Case report: Mononeuritis multiplex in the course of dengue fever.

BACKGROUND: Dengue fever usually presents as a self-limiting acute febrile illness with worsening thrombocytopenia, with a small minority of patients developing hemorrhagic or life-threatening complications. Organ specific manifestations like myocarditis, acalculous cholecystitis, encephalitis has been described but are uncommon presentations. Even more rarely, such manifestations are the presenting complaint of Dengue fever. In this case report, we highlight a case of Dengue fever where unrelated neuropathies were the presenting complaint. CASE PRESENTATION: An elderly man presents with 1 day of diplopia and left foot drop, associated with 2 days history of fever. A decreasing white cell count (WBC) and platelet on the 2nd day of admission prompted Dengue virus to be tested and a positive NS-1 antigen was detected, confirming the diagnosis of Dengue fever. He was treated with supportive treatment with a short duration of intravenous fluids recovered uneventfully and was discharged 6 days after admission with almost full resolution of diplopia and partial resolution of left foot drop. Left foot drop recovered completely 2 weeks later. CONCLUSION: Neurological manifestations can be the presenting symptoms in Dengue fever, a diagnosis which should be borne in mind when such symptoms present in patients from endemic areas or in returning travellers from these areas.

Surgical Treatment of Slipped Capital Femoral Epiphysis / 대한정형외과학회잡지

PURPOSE: The aim of this article is to define the safety and effectiveness of in situ pin fixation in treatment of SCFE (Slipped Capital Femoral Epiphysis). MATERIALS AND METHODS: The author reviewed 14 cases in 13 patients. The mean follow-up period was 38 months. The methods of treatment were divided into two groups. The group A: 4 cases were treated with closed reduction followed by multiple pinning before 1986, and group B: 9 cases were treated with in situ fixation followed by multiple pinning (3 cases) or one central ASNIS screw (6 cases) after 1986. RESULTS: Before 1986, high incidence of complications (Avascular necrosis change followed by severe osteoarthritis) were noted after closed reduction (2/4). In contrast, 9 cases of in situ fixation were well united without further slippage or specific complication such as avascular necrosis or chondrolysis. One case was involved bilaterally and found incidentally during follow up check without any subjective symptom. One case was developed as a manifestation of osteogenesis imperfecta. Failure of removal of the fixated screws (Knowles pin 8 Titanium cannulated screw) were in 3 cases. CONCLUSIONS: Closed reduction may be a very dangerous procedure, increasing the rate of complication in spite of its necessity. We considered that closed reduction should be avoided regardless of the severity of the displacement in chronic case.