Staphylococcal Septicaemia Complicated by Probable Cloxacillin Neurotoxicity and by Jaundice Induced by Fusidic Acid

1983 ◽  
Vol 28 (2) ◽  
pp. 179-180 ◽  
Author(s):  
Dorothea McAreavey ◽  
Penelope J. Redding
Keyword(s):  
Mental State ◽  
Fusidic Acid ◽  
Serum Bilirubin ◽  
Severe Hypertension ◽  
Acute Confusional State ◽  
Confusional State

Two weeks following a renal arteriogram a 56-year-old man with severe hypertension developed a staphylococcal septicaemia. After six weeks treatment with intravenous fusidic acid and cloxacillin he became icteric, confused and disorientated. The fusidic acid was stopped and the serum bilirubin fell to normal. His confusion persisted and serum cloxacillin levels were found to be grossly elevated. The patient's mental state returned to normal following withdrawal of cloxacillin. We attribute his jaundice to treatment with fusidic acid and his acute confusional state to cloxacillin neurotoxicity.

scholarly journals Acute confusional state as a prognostic sign of COVID-19 large-vessel occlusion (LVO)

2021 ◽  
Vol 14 (2) ◽  
pp. e240536
Author(s):  
Smit Sunil Deliwala ◽  
Murtaza Hussain ◽  
Anoosha Ponnapalli ◽  
Dominic Awuah ◽  
Thair Dawood ◽  
...  
Keyword(s):  
De Novo ◽  
Stroke Care ◽  
Organ Damage ◽  
Large Vessel ◽  
Antigenic Structure ◽  
Left Internal Carotid Artery ◽  
Care Pathways ◽  
Acute Confusional State ◽  
Confusional State ◽  
Vessel Occlusion

COVID-19 is well known for its respiratory symptoms, but severe presentations can alter haemostasis, causing acute end-organ damage with poor outcomes. Among its various neurological presentations, cerebrovascular events often present as small-vessel strokes. Although uncommon, in predisposed individuals, large-vessel occlusions (LVOs) can occur as a possible consequence of direct viral action (viral burden or antigenic structure) or virus-induced cytokine storm. Subtle presentations and complicated stroke care pathways continue to exist, delaying timely care. We present a unique case of COVID-19 LVO manifesting as an acute confusional state in an elderly man in April 2020. CT angiography revealed 'de novo' occlusions of the left internal carotid artery and proximal right vertebral artery, effectively blocking anterior and posterior circulations. Delirium can lead to inaccurate stroke scale assessments and prolong initiation of COVID-19 stroke care pathways. Future studies are needed to look into the temporal relationship between confusion and neurological manifestations.

Acute confusional state caused by a large number of small brain infarcts

2006 ◽  
Vol 13 (9) ◽  
pp. e2-e3
Author(s):  
Y. Ueno ◽  
K. Kimura ◽  
Y. Iguchi ◽  
T. Inoue ◽  
K. Wada ◽  
...  
Keyword(s):  
Acute Confusional State ◽  
Confusional State ◽  
Brain Infarcts

JUVENILE MIGRAINE, PRESENTING AS AN ACUTE CONFUSIONAL STATE

PEDIATRICS ◽  
1970 ◽  
Vol 45 (4) ◽  
pp. 628-635
Author(s):  
Generoso Gascon ◽  
Charles Barlow
Keyword(s):  
Metabolic Disease ◽  
Initial Presentation ◽  
Toxic Encephalopathy ◽  
Acute Confusional State ◽  
Confusional State ◽  
Clinical Criteria ◽  
Neurological Signs ◽  
Mental Disturbance ◽  
Unilateral Headache ◽  
Complicated Migraine

In the literature, complicated migraine usually connotes paroxysmal unilateral headache and vomiting associated with neurological signs, such as hemiplegia, hemianopsia, aphasia, ophthalmoplegia, or syncope. A not uncommon form of complicated migraine in childhood is the presentation with an acute confusional state. Four cases are described. Emphasis is placed on the initial presentation with disturbed sensorium and consciousness, with varying degrees of agitation, and the difficulty for the clinician in distinguishing from other causes of acute mental disturbance, such as toxic-metabolic psychoses due to drug ingestion or known metabolic disease, encephalitis, acute toxic encephalopathy, and epilepsy, particularly petit mal status and postictal confusion. The diagnosis of migraine was made only after the acute episode, when the usual clinical criteria for making a diagnosis of migraine was established in retrospect or by subsequent course. In all cases the episodes of confusion were single ones, with no repetition of similar attacks, although the classic or common types of migraine often reoccurred.

An acute confusional state

1988 ◽  
pp. 219-222
Author(s):  
G.S. Venables ◽  
D. Bates ◽  
N.E.F. Cartlidge
Keyword(s):  
Acute Confusional State ◽  
Confusional State

scholarly journals Avoiding Anchoring Bias in the Times of the Pandemic!

2020 ◽  
Vol 12 (3) ◽  
pp. 359-364
Author(s):  
Zohaib Yousaf ◽  
Mohammed Yaseen Ahmed Siddiqui ◽  
Kamran Mushtaq ◽  
Sayeda Efath Feroz ◽  
Mohamed Aboukamar ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Acute Confusional State ◽  
Confusional State ◽  
Mri Findings ◽  
Csf Analysis ◽  
Clinical Presentations ◽  
Anchoring Bias ◽  
The Times ◽  
High Pretest Probability

COVID-19 has a broad spectrum of clinical presentations, including central nervous system manifestations that are not uncommon. The high pretest probability of COVID-19 in pandemic can lead to anchoring. We present a patient of COVID-19 pneumonia who presented with dyspnea and acute confusional state. His initial workup was suggestive of tuberculous meningoencephalitis with lymphocytic pleocytosis, high protein in CSF analysis, and suspicious MRI findings, which was later confirmed with a positive CSF culture. To the best of our knowledge, it is the first such case. Anchoring to the diagnosis of COVID-19 may deter clinicians from considering other concurrent diagnoses and a poor outcome consequently.

Acute confusional state and bronchogenic carcinoma with cerebral metastasis

BMJ ◽  
2002 ◽  
Vol 325 (Suppl S6) ◽  
pp. 0212454
Author(s):  
Hidayath Ansari ◽  
N Balcombe
Keyword(s):  
Bronchogenic Carcinoma ◽  
Cerebral Metastasis ◽  
Acute Confusional State ◽  
Confusional State

Core surgical skills and knowledge

2012 ◽  
Author(s):  
Matthew D. Gardiner ◽  
Neil R. Borley
Keyword(s):  
Cardiac Arrhythmias ◽  
Preoperative Assessment ◽  
Chronic Obstructive ◽  
Healthcare Associated Infection ◽  
Acute Confusional State ◽  
Confusional State ◽  
Basic Principles ◽  
Obstructive Pulmonary Disease ◽  
Electrolyte Homeostasis ◽  
Healthcare Associated

This chapter begins by discussing the basic principles of fluid and electrolyte homeostasis, fluid therapy, healthcare-associated infection, microorganisms and antimicrobials, preoperative assessment, and acute pain, before focusing on the key areas of knowledge, namely deep venous thrombosis, pulmonary embolism, respiratory tract infection, asthma, chronic obstructive pulmonary disease, acute respiratory failure, ischaemic heart disease, heart failure, cardiac arrhythmias, hypertension, diabetes mellitus, acute renal failure, stroke, acute confusional state, and haematological conditions. The chapter concludes with relevant case-based discussions.

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