drhouston
Forum Senior
Topics: 22
Posts: 63
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A 45 y/o female presented with fever and progressive confusion for two days. She is now unable to perform daily activities. Her temperature is 100.4 F she is oriented only to person. She has no rash and a supple neck. Her CT scan head is normal. CSF shows leukocytes 20/cmm, glucose 45, protien 110 and RBC 1000/cmm. What is the most likely cause
a.Bacterial Meningitis; b. Acute alcohol intake; c. brain stem infarct; d. cerebral infarct; e. cryptococcal meningitis; f. enteroviral infection; g. HSV encephalitis; h. hepatic enceph; i. Lymes
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| Jinx
Forum Elite
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Posts: 316
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is this c?
brainstem(pontine haemorrhage)??
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| drhouston
Forum Senior
Topics: 22
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Wouldn't pontine hemorrhage present more acutely and catastrophically with coma, quadriplegia, small reactive pupils and absent horizontal eye movements.
I thought its HSV encephalitis. but I am not sure
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| Jinx
Forum Elite
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ur perfectly correct drhouston--i thot of pontine haem coz of the rbcs in csf--are they present to that degree in HSV?
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| seri
Forum Senior
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c seems the best option
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| jvo_md
Forum Senior
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C...is the answer
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| msyamp
Forum Fanatic
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it shoud be HSV encephalitis
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| achilles
Forum Guru
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i came across a similar question in UW. the answer should be HSV encephalitis.
CSF reveals increased lymphocytes and erythrocytes(hemorrhagic destruction of temporal lobes) and elevated protein levels.
and for brain imaging, MRI is more sensitive than CT in the diagnosis of HSV encephalitis. however the gold standard is PCR analysis of HSV DNA in the spinal fluid.
Rx-acylovir.
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| yasmeen
Forum Guru
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ITS HSV INFECTION.
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