POST CAESARIAN SECTION ALTERED STATE OF CONSCIOUSNESS

27yrs/F with 2 healthy children developed fits,fever,Altered mental status O/e - GCS -7, hemiplegic,Pupils - B/l 4mm RTL.CT brain normal,MRV - Normal, Autoimmune profile normal.Labs - ABG - Normal,B.urea -120,S.creat -3,LDH - 645,CRP - 20. WHAT ARE THE POSSIBLITIES?

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Dr Prashant ,needs more history in this patient. How many days after cessarian she developed the symptoms? Is she hypertensive? Any symptoms of vasculitis?. Needs good history & physical finding especially patient like this. MRI brain shows T2 w hyperintense lesions Lt thalamus ,left hemipons,left sup cerebellar peduncle,left cerebellum If doctors are not writing good history and physical findings, the answer / discussion also will be incomplete Vasculitis vs brain stem encephalitis .

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At present scenario consider COVID infection Supported by short duration of fever, raise urea and creatinine, raised LDH ,raised CRP Normal MRV ,CT brain DD Renal failure, uremic coma Suggest RTPCR for COVID, Abdominal ultrasound,/ CT abdomen, serum ammonia, LFT , LP

Urea dearrange, rule out hepato renal shut down,

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