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What is the diagnosis?From: Eberhard Lisse (el@ac.lisse.na)Wed Oct 23 14:34:25 2002
Hi, Day before yesterday a 26 year old lady was brought in by her family at 34 weeks of pregancy according to the dates in the patient based maternity passport with the complaints of talking inappropriately, if at all, confusion, throwing things, and aundressing herself in public for two days. In the passport we noted 4 visits to ANC, nil of note. Furthermore she had been admitted at a hospital down the road with experienced O&G two weeks ago for a fever, with Malaria smear being negative. The discharge note showed no diagnosis being made. On admission her GCS was 8/15, without localizing signs. Temperature was 38.8 C, she was not anemic, chest was clear. Fundal height was 32-34 weeks, vertex, loose, FH 132, FM present. FBC showed WCC of 6.7, Hb of 9.5 rest nil of note ESR 123 LFT nil of note U&E: Potassium 2.4, rest nil of note. Uric Acid: normal. Fasting glucose 5.4, random glucose 7.6 Two Malaria Smears within 6 hours of each other were negative. Blood Cultures were done, results not back. Empirically put on Pen/Genta ivi. In the ward the level of consciousness fluctuated (GCS 8-11/15) as did the temperature between 36 and 40. She removed her drips and catheter and had to be restained. Ultrasound showed a single vital vertex at 32+3/40. Chest X-Ray (supine) with cover nil of note. So, what's the diagnosis and what further investigations did we do if any? Treatment? What are we going to do about the pregnancy? el -- Dr. Eberhard W. Lisse \ * / Obstetrician & Gynaecologist (Saar) <el@lisse.NA> el108 / |Consultant Obstetrician & Gynaecologist Private Bag X5501 \ / Oshakati State Hospital Oshakati, Namibia ;____/ Telephone: +264 81 124 6733 (cell) Partner: Namibian Network Information Center, the ccTLD Domain Manager Please send DNS/NA-NiC related e-mail to dns-admin@na-nic.com.na only
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