Meningitis Case Study NursingCase history of meningitisMeningitis case presentationMeningitis case reportNMDA encephalitisPneumococcal meningitis case studyMeningitis case studyNMDA receptor meningitisCase report: meningitis as a presenting feature of anti-NMDA ...
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Meningitis is a very rare atypical presenting feature of anti-NMDA receptor encephalitis. In our case report, we describe an unusual ... Skiptomaincontent Advertisement SearchallBMCarticles Search Casereport:meningitisasapresentingfeatureofanti-NMDAreceptorencephalitis DownloadPDF DownloadPDF Casereport OpenAccess Published:07January2020 Casereport:meningitisasapresentingfeatureofanti-NMDAreceptorencephalitis MariaStavrou1,2,3,JingMingYeo4,AlexanderDavidSlater5,OliverKoch6,SaroshIrani7&PeterFoley1,2,3 BMCInfectiousDiseases volume 20,Article number: 21(2020) Citethisarticle 3269Accesses 5Citations 2Altmetric Metricsdetails AbstractBackgroundMeningitisisaveryrareatypicalpresentingfeatureofanti-NMDAreceptorencephalitis.Inourcasereport,wedescribeanunusualclinicalpresentationofanti-NMDAreceptorencephalitiswithabiphasicpatternofmeningitisfollowedbyencephalitisanddiscusspotentialmechanismsunderlyingthispresentation.Weaimtowidenthedifferentialdiagnosistobeconsideredinapatientpresentingwithclinicalmeningitisandpyrexia.CasepresentationThisisacaseofa33-yearoldCaucasianwomanwhoinitiallypresentedwithalymphocyticmeningitisattributedtoaviralinfection.Shesubsequentlydevelopedfluctuatingconsciousness,agitation,visualhallucinations,dyskineticmovements,ageneralizedtonic-clonicseizure,andautonomicinstability.Investigationsrevealedadiagnosisofanti-NMDAreceptorencephalitissecondarytoapreviouslyunidentifiedovarianteratoma.Shemadeanexcellentrecoverywithimmunotherapyandremovaloftheteratoma.ConclusionCliniciansshouldconsiderautoimmuneencephalitidesinindividualswithmeningitis,particularlywhereextensiveinvestigationsfailtoidentifyacausativepathogenandthereisrapiddevelopmentofanencephaliticphenotype. PeerReviewreports BackgroundAnti-NMDAreceptorencephalitisisawell-recognisedimmunotherapy-responsiveconditionwhichoftenoccursasaparaneoplasticphenomenon.Atypicalpresentationisinayoungindividualwithaviral-likeprodromefollowedbythedevelopmentofseverepsychiatricsymptoms,memoryloss,seizures,reducedconsciousnessandsometimesorofacialdyskinesias,andprogressiontoautonomicandrespiratoryinstability.Meningitisisaveryrarepresentingfeatureofanti-NMDAreceptorencephalitiswithourliteraturesearchonlyrevealingoneotherreportedcase.Wepresentacaseofa33-yearoldCaucasianwomanwhoinitiallypresentedwithalymphocyticmeningitisattributedtoaviralinfection,butwhosubsequentlydevelopedclinicalandinvestigativefeaturesconsistentwithanti-NMDAreceptorencephalitis.Theaimofthisreportistopresentanddiscusspossiblemechanismsunderlyingthisatypicalpresentation.CasepresentationA33-yearold,previouslyfitandwell,CaucasianwomanpresentedtoaUKacutemedicalunitwith2 daysofgradualonsetpressure-likeheadache,fever,neckstiffnessandvomiting.Therewasnotravelhistoryofnoteorrecentillcontacts.Onexamination,shewasfebrileat38.6 °Candhadphotophobiawithnuchalrigidity,howeverwithanormalconsciouslevel,andunremarkablesystemicandneurologicalexaminations.InitialtestsincludedanormalserumwhitecellcountandaC-reactiveproteinof
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