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Rubella
Published in Avindra Nath, Joseph R. Berger, Clinical Neurovirology, 2020
Laboratory abnormalities include leukopenia, atypical lymphocytosis, or thrombocytopenia. In aseptic meningitis the CSF shows a lymphocytic pleocytosis and an elevated protein. The diagnosis of rubella infection can be made by detection of rubella-specific IgM and by detecting rubella virus in throat washings or rubella virus RNA in CSF, urine, or saliva by using RT-PCR [18]. Genotyping of the rubella virus can provide useful epidemiological information.
Pneumonitis In Rickettsial Infections
Published in Lourdes R. Laraya-Cuasay, Walter T. Hughes, Interstitial Lung Diseases in Children, 2019
A variety of laboratory parameters may be abnormal in RMSF. The white blood cell count may initially be normal or depressed with a high percentage of stabs on the differential. Anemia and thrombocytopenia may also be seen. Elevated serum transaminases reflect hepatic involvement and azotemia, hyponatremia, and hypoalbuminemia are manifestations of vasculitis with fluid shifts. Cerebrospinal fluid examination may reveal lymphocytic pleocytosis. Elevated prothrombin and activated partial thromboplastin times, along with an increase in fibrin split products, confirm disseminated intravascular coagulation.
Headache associated with central nervous system infection
Published in Stephen D. Silberstein, Richard B. Upton, Peter J. Goadsby, Headache in Clinical Practice, 2018
Stephen D. Silberstein, Richard B. Upton, Peter J. Goadsby
The CSF abnormalities in sarcoidosis are nonspecific and include: 1) lymphocytic pleocytosis; 2) elevated protein concentration; 3) decreased glucose concentration; 4) elevated IgG index and synthesis rate indicative of intrathecal immunoglobulin production; 5) oligoclonal banding; and 6) elevated CSF angiotensin-converting enzyme (ACE).48 To make a diagnosis of neurosarcoidosis, the following are recommended: 1) chest radiography for bilateral, symmetric hilar and mediastinal lymphadenopathy; 2) serum and CSF ACE; and 3) lymph node, skin, or transbronchial lung biopsy.9
Reversible leukoencephalopathy associated with organotin poisoning
Published in Clinical Toxicology, 2023
Tinh Quang Dang, Uyen Vy Doan, Tri Dung Nguyen, Thanh Vinh Nguyen, Thang Ba Nguyen
A 38-year-old healthy male was hospitalized with forgetfulness and trouble walking. For the last two months he was working with industrial color mixing and plastic ceiling fabrication at a private PVC waste processing factory with poor ventilation and no respirator for 10 h/day, six days/week. Part of his job duties was to add about 1 kg of a mixture of trimethyltin and dimethyltin for every 100 kg of PVC; approximately 1,000 kg of PVC was produced daily. He frequently worked barehanded. His family reported a two-week progression of impaired memory, loss of balance, apathy, tinnitus, scaly darkened skin, and psychomotor slowing that rendered him unable to continue his daily activities. On clinical examination, central vestibular nystagmus and ataxic quadriparesis were found. An MRI scan revealed diffuse lesions of bilateral hemispheric white matter and both middle cerebellar peduncles (Figure 1). Bradycardia (30–40 beats/min) with occasional pauses was noted on electrocardiogram and 24-h Holter monitoring, that improved with atropine suggesting supranodal blockade. Cerebrospinal fluid showed a non-specific lymphocytic pleocytosis. Arterial blood gas showed: pH 7.33; PCO2 32 mmHg (4.3 kPa); bicarbonate concentration 16.9 mmol/L. Serum potassium was within normal limits on admission. Assessment of cognitive function revealed an abnormal mini mental status examination of 15/30 with reduced verbal memory.
Incidence and clinical outcome of Cryptococcosis in a nation with advanced HIV surveillance program
Published in The Aging Male, 2020
Fatma Ben Abid, Hussam Abdel Rahman S. Al Soub, Muna Al Maslamani, Wanis Hamad Ibrahim, Hafedh Ghazouani, Abdullatif Al-Khal, Saad Taj-Aldeen
Routine laboratory investigations are usually unhelpful to establish the diagnosis. Lumbar puncture preceded by neuro-imaging is the key for diagnosis for cryptococcal meningitis. Cerebrospinal (CSF) pressure is usually elevated. CSF analysis typically shows lymphocytic pleocytosis with high protein and low glucose in half of the cases. CSF should be tested for India ink, cryptococcal latex agglutination test and fungal culture. The yield of India ink testing is much less in HIV-negative cases compared to HIV-infected cases (60% and 90% respectively) [19]. This is usually explained by the higher concentration of the yeast in the CSF of AIDS patients as compared to those who are immuno-competent. Latex agglutination test or enzyme-linked immunosorbent assay (ELISA) rarely misses positive cases with the exception of cases with very early disease or in those with very high titers due to the prozone effect [21]. Fungal culture is the gold-standard and is positive in nearly all cases. Nevertheless, cryptococcal culture can take a long time.
Treatment Options for Anti-N-methyl-D-aspartate Receptor Encephalitis
Published in The Neurodiagnostic Journal, 2018
The following investigations are required in order to diagnose anti-NMDAR encephalitis: cerebrospinal fluid (CSF), lymphocytic pleocytosis, oligoclonal bands, routine EEG, and long-term video EEG monitoring. CSF is abnormal in 79% of cases (Le Guen et al. 2015). Lymphocytic pleocytosis with an increased protein level is less common. Oligoclonal bands are also present in 60%–70% of cases (Dalmau et al. 2011). Oligoclonal bands are immunoglobulins detected in a patient’s CSF. A routine EEG and long-term video EEG monitoring show abnormal brainwave activity in 90% of cases (Kadoya et al. 2015). EEG monitoring can be used to confirm the presence of abnormal activity such as rhythmic, diffuse generalized extreme delta brush (EDB) and focal or multifocal epileptic activity (Veciana et al. 2015).