Case report “headache” (2)

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Presentation transcript:

Case report “headache” (2) Dr. David Tran Medical meeting 1st september 2010

Man 64 years old 19/06/10: Consults for fever & bodyache for 4 days Pulse 97/min, BP 140/75, G15, T 38, FR 18, SaO2 98% Past history of head injury 45 years ago Physical exam normal, no neck stiffness, no neurological symptoms Urinary test: leuco ++, nitrite -, blood -

Blood test Dengue serology negative (IgM & IgG) CBC: 16400 WBC (80%N, 10% mono, 8% lympho) CRP 2.5mg

Follow up 20/06/10 The patient is hospitalized in medical ward for “infectious condition” Head CT scanner is performed the day after.

Head CT scanner result

Evolution 21/06/2010 Persistant headaches Decision to perform lumbar puncture because CRP increased 42mg, WBC 15800 (78% N, 13% mono, 7% lympho) and still fever.

Cytology results of LCR

Chemical results of LCR

Bacteriologic results LCR

LCR analysis and management

Evolution: comatose > ICU