ABSTRACT
Although neurological manifestations of typhoid fever was thought to be obsolete from modern world, emergence of multidrug resistant typhoid bacilli and reporting of outbreak of typhoid fever with a range of early neuropsychiatric manifestations from various parts of world has led clinicians and investigators to re-evaluate the clinical spectrum of this endemic sinister disease. An 18-year-old male student was admitted in psychiatry ward with mutism, staring look, posturing and rigidity. There was history of typhoid fever 1 week before for which he was prescribed cefuroxime. Although investigations fail to provide any clue, his catatonic symptoms disappeared 2 weeks later giving way to resting tremor, bradykinesia, cog-wheel rigidity but without gait abnormality. He was successfully treated with lorazepam, amantidine, olanzapine and pramiprexole. The patient was asymptomatic within a month. He had no recurrence of symptoms till last follow-up, 6 months from the illness.
Subject(s)
Catatonia/etiology , Parkinsonian Disorders/etiology , Typhoid Fever/complications , Adolescent , Amantadine/therapeutic use , Antiparkinson Agents/therapeutic use , Antipsychotic Agents/therapeutic use , Benzodiazepines/therapeutic use , Benzothiazoles/therapeutic use , Catatonia/drug therapy , Humans , Hypnotics and Sedatives/therapeutic use , Lorazepam/therapeutic use , Male , Olanzapine , Parkinsonian Disorders/drug therapy , PramipexoleABSTRACT
Epidemiological data of HIV affected individuals of aged 50 years and above in India are lacking for various reasons. Diagnosing HIV infection among the elderly is challenging as chronic HIV/AIDS can mimic those typically associated with aging in parallel to the myth that elderly individuals lead asexual lives. In this study, low-literate, poor, urban men were the major group. The most common presentation at diagnosis was frailty or unexpected weight loss and neurocognitive impairment, whereas the incidence of TB was much less. Policy makers and social workers should be aware of this descriptive analysis in order to address the emerging issue of HIV among geriatrics and to create a broader awareness programme and more liberal HIV testing among this group. This study also highlights the need for a larger population based study involving elderly HIV infected persons in India.
