Bell palsy: Idiopathic. Ramsay Hunt syndrome: Bell palsy associated with vesicles within the outer ear canal or behind the ear. due to herpes zoster infection.
Central Nervous System Infections
Assessment of Fever
Description of symptom(s) (i.e., nature, onset, duration, severity, associated symptoms). Description of any factors that seem to precipitate, exacerbate, and/or relieve the patient’s symptom(s). Description of the patient’s efforts to relieve the symptoms.
Intravascular Catheter-Related Infections
Can be life-threatening. Often prolong hospital stay, and can be complicated by metastatic lesions and bacterial endocarditis. A 53-year-old white woman was admitted to the hospital with complaints of severe shaking during infusion of her hyperalimentation solution. She had been receiving intravenous hyperalimentation for 16years for a severe dumping syndrome that prevented eating by mouth.
Myocarditis
Fulminant myocarditis can be fatal or lead to chronic congestive heart failure. Most cases are self-limiting and are followed by full recovery The true incidence of myocarditis (inflammation of the heart) is unknown, because most cases are asymptomatic.
Central Nervous System Infections
Central nervous system infections are fortunately rare, but they are extremely serious. The cerebral cortex and spinal cord are confined within the restricted boundaries of the skull and boney spinal canal. Inflammation and edema therefore have devastating consequences, often leading to tissue infarction that in turn results in permanent neurologic sequelae or death.
Meningitis
Bacterial meningitis remains one of the most feared and dangerous infectious diseases that a physician can encounter. This form of meningitis constitutes a true infectious disease emergency. It is important that the physician quickly make the appropriate diagnosis and initiate antibiotic therapy.
Encephalitis
A 74-year-old white man with a history of chronic steroid use (10 mg prednisone daily) and stage I chronic lymphocytic leukemia presented at the emergency room with confusion and fever. Four days before admission, he complained of being increasingly tired. Two days before admission, he became increasingly lethargic, sleeping on floor.
Central Nervous System Abscess
Brain abscess is an uncommon disease, found in about 1 in 10,000 general hospital admissions. Infection of the cerebral cortex can result from the direct spread of bacteria from another focus of infection (accounts for 20% to 60% of cases) or from hematogenous seeding.
Central Nervous System Infections
Central nervous system infections include a wide variety of clinical conditions and etiologies: meningitis, meningoencephalitis, encephalitis, brain and meningeal abscesses, and shunt infections. The focus of this chapter is meningitis. N. meningitidis meningitis is the leading cuase of bacterial meningitis in children and young adults in the United States.
Clinical presentation and symptoms of meningitis
Clinical presentation varies with age, and generally, the younger the patient, the more atypical and the less pronounced is the clinical picture.