ABSTRACT
Tuberculous meningitis (TBM) is a central nervous system infection with a high mortality rate and requires early diagnosis and treatment. Identification of Mycobacterium tuberculosis in the cerebrospinal fluid is of primary importance in the diagnosis of TBM, however, conventional methods have some disadvantages: Rapid results tests such as smear and regular PCR method do not have sufficient diagnostic sensitivity; Nested PCR, which is one of the most sensitive tests, is not available in all facilities; Culture tests require a long period of 4-8 weeks for results. Here we report a case of TBM, diagnosed 14 days earlier than culture test by direct Loop-Mediated Isothermal Amplification (LAMP) method using centrifuged medium of cerebrospinal fluid (day 18) culture. The method we used here is simple, widely available, and considered to be useful for early detection of TBM.
Subject(s)
Mycobacterium tuberculosis , Tuberculosis, Meningeal , Humans , Tuberculosis, Meningeal/diagnosis , Sensitivity and Specificity , Mycobacterium tuberculosis/genetics , Nucleic Acid Amplification Techniques/methods , Cerebrospinal Fluid/microbiologySubject(s)
Epilepsies, Myoclonic , Status Epilepticus , Humans , Adult , Seizures/drug therapy , Status Epilepticus/chemically induced , Status Epilepticus/drug therapy , Carbamazepine/adverse effects , Epilepsies, Myoclonic/chemically induced , Epilepsies, Myoclonic/drug therapy , Epilepsies, Myoclonic/genetics , Anticonvulsants/adverse effects , ElectroencephalographyABSTRACT
Continuous intrajejunal infusion of levodopa-carbidopa intestinal gel (LCIG) is an established device-aided therapy for advanced Parkinson's disease (PD). Phytobezoar associated with LCIG is a rare device-related complication and presents with exacerbations of gastrointestinal and PD symptoms. We herein report the case of a phytobezoar that was formed at a knot on the pigtail-shaped J-tube and developed only in association with postprandial abdominal pain, similar to a feeling of a tube being pulled in without an exacerbation of PD symptoms. Such abdominal pain may be a warning sign of phytobezoar in LCIG-treated patients. Despite device-related complications, high-pressure alarms are not always present, and PD symptoms are not always exacerbated.