ABSTRACT
A 52-year-old male was carried to hospital by ambulance, because of an abrupt abnormal behavior and impaired consciousness. Soon after the arrival, the patient started a generalized seizure. Although the seizure was stopped by Midazolam, amnesia were observed. With meningeal irritation signs, in addition to the clinical course, the patient was thought to develop limbic encephalitis. The cause of the encephalitis was diagnosed as neurosyphilis because of the positive serum and CSF syphilis reactions, and the patient was treated with penicillin G from the first admission day on. Steroid pulse therapy was also conducted, followed by acyclovir since herpes encephalitis could not be ruled out; the brain MRI showed left-side dominant T2/FLAIR high intensity lesions in the bilateral temporal lobes and left hippocampus. With the treatment progression, the amnestic syndrome improved and the patient returned to work. Although neurosyphilis is a rare cause of acute onset limbic encephalitis, it is important to keep the possibility of this disease in mind in making a treatment plan.
Subject(s)
Encephalitis, Herpes Simplex , Limbic Encephalitis , Neurosyphilis , Male , Humans , Middle Aged , Limbic Encephalitis/diagnosis , Limbic Encephalitis/etiology , Limbic Encephalitis/drug therapy , Neurosyphilis/complications , Neurosyphilis/diagnosis , Neurosyphilis/drug therapy , Magnetic Resonance Imaging , Penicillin G , Encephalitis, Herpes Simplex/complications , Seizures/drug therapyABSTRACT
Causative agent identification is important in the treatment of poisoning. We report the case of a patient who presented with an altered level of consciousness after drinking a fluorescent pink liquid. Upon measuring the anion gap and urinary calcium oxalate level, the patient was diagnosed with early ethylene glycol poisoning.
