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Does managing encephalitis makes your head hurt?!

29/5/2015

 
Picture
A 79 year old lady, who had been previously fit and well, presented with fever, acute confusion and aggression after a seizure. Her family said she had been her normal happy self the day before but she had been complaining of a headache. The doctors admitting her made a clinical diagnosis of encephalitis. A CT scan of the patients head was done to rule out raised intracranial pressure, and showed no abnormality. Cerebrospinal fluid (CSF) from a lumbar puncture showed raised lymphocytes, high protein and normal glucose compared to serum glucose.  

What are the clinical features of encephalitis?
Encephalitis is acute inflammation of the brain. It can present with a mixture of symptoms and signs including:
  • Fever
  • Headache
  • Neck stiffness
  • Decreased conscious level
  • Confusion
  • Seizures
  • Focal neurological signs
  • Personality change, hallucinations, aphasia (with HSV)
  • Ophthalmic shingles (with VZV)
  • Rash (with Enterovirus and Measles Virus)


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Septic from a Saint Bernard...

6/5/2015

 
I was recently called about what antibiotics to give to a septic patient in the emergency department. I was a bit surprised about this as we have excellent sepsis guidelines and normally the doctors just crack on with managing the patient. The difference for this patient was that he had been bitten by his pet dog a few days earlier and the doctors quite rightly wanted to make sure he was on the correct antibiotics for severe sepsis following a dog bite.

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    Blog Author:

    David Garner
    Consultant Microbiologist
    Surrey, UK

    Please DO NOT advertise products and conferences on our website or blog

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