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Prolonged neurological symptoms such as 'brain fog' and cognitive impairment have occurred after coronavirus disease 2019 (COVID-19) infection. In this report, we describe impaired consciousness caused by cefepime hydrochloride (CFPM) in a patient with cognitive sequalae of COVID-19. A 56-year-old male patient was diagnosed with penile abscess after COVID-19 infection, and a blood culture detected two drug-resistant Pseudomonas aeruginosa strains. Therefore, CFPM 2 g x twice/day was administered on day 71 after intensive care unit admission. Approximately 48 h after CFPM administration, the patient showed disturbances in consciousness. Contrast-enhanced computed tomography, magnetic resonance imaging, and spinal fluid examination revealed no obvious abnormalities. Therefore, CFPM-induced neurotoxicity was suspected. CFPM was discontinued and ceftazidime 2 g x three times/day was initiated. The patient's consciousness improved 30 h after the final administration of CFPM. Serum CFPM concentrations were 14.2, 21.7, 21.7, and 11.9 [mu]g/mL on days 1, 2, and 3 after the initiation of CFPM and on the day after CFPM was discontinued, respectively. In conclusion, intensivists should pay attention to new neurological symptoms such as CFPM-induced encephalopathy in patients with prolonged neurological symptoms after COVID-19 infection., Author(s): Tomoyuki Nakamura [sup.1], Tomoaki Yatabe [sup.2], Naohide Kuriyama [sup.1], Toshihisa Hiraiwa [sup.3], Kana Matsumoto [sup.4], Osamu Nishida [sup.1] Author Affiliations: (1) grid.256115.4, 0000 0004 1761 798X, Department of Anesthesiology [...]

Byline: Emilija. Nestorovic, Silvia. Mariani, Jan. Schmitto, Aleksandar. Pantovic Sir, Young patients receiving heart transplantation (HT) might develop posterior reversible encephalopathy syndrome (PRES). Herein, we discuss the case of a [...]

Posterior reversible encephalopathy syndrome (PRES) is a relatively new clinical entity characterized by reversible neurological symptoms with findings indicating leukoencephalopathy on imaging studies. Reports of PRES in the field of anesthesiology have been quite limited. A patient with therapeutic anticoagulant developed PRES immediately after emergence from anesthesia, in which her status was initially recognized as delayed recovery from anesthesia with transient hypertension because an emergent head computed tomography (CT) scan was almost normal. Subsequently, magnetic resonance imaging (MRI) was also performed according to a radiologist's recommendation because the CT results showed areas of slightly low attenuation in the frontoparieto-occipital lobes bilaterally, suggesting PRES; otherwise, ischemic events. MRI showed subcortical increased T.sub.2 and fluid-attenuated inversion recovery (FLAIR) intensity in the occipitoparietal regions bilaterally with slight increase in the apparent diffusion coefficient signal on diffusion-weighted imaging, which confirmed a diagnosis of PRES. Gradually, the patient regained consciousness and became responsive with antihypertensive therapy. A prompt and accurate diagnosis of PRES is important to avoid irreversible brain damage, for example, intracranial hemorrhage, especially in a patient receiving anticoagulation therapy., Author(s): Satoki Inoue[sup.1] , Masahiko Kawaguchi[sup.1] , Hitoshi Furuya[sup.1] Author Affiliations: (1) Department of Anesthesiology, Nara Medical University, 840 Shijo-cho, 634-8522, Kashihara, NaraJapan Introduction As described by Hinchey and colleagues [...]

Posterior reversible encephalopathy syndrome (PRES) is a relatively new clinical entity characterized by reversible neurological symptoms with findings indicating leukoencephalopathy on imaging studies. Reports of PRES in the field of anesthesiology have been quite limited. A patient with therapeutic anticoagulant developed PRES immediately after emergence from anesthesia, in which her status was initially recognized as delayed recovery from anesthesia with transient hypertension because an emergent head computed tomography (CT) scan was almost normal. Subsequently, magnetic resonance imaging (MRI) was also performed according to a radiologist's recommendation because the CT results showed areas of slightly low attenuation in the frontoparieto-occipital lobes bilaterally, suggesting PRES; otherwise, ischemic events. MRI showed subcortical increased T2 and fluid-attenuated inversion recovery (FLAIR) intensity in the occipitoparietal regions bilaterally with slight increase in the apparent diffusion coefficient signal on diffusion-weighted imaging, which confirmed a diagnosis of PRES. Gradually, the patient regained consciousness and became responsive with anti-hypertensive therapy. A prompt and accurate diagnosis of PRES is important to avoid irreversible brain damage, for example, intracranial hemorrhage, especially in a patient receiving anticoagulation therapy. Keywords Posterior reversible encephalopathy syndrome * Ketamine * Anticoagulation * Hypercapnia * Hypertension, Introduction As described by Hinchey and colleagues [1], reversible posterior leukoencephalopathy syndrome, in which posterior reversible encephalopathy syndrome (PRES) is now more usually used to described to this syndrome, is [...]

