ABSTRACT
A first-trimester primigravid patient presented with hyperemesis and malaise. Work-up was consistent with primary hyperparathryoidism. During acute treatment, she developed generalized motor seizures considered to be secondary to hypercalcemia. Evaluation and treatment of women with primary hyperparathyroidism and hypercalcemia are reviewed, and the pathogenesis of seizures associated with hypercalcemia is discussed.
Subject(s)
Adenoma/diagnosis , Hypercalcemia/etiology , Hyperparathyroidism/etiology , Parathyroid Neoplasms/diagnosis , Pregnancy Complications , Seizures/etiology , Adenoma/complications , Adenoma/surgery , Adult , Anticonvulsants/therapeutic use , Female , Fluid Therapy/methods , Gravidity , Humans , Hypercalcemia/therapy , Hyperemesis Gravidarum/etiology , Hyperparathyroidism/surgery , Parathyroid Hormone/blood , Parathyroid Neoplasms/complications , Parathyroid Neoplasms/surgery , Parathyroidectomy , Pregnancy , Pregnancy Complications/diagnosis , Pregnancy Complications/etiology , Pregnancy Complications/therapy , Pregnancy Trimester, First , Seizures/drug therapy , Treatment OutcomeABSTRACT
We report the case of a 25-year-old HIV-negative man with disseminated multidrug-resistant tuberculosis (MDRTB), who-on a retreatment regimen-experienced total resolution of TB miliary disease, but progressive TB meningitis. Therefore, intrathecal treatment with amikacin and levofloxacin was instituted, with successful clinical and microbiological results.
Subject(s)
Amikacin/therapeutic use , Anti-Bacterial Agents/therapeutic use , Anti-Infective Agents/therapeutic use , Levofloxacin , Ofloxacin/therapeutic use , Tuberculosis, Meningeal/drug therapy , Tuberculosis, Multidrug-Resistant/drug therapy , Adult , Amikacin/administration & dosage , Anti-Bacterial Agents/administration & dosage , Anti-Infective Agents/administration & dosage , Drug Therapy, Combination , Humans , Injections, Spinal , Male , Mycobacterium tuberculosis/drug effects , Ofloxacin/administration & dosage , Tuberculosis, Meningeal/microbiology , Tuberculosis, Multidrug-Resistant/microbiologyABSTRACT
BACKGROUND: Infants with stage 5 retinopathy of prematurity (ROP) usually experience severe visual loss, even when the retina is reattached surgically. Such visual loss has been attributed to persistent retinal dysfunction in most cases, but this has not been established electroretinographically. METHODS: Electroretinograms (ERGs) were performed on 5 eyes of 4 children with partial or complete retinal attachment after vitreoretinal surgery for stage 5 ROP. Duration of detachment before surgery was 2 weeks in 1 eye, 4-5.5 weeks in 3 eyes, and 15 weeks in 1 eye. The ERG findings for these eyes were then compared with ERG findings in a child with regressed ROP after laser photoablation of the peripheral avascular retina. RESULTS: All of the eyes with surgically repaired stage 5 ROP had nonrecordable ERGs. The child with regressed ROP after laser photoablation had an attenuated but recordable ERG. CONCLUSION: Severe retinal dysfunction persists in eyes with stage 5 ROP even after the retina is surgically reattached, which is probably one of the primary reasons that these eyes continue to have a poor visual outcome.
