ABSTRACT
We report a case of hemolytic uremic syndrome (HUS) in an adult patient with Plasmodium vivax malaria. The patient presented with worsening anemia, persistent thrombocytopenia and acute kidney injury. HUS was diagnosed based on the high serum lactate dehydrogenase, elevated reticulocyte count and presence of schistocytes on peripheral blood smear. Kidney biopsy showed features of thrombotic microangiopathy. Complete hematological remission was achieved after five sessions of therapeutic plasma exchange. Renal function partially recovered and stabilized at discharge. Vivax malaria, generally considered benign, may be rarely associated with HUS.
ABSTRACT
Optic nerve involvement is a rare side effect of isoniazid (INH) and has not been described in children. We describe this adverse reaction in a 10-year-old boy, who was treated for tuberculous meningitis. The patient showed almost complete resolution following withdrawal of INH and administration of pyridoxine and steroids.
Subject(s)
Antitubercular Agents/adverse effects , Isoniazid/adverse effects , Optic Neuritis , Antitubercular Agents/therapeutic use , Child , Humans , Isoniazid/therapeutic use , Magnetic Resonance Imaging , Male , Optic Neuritis/chemically induced , Optic Neuritis/diagnosis , Optic Neuritis/physiopathology , Tuberculosis, Meningeal/drug therapyABSTRACT
"Tripod Sign" or "Amoss's Sign" is a sign of meningeal irritation. Although useful in diagnosing meningitis, it is not pathognomic and may be seen in a variety of clinical conditions. Infants < 1 year of age and immunocompromised individuals may not demonstrate signs of meningeal irritation. Since elicitation of the sign requires voluntary sitting up, it is of limited use in patients with marked altered sensorium and young infants.
