ABSTRACT
Here we report two patients with late post-partum eclampsia without pre-existing preeclampsia presenting with atypical features of posterior reversible encephalopathy syndrome (PRES) which was diagnosed by serial MRI with good outcome emphasizing the fact that early diagnosis and treatment can prevent complications.
Subject(s)
Eclampsia , Posterior Leukoencephalopathy Syndrome/diagnostic imaging , Postpartum Period , Adult , Brain/diagnostic imaging , Female , Humans , Magnetic Resonance Imaging , Posterior Leukoencephalopathy Syndrome/complications , Posterior Leukoencephalopathy Syndrome/diagnosis , PregnancyABSTRACT
Cellulitis is an unusual presentation of cryptococcal infection in renal allograft recipients. In such patients, disseminated cryptococcal infection can result in significant morbidity and mortality. Patients are often treated with antibiotics before a definitive diagnosis is made, delaying appropriate therapy. We describe the case of a 43-year-old post renal transplant recipient presenting with fever and swelling in the right thigh. On physical examination, the patient was found to have features suggestive of cellulitis with minimal slurring of speech. Material obtained from incision and drainage of the wound showed yeast cells resembling Cryptococcus spp. Blood culture and cerebrospinal fluid culture were also found to have growth of Cryptococcus neoformans. He received treatment with amphotericin B 6 mg/kg daily intravenously for two weeks, then continued with fluconazole 400 mg daily for three months. The patient showed a remarkable improvement. There was no recurrence of cryptococcosis after four months of follow-up. The diagnosis of disseminated cryptococcosis should be considered in differential diagnosis of cellulitis among non HIV immunocompromised hosts. A high clinical suspicion and early initiation of therapy is needed to recognize and treat patients effectively.
Subject(s)
Cellulitis/diagnosis , Cryptococcosis/diagnosis , Cryptococcus neoformans/isolation & purification , Cryptococcus/isolation & purification , Kidney Transplantation/adverse effects , Adult , Amphotericin B/therapeutic use , Antifungal Agents/therapeutic use , Cellulitis/drug therapy , Cellulitis/microbiology , Cryptococcosis/drug therapy , Cryptococcosis/microbiology , Cryptococcus/drug effects , Cryptococcus neoformans/drug effects , Diagnosis, Differential , Fluconazole/therapeutic use , Humans , Immunocompromised Host , Male , Treatment OutcomeABSTRACT
A 40-year-old man presented with a nonhealing wound on the left ankle for the last 5 weeks, a tingling sensation in both hands for 20 days, and weakness in all four limbs for 10 days. He had been bitten by a snake while working in a sugarcane field 6 weeks earlier and had received tetanus toxoid and anti-snake venom on the day of the bite. He had clinical, biochemical, and electrophysiological features of Guillain-Barré syndrome, with motor and sensory neuropathy-primarily suggestive of demyelination with secondary axonal degeneration. Recognition of this unusual complication following snake bite or use of anti-snake venom / tetanus toxoid has considerable epidemiological, therapeutic, and prognostic significance.
