A 52-year-old man developed fever, meningismus, and decreasing level of consciousness over 2 days. On arrival he was minimally responsive to external stimuli and was profoundly rigid. There was no history of immunosuppression; however, he worked as a vacuum truck operator and reported exposure to chicken and pigeon feces in the weeks prior to his illness. CSF opening pressure was 30 cm of H2O w...

Cerebral vasospasm is commonly reported following traumatic brain injury (TBI) and traumatic subarachnoid hemorrhage (tSAH). However, severe vasospasm after TBI with minimal, focal tSAH is rare and often forgotten. A 62-year-old woman experienced an evident mechanical fall with head injury, but with no loss of consciousness or abrasions to the head or neck. She was being treated for hypertensio...

OBJECTIVE Intravenous immunoglobulin is widely used to treat various autoimmune disorders. After observing instances of aseptic meningitis in treated patients, we studied the frequency and associated risk factors for aseptic meningitis in patients treated with high-dose intravenous immunoglobulin. DESIGN Retrospective analysis of a prospective cohort study. SETTING Tertiary research referra...

OBJECTIVE To determine whether the addition of intravenous dexamethasone to standard emergency department (ED) migraine therapy would decrease the incidence of severe recurrent headache 24 to 48 hours after initial treatment. METHODS Patients aged 19 to 65 years whose headache was severe enough to require parenteral therapy and who met International Headache Society migraine criteria were eli...

suMMARY Lymphoblastic leukaemia in a 3-year-old child was complicated by rhinopulmonary mucor-mycosis. This was successfully treated by surgical resection of the nasal mass, pulmonary lobectomy, combined with amphotericin. Effective treatment of childhood lymphoblastic leukaemia has been associated with an increased Myer et al., 1972). Successful management of rhinopulmonary mucormycosis in chi...

Following the report of two Canadian Aboriginal patients with severe hepatic failure by Mhanni et al. (2006), 1 suffering from hyperammonemia, hyperornithinemia, and hyperhomoci-trullinuria (HHH) syndrome, to the best of our knowledge, we are presenting the third and the oldest Aboriginal patient with HHH syndrome. Our patient, a 34-year-old male of Métis descent, with chronic cognitive dysfunc...

The task of diagnosis in a patient with pyrexia of uncertain origin demands a close alliance between clinician and pathologist-an alliance based on a full understanding of each other's powers and limitations. On the one hand the clinician must have a sound knowledge of the tests which he asks the pathologist to carry out; on the other, the pathologist must not be used merely as a sort of penny ...

far from complete. This, of course, is inevitable in such a text and, in fact, it is highly desirable since it should motivate the reader to seek further information. Appropriate sources for further reading are provided in the carefully selected bibliographies. In the course of his reading the reviewer had many occasions to use the index and found it to be quite complete and providing a rather ...

Distinction between acute disseminated encephalomyelitis and acute multiple sclerosis is often clinically difficult. Perivenous demyelination is the pathological hallmark of acute disseminated encephalomyelitis, whereas confluent demyelination is the hallmark of acute multiple sclerosis. We investigated whether perivenous demyelination versus confluent demyelination distinguishes acute dissemin...

TOPIC: Critical Care TYPE: Medical Student/Resident Case Reports INTRODUCTION: Acute encephalopathy has a broad differential diagnosis. HIV infection can present as serious neurological manifestations varying from seizures, encephalopathy, severe headaches, photophobia or meningismus. These presentations are scarce within themselves but even more rare is acute in seronegative individual. Below ...