug treatment. There were no complications or sequelae. Intracranial hypertension due to fluoroquinolones is described in the medical literature, its appearance during such treatments, despite being a rare adverse event, should be monitored.

Varicella zoster meningitis in a pregnant woman with uncontrolled type 1 diabetes mellitus

2021 ◽  
Vol 14 (2) ◽  
pp. e236644
Author(s):  
Laura Mroue ◽  
Harpreet Brar ◽  
Bernard Gonik
Keyword(s):  
Medical Literature ◽  
Pregnant Patient ◽  
Cerebrospinal Fluid Analysis ◽  
Neck Stiffness ◽  
Varicella Zoster ◽  
Fluid Analysis ◽  
First Case ◽  
The Us ◽  
History Of

We report the case of retrograde varicella zoster virus (VZV) reactivation presenting as aseptic meningitis without rash in a generally healthy pregnant patient. A 27-year-old nulliparous woman at 25 weeks of gestation presented to the emergency department with a 1-day history of severe headache associated with nausea, photophobia and neck stiffness. After ruling out a space-occupying lesion by brain imaging, lumbar puncture was performed. Cerebrospinal fluid analysis by PCR revealed the presence of VZV, making the diagnosis of acute varicella meningitis. The patient had immunoglobulin studies consistent with a history of primary VZV infection, thus confirming reactivation of VZV rather than primary infection. The patient was treated with acyclovir for 14 days and recovered fully. Her neonate was delivered full term without any evidence of vertical transmission. This is only the second reported case of VZV meningitis in a pregnant patient in the medical literature, and the first case in the US that was reported.

scholarly journals Increased Intracranial Pressure in the Setting ofEnterovirusand Other Viral Meningitides

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Jules C. Beal
Keyword(s):  
Cerebrospinal Fluid ◽  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Rare Case ◽  
Case Reports ◽  
Viral Meningitis ◽  
Elevated Intracranial Pressure ◽  
Increased Intracranial Pressure ◽  
Cerebrospinal Fluid Analysis ◽  
Fluid Analysis

Increased intracranial pressure due to viral meningitis has not been widely discussed in the literature, although associations withVaricellaand rarelyEnterovirushave been described. Patients with increased intracranial pressure and cerebrospinal fluid analysis suggestive of a viral process are sometimes classified as having atypical idiopathic intracranial hypertension (IIH). However, a diagnosis of IIH requires normal cerebrospinal fluid, and therefore in these cases an infection with secondary intracranial hypertension may be a more likely diagnosis. Here seven patients are presented with elevated intracranial pressure and cerebrospinal fluid suggestive of viral or aseptic meningitis. Of these, 1 hadEnterovirusand the remainder were diagnosed with nonspecific viral meningitis. These data suggest that viral meningitis may be associated with elevated intracranial pressure more often than is commonly recognized.Enterovirushas previously been associated with increased intracranial pressure only in rare case reports.

scholarly journals Cerebrospinal fluid confirmed COVID-19-associated encephalitis treated successfully

2020 ◽  
Vol 13 (9) ◽  
pp. e237378 ◽  
Author(s):  
Yasmine Mohamed Kamal ◽  
Yasmin Abdelmajid ◽  
Abubaker Abdul Rahman Al Madani
Keyword(s):  
Cerebrospinal Fluid ◽  
Respiratory Symptoms ◽  
Medical Literature ◽  
Clinical Presentation ◽  
Early Recognition ◽  
Neurological Complications ◽  
Red Flags ◽  
Cerebrospinal Fluid Analysis ◽  
Fluid Analysis ◽  
The Brain

