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Re: What is the diagnosis?From: viv souter (vsouter@yahoo.com)Wed Oct 23 15:06:31 2002
Sound like she needs brain imaging before embarking on a spinal tap. Any focal neurological signs? Drug screen? Urine and serum osmolality? I agree herpes should be looked for too. Viv "Lynn D. Montgomery, M.D." <apgar10@montanadsl.net> wrote:Psuedotumor -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Eberhard Lisse Sent: Wednesday, October 23, 2002 1:37 PM To: Multiple recipients of list OB-GYN-L Subject: What is the diagnosis? 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) el108 / |Consultant Obstetrician & Gynaecologist
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