A Rare Case of Water Intoxication in Unusual Chiropratic Prescription: A Medico-Legal Analysis Due to Alleged Malpractice.

Introduction: Water intoxication is a well-recognized cause of symptomatic hyponatremia, whose often fatal consequences are de-scribed in a wide variety of conditions such as psychiatric disorders, metabolic dysfunctions, child abuse, drug abuse and several medical procedures. The case: We here report a rare case of a 67-year-old woman with severe acute hyponatremia due to an excessive voluntary water intake - 14 litres in two days - following a chiropractic prescription. The patient developed sudden severe symptoms, including water retention, sensory alteration, altered mental status and tonic-clonic seizures. She was thus admitted to the Intensive Care Unit with a diagnosis of coma due to electrolyte alterations following water intoxication. Conclusion: The evaluation, in the present case, of the medico-legal implications related to malpractice involving a practitioner of Complementary and Alternative Medicine, led to the admission of a professional liability of the chiropractor.

A lethal Tick-Borne Encephalitis (TBE) due to TBE Virus in Sicily (Italy): a case of IgG+/IgM- response?

Tick-borne encephalitis (TBE) is an important viral infection of the central nervous system with high morbidity and mortality. With the increase of tourism TBE is becoming a problem also outside endemic regions. Italy is considered a country with low incidence of TBE and geographically restricted to the central and north eastern part of the country. In the south of Italy there is no evidence of disease presence, but neither is there much evidence of its absence. We report our experience about a lethal case of meningoencephalitis with a single-phase clinical course of the disease likely due to TBEV infection in a 13-year-old man. This is the first report of an autochthonous case of TBE in Sicily, region in the in Southern Italy.