Mental Status Changes
 
Introduction
Acute Confusion
   Infectious
   Metabolic
Cases
   Headache
   Fever & Confusion
   Focal Weakness
   Nice Doggie
   She's Talking a Lot
   Hemiparesis
   Unconscious
   Police Call
 

On morning rounds her neurologic exam is unchanged; temperature is 38.7°C

  • Her biox is 96%.
  • Oral exam reveals thrush.
  • LP results are normal except for mild elevation of protein.
  • Her ELIZA comes back positive.
  • The family is approached about doing a CT.
  • Fluconazole is added for her thrush.

Two days later her condition is unchanged and the family is still trying to get the money for the cranial CT.

  • IV dexamethasone is started and the following day her condition is improved.
  • The CT is finally done and the one centimeter cuts show no abnormality.
  • Chest X-ray is done also, and is essentially normal.
  • Repeat LP shows no WBCs, but protein is 10 times normal.

Monicah expired that night.

An autopsy was done.

 
  Home  |  Clinical Cases  |  Quizzes