Re: What is the diagnosis?
From: Efrain Ramirez (eramirezt@coqui.net)
Wed Oct 23 22:21:25 2002
Agree - MRI - VDRL
>At Wed, 23 Oct 2002, Dr. Ainsworth wrote:
>
>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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--
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