Acute demyelinating encephalomyelitis with polyneuropathy caused by acute brucella infection: a case report

Brucellosis is a zoonotic infectious illness. It is the commonest zoonotic illness in the world. Our patient, a forty-year-old Saudi lady had fever, diminished level of consciousness, bilateral optic atrophy, bilateral sensorineural deafness and upper motor neurone type paraparesis with bladder involvement. This is an uncommon and rare combination of clinical presentation in acute brucellosis. Brain magnetic resonance imaging [MRI] showed features of acute demyelinating encephalomyelitis [ADEM]. Electrophysiological studies of the extremities revealed motor sensory neuropathy with axonal involvement. To the best of our knowledge, a case of acute brucellosis with such a combination involving both the central and peripheral systems simultaneously in a patient has not been reported before. After appropriate diagnosis our patient responded remarkably well to the treatment

High incidence of idiopathic thrombocytopenic purpura in Jahra region of Kuwait

To study the incidence of ITP in adults in Jahra region. A retrospective study of all thrombocytopenic patients admitted to adult medical wards of Al Jahra hospital was performed during two years, [2003-2004 inclusive]. Adult medical wards of Al Jahra hospital, Kuwait. Out of the total 81 patients with thrombocytopenia, 34 cases [41.2%] were found to be due to ITP. Jahra hospital is the only referral hospital in Jahra region, catering to a population of 280,000 which makes the incidence of 60 per million populations per year. Thirty ITP patients had first line medical treatment, 3 required splenectomy and one responded to second line treatment of Azathioprine. Incidence of ITP varies significantly in different parts of the world. The incidence in Kuwait is higher than that seen in other parts of the world