The case describes a 25-year-old Caucasian female diagnosed with Alexander's disease (AxD) as an outpatient after extensive inpatient workup. Her presenting complaints included incontinence, clumsiness, seizures, dysphagia, and dysarthria. She was also found to have pancytopenia and dysautonomia. A full neurologic and hematologic workup yielded very little results, until a thorough literature search of her presenting complaints and radiologic findings pointed to adult-onset Alexander's Disease. Alexander's disease is a rare genetic leukodystrophy with a broad variety of presentations. Despite its infrequency in adults and the difficulty in diagnosis, the prevalence of AxD has been increasing due to ease of genetic analysis and identification of key clinical and radiological findings. This case illustrates the necessity of vigilance and persistence in the face of unusual patient presentations; occasionally, the sound of hoofbeats is zebras.
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Τετάρτη 9 Ιανουαρίου 2019
A Novel Mutation in the Adult-Onset Alexander’s Disease GFAP Gene
Immediate Use of Continuous Positive Airway Pressure in Patients With Obstructive Sleep Apnea Following Transsphenoidal Pituitary Surgery: A Case Series
http://bit.ly/2RkwF74
Noninvasive continuous arterial pressure monitoring with Clearsight during awake carotid endarterectomy: A prospective observational study
http://bit.ly/2Fib7Bs
Development of a prediction model for postoperative pneumonia: A multicentre prospective observational study
http://bit.ly/2FmgCOU
Intra-operative tachycardia is not associated with a composite of myocardial injury and mortality after noncardiac surgery: A retrospective cohort analysis
http://bit.ly/2FjGr21
Relevance of peripheral cholinesterase activity on postoperative delirium in adult surgical patients (CESARO): A prospective observational cohort study
http://bit.ly/2FmpKmy
Goal-directed therapy during transthoracic oesophageal resection does not improve outcome: Randomised controlled trial
http://bit.ly/2Fhax73
Orthostatic intolerance following hip arthroplasty: incidence, risk factors and effect on length of stay: A prospective cohort study
http://bit.ly/2FmpJPw
Peri-operative endothelial dysfunction in patients undergoing minor abdominal surgery: An observational study
http://bit.ly/2FllVOq
Monitoring haemodynamic response to fluid-challenge in ICU: comparison of pressure recording analytical method and oesophageal Doppler: A prospective observational study
http://bit.ly/2Flbz0Z
Early-Onset Neonatal Meningitis Caused by an Unusual Pathogen‐Moraxella catarrhalis
Introduction. Moraxella catarrhalis are part of the normal flora of the human respiratory tract and are known to have low pathogenic potential. The organism is rarely reported in the literature as the causative agent of meningitis. We report the first case of early-onset neonatal meningitis associated with M. catarrhalis from Nepal. Case Report. A 3-day-old baby with fever and yellowish discolouration of the body since 48 hrs was admitted to the neonatal ward. The baby developed 3 episodes of seizures in the form of uprolling of eyes on the first day of admission during phototherapy course for raised serum bilirubin. Sepsis screen was positive, and meningitis was confirmed as the cerebrospinal fluid culture grew M. catarrhalis. Cranial ultrasound scan was normal. The baby received a 21-day course of intravenous cefotaxime and amikacin. Recovery has been uneventful to date. Conclusion. Neonatal meningitis is a life-threatening infection. This case report presents an uncommon aetiology of neonatal meningitis which can be misidentified in the diagnostic bacteriology laboratory in resource constraints area like ours.
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A nail in the appendix, accidental discovery on an asymptomatic patient
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Spontaneous regression as a ‘burned-out’ non-seminomatous testicular germ cell tumor: a case report and literature review
http://bit.ly/2VCinxb
Complete duplication of left and right external iliac vein: two case reports and review of the literature
http://bit.ly/2QzHCME
Madelung’s disease: long-term follow-up
http://bit.ly/2VDhELX
Primary hydatid cyst localized in soft tissue during pregnancy
http://bit.ly/2QzHvRe
Literature review and case series of haemorrhagic cholecystitis
http://bit.ly/2VDhFiZ
An anomalous band originating from the fabella causing semimembranosus impingement presenting as knee pain: a case report
The presentation of patients with knee injuries which can have a significant impact on their ability to work and perform activities of daily living is constantly rising. The posterolateral corner of the knee h...
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The haemodynamic instability score: Development and internal validation of a new rating method of intra-operative haemodynamic instability
http://bit.ly/2H1uwIH