The COVID-19 pandemic that attracted global attention in December 2019 is well known for its clinical picture that is consistent with respiratory symptoms. Currently, the available medical literature describing the neurological complications of COVID-19 is gradually emerging. We hereby describe a case of a 31-year-old COVID-19-positive patient who was admitted on emergency basis. His clinical presentation was primarily neurological, rather than the COVID-19’s classical respiratory manifestations. He presented with acute behavioural changes, severe confusion and drowsiness. The cerebrospinal fluid analysis was consistent with COVID-19 encephalitis, as well as the brain imaging. This experience confirms that neurological manifestations might be expected in COVID-19 infections, despite the absence of significant respiratory symptoms. Whenever certain red flags are raised, physicians who are involved in the management of COVID-19 should promptly consider the possibility of encephalitis. Early recognition of COVID-19 encephalitis and timely management may lead to a better outcome.

scholarly journals Diagnostic tools for neurosyphilis: a systematic review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Gustavo Henrique Pereira Boog ◽  
João Vitor Ziroldo Lopes ◽  
João Vitor Mahler ◽  
Marina Solti ◽  
Lucas Tokio Kawahara ◽  
...  
Keyword(s):  
New Technologies ◽  
Clinical Suspicion ◽  
Risk Of Bias ◽  
Diagnostic Methods ◽  
Diagnostic Tools ◽  
Test Accuracy ◽  
Cerebrospinal Fluid Analysis ◽  
Evaluation Methodologies ◽  
Fluid Analysis ◽  
Criteria For Diagnosis

Abstract Purpose Increasing incidences of syphilis highlight the preoccupation with the occurrence of neurosyphilis. This study aimed to understand the current diagnostic tools and their performance to detect neurosyphilis, including new technologies and the variety of existing methods. Methods We searched databases to select articles that reported neurosyphilis diagnostic methods and assessed their accuracy, presenting sensitivity and specificity values. Information was synthesized in tables. The risk of bias was examined using the Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy recommendations. Results Fourteen studies were included. The main finding was a remarkable diversity of tests, which had varied purposes, techniques, and evaluation methodologies. There was no uniform criterion or gold standard to define neurosyphilis. The current basis for its diagnosis is clinical suspicion and cerebrospinal fluid analysis. There are new promising tests such as PCR tests and chemokine measurement assays. Conclusions The diagnosis of neurosyphilis is still a challenge, despite the variety of existing and developing tests. We believe that the multiplicity of reference standards adopted as criteria for diagnosis reveals the imprecision of the current definitions of neurosyphilis. An important next step for the scientific community is to create a universally accepted diagnostic definition for this disease.

scholarly journals New-Onset Seizure With Possible Limbic Encephalitis in a Patient With COVID-19 Infection: A Case Report and Review

2021 ◽  
Vol 9 ◽  
pp. 232470962098630
Author(s):  
Riwaj Bhagat ◽  
Barbara Kwiecinska ◽  
Nolan Smith ◽  
Matthew Peters ◽  
Christopher Shafer ◽  
...  
Keyword(s):  
Brain Magnetic Resonance Imaging ◽  
Nasopharyngeal Swab ◽  
Onset Seizure ◽  
Cerebrospinal Fluid Analysis ◽  
Fluid Analysis ◽  
Global Pandemic ◽  
Elevated Protein ◽  
T2 Hyperintensity ◽  
Elevated Protein Level ◽  
New Onset

With the outbreak of COVID-19 (coronavirus disease 2019) as a global pandemic, various of its neurological manifestations have been reported. We report a case of a 54-year-old male with new-onset seizure who tested positive for severe acute respiratory syndrome coronavirus 2 from a nasopharyngeal swab sample. Investigative findings, which included contrast-enhancing right posterior temporal lobe T2-hyperintensity on brain magnetic resonance imaging, right-sided lateralized periodic discharges on the electroencephalogram, and elevated protein level on cerebrospinal fluid analysis, supported the diagnosis of possible encephalitis from COVID-19 infection. The findings in this case are placed in the context of the existing literature.

scholarly journals Idiopathic intracranial hypertension presenting as iron deficiency anemia: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Peng Yong Sim ◽  
Priyal Taribagil ◽  
Ione O. C. Woollacott ◽  
Safina Rashid ◽  
Desmond P. Kidd
Keyword(s):  
Case Report ◽  
Iron Deficiency ◽  
Intracranial Hypertension ◽  
Iron Deficiency Anemia ◽  
Idiopathic Intracranial Hypertension ◽  
Deficiency Anemia ◽  
Visual Deficits ◽  
Fluid Analysis ◽  
Optic Disc Swelling