The route of transmission of most naturally acquired transmissible spongiform encephalopathy (TSE) infections remains speculative. To investigate urine as a potential source of TSE exposure, we used a sensitive method [...]

Transmissible mink encepholapathy (TME) is a food-borne transmissible spongiform encephalopathy (TSE) of ranch-raised mink; infection with a ruminant TSE has been proposed as the cause, but the precise origin of [...]

ABBREVIATION. PVL, periventricular leukomalacia. The dominant encephalopathy of premature infants is considered generally to involve principally white matter. (1) Periventricular leukomalacia (PVL) is the major form of white matter injury [...]

Research has been conducted on the opportunistic infections and neiplasia in late-stage AIDS. The use of clinical data and autopsy findings in investigating the relationship between neuropathological findings, concominant opportunistic infections and neoplasia and clinical progression is discussed.

Adverse cardiac events appear to increase among children infected with HIV as the disease progresses. Heart function was assessed among 81 young children infected with HIV. Elevated heart rate, which was seen in 52 (64%) of the children, was the most common heart abnormality. An abnormally slow heart rate was noted in nine (11%) of the children. Fifteen of the children had high blood pressure, and 16 had low blood pressure. Dysrhythmia, which is an abnormality in the heart rhythm, occurred in 28 (35%) of the children. Seven children experienced cardiac arrest, and eight had congestive heart failure. Heart abnormalities were more severe and more frequent in children with advanced HIV disease. Heart dysfunction was associated with death in 10 of the 37 children who died. Encephalopathy, which is degeneration of the brain, was the strongest predictor of cardiac arrest, and infection with Epstein-Barr virus was the strongest predictor of the development of congestive heart failure., Objective.--Dysrhythmias, hemodynamic instability, congestive heart failure, and sudden death are serious complications of human immunodeficiency virus (HIV) infection that, to our knowledge, have not been studied systematically. We sought to determine the cumulative incidence and clinical predictors of these adverse events in a cohort of HIV-infected children. Design.--Historical cohort study. Setting.--University-affiliated, primary and tertiary care pediatric hospital and ambulatory care center. Participants.--Eighty-one HIV-infected children who had one or more cardiac evaluations between 1984 and 1991 form the study cohort. The initial cardiac evaluation occurred at a median age of 1.5 years, and children were followed up to a median age of 3.6 years. Main Outcome Measures.--Mortality (related to cardiac dysfunction as well as noncardiac causes), tachycardia, bradycardia, hypertension, hypotension, marked sinus arrhythmia, cardiac arrest, and chronic congestive heart failure. Results.--Hemodynamic abnormalities and dysrhythmias occurred frequently. Eight unexpected cardiorespiratory arrests occurred in seven children (9%). Chronic congestive heart failure was noted in 10% of patients. Thirty children died, 10 with significant cardiac dysfunction. As HIV-infected children progressed from acquired immunodeficiency syndrome (AI DS)-related complex to AI DS, significant cardiac problems were more likely to occur. Both nonneurologic AIDS and encephalopathy were strongly associated with most severe cardiac outcomes. However, encephalopathy was the strongest correlate of cardiorespiratory arrest (P=-.002). Epstein-Barr virus coinfection was the strongest correlate of chronic congestive heart failure (P Conclusions.---Cardiac morbidity and mortality are more common with advanced HIV infection. The presence of encephalopathy or Epstein-Barr virus coinfection identifies HIV-infected children at especially high risk for adverse cardiac outcomes. (JAMA. 1993;269:2869-2875)

To the Editor: Since the World Health Organization declared a global pandemic of influenza A pandemic (H1N1) 2009 in June 2009, the number of cases of this strain of influenza [...]

Byline: Saroj. Yadav, Malini. Lawande, Shilpa. Kulkarni, Deepak. Patkar Acute encephalopathy with biphasic seizures and reduced diffusion (AESD) is a syndrome of encephalopathy characterized by biphasic seizures and altered consciousness [...]