47 years old female patient on & off fever from last 3 months headache from 10 days along with 10-15 episodes of vomitting lethargic from 5-6 days episode of abnormal body movements 2 days back now admitted in hospital from 2 days. altered sensorium and drowsiness present unable to speak properly dioriented to time place and person PAST HISTORY:- hypothyroidism from 18 years type 2 DM from 7 years DRUG HISTORY: pt is on antipyschotics for schizophrenia missed antipsychotic doses from last 10 days ct scan normal csf analysis suggestive of TBM MRI and PCR TB reports are attached plzz give ur valuable advice
What is corresponding sugar ? Csf protein is raised and sugar is appears ok if blood sugar is good. what about fungal stain, cryptococcal antigen .This csf report is not very much informative in view of high rbcs Still required to r/o metabolic causes as hyponatremia , hyperglycemia , other electrolyte imbalance What was anti psychotic medication if it was lithium again electrolyte have to check , what about hypothyroid status ??? is there no hydrocephalus in ct despite of high protein
Ask for CB NAAT X RAY CHEST PA VIEW CT SCAN OF BRAIN
Fungal meningitis is one thing to be ruled out. Pls send for CSF Culture ATT and long term steroids are important part of management.
Anti tubercular drugs Antiinflamatory drugs
Thnku for ur valuable suggestions
Cases that would interest you
- Login to View the image
20yrs female c/o intractable hiccups since 1month CBC uric acid .BL urea Srcret tsh normal what other investigations needed to diagnosis
Dr. Gopal B Patil0 Like18 Answers - Login to View the image
A very young female aged 17 years presented with history of High grade Fever with chills (intermittently) since 7 days with sudden development of Altered Sensorium since 1 day....On asking attendants, history of Occasional Headache was revealed since 1 yr...Virtually no other comorbidity was present...At presentation, GCS was E1V1M1 and pt was unresponsive to any stimuli...No NR or KS was present and pupils were NSNR...Her MRI Brain was done...Comment on her grave condition and how shd she be treated
Dr. Hardik Ahuja2 Likes14 Answers - Login to View the image
A male 58 yrs old presented with complaints of Poor Appetite, Fever(on/off) and Poor concentration since 2 months and Altered Sensorium since 4 days....He went into respiratory distress soon after he arrived at ED and had to be intubated...His MRI was done...Identify the pathology and guide the management of this patient
Dr. Hardik Ahuja2 Likes10 Answers - Login to View the image
A young male aged 30 yrs presented with complaints of Severe Headache, High grade Fever with chills , Nausea since 5 days and Altered Sensorium since 1 day....See his CSF report....Discuss his management....
Dr. Hardik Ahuja0 Like20 Answers - Login to View the image
2 days female baby Good movement of lower limbs Please help in diagnosis and ttt Thanks What about prognosis?
Dr. Abd Elnasser Badawy3 Likes20 Answers
2 Likes