ABSTRACT
To define the demographic, clinical and laboratory features, methods of diagnosis and outcome, in patients with meningococcal meningitis in Qatar, records were reviewed retrospectively to 25 patients [21 male, 4 female; mean age 24 years] treated for meningococcal meningitis at the Hamad Medical Corporation [HMC] between 1 992 and 2008]. Most [88%] were expatriates. The most common presenting symptoms were fever, vomiting, headache and altered consciousness. Neck stiffness and impaired level of consciousness were the most common signs. Elevated WBC, elevated protein and low glucose in CSF were present in 95.6%, 84% and 80% of cases respectively. Positive CSF Grain-stain showing gram negative diplococci and culture growing N. meningitidis in CSF and blood were seen in 64%, 44% and 7 2.7% of cases respectively. The most common serotypes were Groups A and W 1 35 accounting for 50% and 25% respectively. 1 5.8% of isolates were intermediately resistant to penicillin, while all were sensitive to ceftriaxone. One patient [4%] died and 24 [96%] survived. Six of those who survived developed neurologic sequelae. Meningococcal meningitis remains uncommon in Qatar but the incidence has increased markedly recently especially among expatriates. Because the clinical features of the disease are non-specific, a high index of suspicion is essential for early diagnosis. Empirical treatment with ceftriaxone in a patient with suspected meningococcal meningitis seems prudent to avoid an unfavorable outcome
ABSTRACT
Despite adequate antiviral treatment an immuno-competent 57-year-old Asian male developed hemiplegia two months after an attack of herpes zoster ophthalmicus. He survived with significant residual neurologic sequelae. Several mechanisms have been postulated for the pathogenesis of this rare condition. There is no agreement on the best treatment; antivirals and steroids have been used with inconclusive results
Subject(s)
Humans , Male , Hemiplegia/etiology , Herpes Zoster Ophthalmicus/diagnosis , Vasculitis/diagnosis , Tomography, X-Ray ComputedABSTRACT
To define the demographic, clinical and laboratory features, and outcome of patients with Kikuchi-Fujimoto disease in Qatar and to compare it with those reported by others, fourteen cases of Kikuchi-Fujimoto disease seen at Hamad Medical Corporation between 1995 and 2004 were reviewed retrospectively. Unusually there was an unexplained male predominance amongst the ten males and four females even amongst the Qatari nationals who comprised 57% of the cases. All had lymphadenopathy, mostly cervical, and less commonly fever, anorexia, chills, weight loss, hepatomegaly, and skin rash. The diagnosis was made by lymph node biopsy, with no indication of any etiologic agent. All patients survived although symptomatic treatment with non-steroidal anti-inflammatory drugs and steroids was required in five patients. There was recurrence in two patients. It seems that Kikuchi-Fujimoto disease is rare in Qatar although the incidence might be increasing possibly due to greater awareness amongst clinicians. The clinical features are similar to those reported by others but certain diagnosis requires lymph node biopsy. The outcome is good