Re: What is the diagnosis?
From: Dr. Ainsworth (ainsron@sbcglobal.net)
Wed Oct 23 15:55:39 2002
I agree. We had a similar patient with extreme mood swings, LOC changes
- not a fever. Imaging studies showed a brain tumor!
>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
>
>Private Bag X5501 \ / Oshakati State Hospital
>Oshakati, Namibia ;____/ Telephone: +264 81 124 6733 (cell)
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