RESUMO
Enterovirus 71 (EV71) is a common cause of hand, foot, and mouth disease and sometimes causes severe neurologic complications, mainly in children. We report a case of adult-onset encephalitis caused by intrafamilial transmission of a subgenogroup C4 strain of EV71. This case elucidates the risk for EV71 encephalitis even in adults.
Assuntos
Infecções Comunitárias Adquiridas/transmissão , Encefalite Viral/transmissão , Encefalite Viral/virologia , Enterovirus Humano A/isolamento & purificação , Infecções por Enterovirus/transmissão , Família , Doença de Mão, Pé e Boca/transmissão , Doença Aguda , Adulto , Criança , Pré-Escolar , Infecções Comunitárias Adquiridas/virologia , Infecções por Enterovirus/virologia , Feminino , Doença de Mão, Pé e Boca/virologia , Humanos , Lactente , MasculinoRESUMO
Orthostatic hypotension (OH) is defined by evaluating postural blood pressure (BP) change, but the correlation between postural BP decreases and OH-associated symptoms is poor. We examined carotid duplex ultrasonography during HUT in 27 patients with various neurological disorders. Nine patients were diagnosed to have OH, and 4 of them had symptoms associated with OH. Decreased end-diastolic velocity of common carotid artery in symptomatic OH patients (-24.5 +/- 4.2 cm/s) was significantly larger than that in asymptomatic OH patients (-11.0 +/- 8.0 cm/s; p = 0.0143), despite no significant differences in values and changes of BP between them. This may be useful for predicting the development of OH symptoms.
Assuntos
Artéria Carótida Primitiva/diagnóstico por imagem , Hipotensão Ortostática/diagnóstico por imagem , Postura , Ultrassonografia Doppler Dupla , Adulto , Idoso , Velocidade do Fluxo Sanguíneo , Pressão Sanguínea , Diástole , Feminino , Decúbito Inclinado com Rebaixamento da Cabeça , Frequência Cardíaca , Humanos , Hipotensão Ortostática/diagnóstico , Hipotensão Ortostática/fisiopatologia , Masculino , Pessoa de Meia-Idade , SístoleRESUMO
A formerly healthy 32-year-old woman was hospitalized for a closer examination of undiagnosed fever with mild headache. Despite lack of distinct findings on physical and laboratory examinations at admission, she suddenly developed anuresis due to acontractile neurogenic bladder. On the basis of her symptoms and the faint nuchal rigidity revealed later, as well as the results of cerebrospinal fluid analyses, a diagnosis of aseptic meningitis was eventually reached. While aseptic meningitis subsided within 3 weeks, about 10 weeks, including a 26-day period of anuria, was necessary for complete restoration of normal voiding function, necessitating intermittent self-catheterization. Acute urinary retention should be considered an uncommon but critical manifestation of aseptic meningitis.
Assuntos
Meningite Asséptica/complicações , Retenção Urinária/etiologia , Adulto , Técnicas de Diagnóstico Urológico , Feminino , Cefaleia/líquido cefalorraquidiano , Cefaleia/etiologia , Humanos , Meningite Asséptica/líquido cefalorraquidiano , Bexiga Urinaria Neurogênica/líquido cefalorraquidiano , Bexiga Urinaria Neurogênica/etiologia , Bexiga Urinaria Neurogênica/terapia , Cateterismo Urinário , Retenção Urinária/líquido cefalorraquidiano , Retenção Urinária/terapiaRESUMO
We describe a consanguineous family that had progressive myopathy with rimmed vacuole (RV) formation and amyloid deposition. Patient 1 is a 71-year-old woman with muscle atrophy in the lumbar girdle and lower extremities. Patient 2 is a 40-year-old man (the son of Patient 1) with fatty changes in the biceps femoris muscles. Muscle biopsies revealed myopathic and neurogenic degeneration with RV, necrotic fibers, and interstitial amyloid deposition. Amyloid deposition was detected only in the muscle tissue.