Tuesday, February 10, 2015

February 10, 2015 Grand Rounds

Case # 1: 22/F, intravenous drug user (IDU), who p/w acute right-sided hemiparesis secondary to cerebral zygomycosis.

 From: http://www.neurology.org/content/76/1/e1/F1.expansion.html

1. Among IDU's, cerebral involvement represents the most common form of disease zygomycosis. 

2. Suspect cerebral zygomycosis in the setting of IDU, unilateral basal ganglia involvement, rapid progression of a unilateral lesion to involve the contralateral side, and unexplained large infarcts in the brain.

3. Carries a very high mortality rate of almost 70%. Brain biopsy is always almost essential to establish the diagnosis. Of those who died from it, only 1/3 had a diagnosis of zygomycosis before death.

Case # 2. Update and review of measles.

1. Spread by aerosol, droplet, or contact. It is contagious 4 days prior and up to 4 days after the rash.

2. Usual course: 8-12 days of incubation period, followed by 2-4 days of fever, conjunctivitis, coryza, and cough, followed by 2-3 days of rash that begins from the hair line and spreads downward. Koplik's spots are bluish to whitish papules seen in the buccal mucosa 1 day before appearance of the rash and lasts for 2-3 days.

3. As of 2/6/2015, there have been 121 measles cases from 17 states. Illinois (mostly from Chicago) has 3 cases already.

1 comment:

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