Cases reported "Meningitis, Viral"

Filter by keywords:



Filtering documents. Please wait...

1/6. The role of the biochemistry department in the diagnosis of pituitary apoplexy.

    A 47-year-old man presented with severe clinical hypoglycaemia. He had long-standing insulin-dependent diabetes with previously good glycaemic control. Intense headaches and vomiting initiated hospitalization. A brain computed tomography (CT) scan was normal, and a lumbar puncture showed elevated cerebrospinal fluid (CSF) protein [0.67 g/L; normal range (NR) 0.15-0.45 g/L], suggesting resolving viral meningitis. Routine thyroid function tests were abnormal (free thyroxine 10.6 pmol/L, NR 9-22.5 pmol/L; thyroid-stimulating hormone 0.16 mU/L, NR 0.35-5 mU/L). In the absence of evident thyroid therapy, the laboratory policy required an urgent cortisol assay to be added; this was very abnormal (42 nmol/L), suggesting hypopituitarism. Later analysis showed that concentrations of gonadotrophins and adrenocorticotrophin were low. An urgent pituitary magnetic resonance imaging scan revealed an unsuspected pituitary tumour with recent haemorrhage (pituitary apoplexy). The patient was given intravenous hydrocortisone and then stabilized on oral hydrocortisone, thyroxine and mesterolone. He made a full recovery and the hypoglycaemia resolved. The normal brain CT scan was falsely reassuring and the CSF protein was not due to viral meningitis but to haemorrhage into the pituitary tumour. If laboratory policy had not required the urgent cortisol assay be added, the diagnosis of hypopituitarism would have been delayed or even missed altogether. This could have led to the death of the patient.
- - - - - - - - - -
ranking = 1
keywords = puncture
(Clic here for more details about this article)

2/6. salmonella paratyphi a enteric fever mimicking viral meningitis.

    Enteric fevers are caused by invasive strains of Salmonella. Classic enteric fever is caused by S. typhi and usually less severe enteric fevers are caused by S. paratyphi A, B, or C. We present a case of S. paratyphi A enteric fever aseptic meningitis. headache was so prominent in the case presented that a lumbar puncture was performed to rule out meningitis. Rose spots were not apparent in this dark-skinned patient. Our patient did not have increased serum transaminases and did not have leukopenia, which are common findings in enteric fever. The absence of these findings and the relative bradycardia may be explained by the antimicrobial therapy the patient received before admission. After ruling out malaria, clinicians should suspect enteric fever in patients recently returning from endemic areas, in patients presenting with acute fevers without localizing signs.
- - - - - - - - - -
ranking = 1
keywords = puncture
(Clic here for more details about this article)

3/6. Acute urinary retention secondary to herpes simplex meningitis.

    We report a case of acute urinary retention in a 24-year-old man with herpes simplex meningitis without genital lesions. Since the differential diagnosis in young patients who present with acute urinary retention also includes multiple sclerosis, lumbosacral disk herniation, rheumatological disorders and drug intoxication, a thorough history and careful neurological examination are of paramount importance in distinguishing these syndromes. As part of a directed neurological evaluation prompt performance of lumbar puncture is indicated; a lymphocytic pleocytosis is suggestive of herpetic meningitis. culture of herpes simplex virus from the cerebrospinal fluid should be attempted. We recommend conservative management only, typically with intermittent catheterization, since bladder function usually normalizes within 10 to 14 days.
- - - - - - - - - -
ranking = 1
keywords = puncture
(Clic here for more details about this article)

4/6. Management of central nervous system infections during an epidemic of enteroviral aseptic meningitis.

    Four hundred and fifty-six patients with signs and symptoms of potential central nervous system infection were evaluated from June 28, 1978, to September 30, 1978. The majority of the children had a relatively brief and mild illness characterized by a constellation of features previously described with central nervous system infections. fever, headache, and vomiting were typical. Altered sensorium and nuchal rigidity were inconstant. One distinct and another infrequently reported feature of enteroviral disease, hypoglycorrhachia and cerebrospinal fluid pleocytosis in excess of 2,000 cells/mm3, occurred independently or in concert in 18% of the cases. When these unexpected findings were associated with a presumptive clinical diagnosis of aseptic meningitis, watchful observation and repeat lumbar puncture precluded the necessity to administer antibiotics in every case. The possibility of enteroviral aseptic meningitis being a definitive diagnostic entity manageable on a group, yet individual basis utilizing a disposition protocol is discussed.
- - - - - - - - - -
ranking = 1
keywords = puncture
(Clic here for more details about this article)

5/6. Case report on a diver with type II decompression sickness and viral meningitis.

    A 33-yr-old man came to the emergency department with the chief complaint of a severe headache and decreased sensation in his right hand following a deep dive on scuba. physical examination before recompression treatment was remarkable only for hypesthesia on the right hand. We diagnosed type II decompression sickness and the patient underwent standard recompression therapy. The patient experienced near-complete resolution of his symptoms, his only residual complaint being that of neck pain with head movement. To investigate other causes of headache, a computed tomography of the head was performed which was normal, and a lumbar puncture was performed which was consistent with viral meningitis. This is the first reported case of recompression treatment on a patient with viral meningitis and decompression sickness.
- - - - - - - - - -
ranking = 1
keywords = puncture
(Clic here for more details about this article)

6/6. intracranial hypertension and hiv associated meningoradiculitis.

    Two patients with meningoradiculitis associated with hiv presented with symptoms and signs of intracranial hypertension. In the patients described, the raised intracranial pressure resolved after lumbar puncture. After exclusion of opportunistic infection, such patients may be managed with therapeutic lumbar puncture alone.
- - - - - - - - - -
ranking = 2
keywords = puncture
(Clic here for more details about this article)


Leave a message about 'Meningitis, Viral'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.