1 / 19

Initial Presentation

Initial Presentation. 43-year-old Caucasian male suffered a seizure 20 days ago. He also had a history of seizure 2 months before, which he did not seek medical attention. He also experience headache, nausea, weakness/numbness of the arm, and poor dental health. Hx.

drake
Download Presentation

Initial Presentation

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Initial Presentation • 43-year-old Caucasian male suffered a seizure 20 days ago. He also had a history of seizure 2 months before, which he did not seek medical attention. • He also experience headache, nausea, weakness/numbness of the arm, and poor dental health.

  2. Hx • Has been diagnosed to have COPD for the past 10 years (currently uses salbutamol to ease the symptoms). • Heavy nicotine addiction (70 pack/year)

  3. Hx Cont’d Family history: • Both parents have heart conditions and mental illnesses.

  4. Hx Cont’d Social/Occupational Hx: • Farmer • Sedentary lifestyle • Still smoking but less

  5. Physical Examinations • BMI: 27 • BP: 123/72 mmHg • HR: 88 beats/min • RR: 15/min • Temp: 38.2 °C

  6. More examination • Purulent gingival drainage and several septic teeth. • Glasgow Coma Scale of 15/15 • Normal PERLLA • Unimpaired cranial nerves and motor-sensor functions • Intact tendon reflexes

  7. DDx • What test should we order? • What organs should we check for?

  8. Smear Test • Positive result of patient’s gingival smear test, indicating the presence of Staphylococcus Haemolyticus

  9. Blood Test • Blood test shows elevated white count, serum C-reactive protein, and procalcitonin • Slightly abnormal blood clot test

  10. Imaging study

  11. Diagnosis ???

  12. Treatment ???

  13. Treatment Cont’d • Surgical removal • Phenytoin • Antibiotics: meropenem, metronidazole, and teicoplanin

  14. Follow up • Patient’s condition has improved dramatically. Blood test shows no inflammation. However, he suffered from another seizure attack 2 days ago.

  15. DDx • What did we miss? Or was it a newly developed condition? • What test should we order?

  16. Bubble Test

  17. Diagnosis ???

  18. Treatment ???

  19. Treatment Cont’d • Blood thinning medication: heparin and warfarin • Closure of PFO via cardiac catheterization

More Related