ABSTRACT
A 53-year-old presented to the emergency department following a fall and was found to have recurrent episodes of torsades de pointes and pulseless ventricular tachycardia on cardiac monitoring. He had been abusing nimetazepam for sleep issues over the preceding one month. Despite correction of electrolytes, the arrhythmias were persistent which necessitated temporary overdrive pacing. The patient made an uneventful recovery and the temporary pacing was successfully removed with no recurrence of the malignant arrhythmias prior to discharge.
ABSTRACT
Burkholderia pseudomallei affecting the central nervous system has been extensively reported in the literature. However, combined central nervous system and peripheral nervous system involvement in melioidosis has never been reported. We report a 66-year-old man with diabetes mellitus who was diagnosed to have central nervous system melioidosis and developed acute flaccid quadriplegia. Nerve conduction studies and anti-ganglioside antibodies were consistent with Guillain-Barre syndrome. This case report highlights the importance to recognise the possibility of Guillain Barre syndrome complicating central nervous system melioidosis and stresses the urgency of early consideration of this complication, as early immunomodulatory therapy may hasten neurological recovery.
Subject(s)
Guillain-Barre Syndrome , Melioidosis , Male , Humans , Aged , Guillain-Barre Syndrome/complications , Guillain-Barre Syndrome/diagnosis , Melioidosis/complications , Melioidosis/diagnosis , Melioidosis/drug therapy , Central Nervous SystemSubject(s)
COVID-19 , Fistula , Mediastinal Emphysema , Pneumopericardium , Pneumothorax , Humans , COVID-19/complications , Pneumothorax/diagnostic imaging , Pneumothorax/etiology , Pneumopericardium/diagnostic imaging , Pneumopericardium/etiology , Mediastinal Emphysema/diagnostic imaging , Mediastinal Emphysema/etiologyABSTRACT
Acquired haemophilia A (AHA) is a rare disease believed to be caused by spontaneous inhibition of clotting Factor VIII by autoantibodies. This is in contrast to the more common congenital haemophilias which are largely due to an absolute deficiency in coagulation factors. It has a prevalence of approximately one per million per year. However, this figure may be underestimated because there are many undocumented cases due to a lack of recognition. Patients who develop this disease may present with catastrophic bleeding despite having no previous bleeding history. In this study, we report a case of acquired Haemophilia A presenting with spontaneous unprovoked bruising and discuss the approach to diagnosis and how to alert the clinician to suspect this potentially rare but devastating disease.