Abstract Background The presentation of idiopathic intracranial hypertension (IIH) in association with iron deficiency anemia (IDA) is rare. Case presentation This case report depicts the unusual case of a 31-year-old woman of mixed Jamaican and English heritage with IIH who presented initially as IDA in the context of menorrhagia. Subsequent ophthalmic review, lumbar puncture, cerebrospinal fluid analysis and neuroimaging studies revealed severe bilateral optic disc swelling and raised intracranial pressure in keeping with IIH. Prompt treatment of IDA with blood transfusion and orally administered iron supplements, in addition to medical treatment for IIH, contributed to significant improvement of symptoms and prevented long-term visual deficits. Conclusion The possibility of IDA, albeit rare, should always be considered and investigated appropriately in all patients with IIH, as the treatment of the anemia alone may be sight-saving.

On the need for a legislative norm for high degrees of hypermetropia in relation to military-combatant services

1902 ◽  
Vol 2 (10) ◽  
pp. 567-567
Author(s):  
V. F. Velyamovich
Keyword(s):  
Visual Acuity ◽  
Military Service ◽  
Normal Visual Acuity ◽  
The Law

As for the current Russian laws on anomalies in the organs of vision that allow or restrict the ability to perform military service, hyperopia, for which the law does not specify a predetermined degree, is completely ignored, compatible with the requirements of military service. Any hyperopia, no matter how high its degree of abnormal refraction, is recognised as extremely suitable for military service, unless it has a normal visual acuity without glasses.

Autoimmune Encephalitis Related to Cancer Treatment With Immune Checkpoint Inhibitors: Systematic Review

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012122
Author(s):  
Vardan Nersesjan ◽  
Oskar McWilliam ◽  
Lars-Henrik Krarup ◽  
Daniel Kondziella
Keyword(s):  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitor ◽  
Checkpoint Inhibitors ◽  
Autoimmune Encephalitis ◽  
Cochrane Library ◽  
Cerebrospinal Fluid Analysis ◽  
Fluid Analysis ◽  
Heterogenous Group ◽  
The Cochrane Library ◽  
Common Laboratory

OBJECTIVE:To determine the clinical and laboratory features of immune checkpoint inhibitor (ICPI)-associated autoimmune encephalitis (ICPI-AIE), an increasingly recognized adverse event with ICPI treatment.METHODS.We searched PubMed, The Cochrane Library and Embase for ICPI-AIE cases from the first description in 2015 until 01/2020 using standard bibliographic measures including PRISMA guidelines and pre-registration with PROSPERO (CRD42019139838).RESULTS.Thirty-nine studies met inclusion criteria, resulting in 54 ICPI-AIE patients (mean age 58.6 years; 43% females). Common cancers included melanoma (30%) and non-small cell lung cancer (30%). Brain metastases were found in 16 patients (30%). The most frequent ICPI was nivolumab (61%). Onset of ICPI-AIE occurred after a median of 3.5 treatment cycles, but very early and late presentations were common. Non-limbic AIE was roughly twice as frequent as limbic AIE (p<0.05). The most common laboratory abnormalities included bitemporal FLAIR lesions on MRI, continuous slow waves and diffuse slowing on EEG, and monocytic pleocytosis on cerebrospinal fluid analysis. Of note, intraneuronal antibodies were more frequent than neuronal surface antibodies, and a significant predictor for lack of improvement after 1st line immunotherapy (p<0.05).CONCLUSIONS.ICPI-AIE consists of a heterogenous group of conditions. Neurologists will likely encounter ICPI-AIE more often in the future, but important unresolved questions include the exact pathophysiological mechanisms, the epidemiology and the best treatment approaches associated with ICPI-AIE.

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