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East and Central African Journal of Surgery
Association of Surgeons of East Africa and College of Surgeons of East Central and Southern Africa
ISSN: 1024-297X EISSN: 1024-297X
Vol. 17, No. 1, 2012, pp. 139-140
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Bioline Code: js12025
Full paper language: English
Document type: Case Report
Document available free of charge
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East and Central African Journal of Surgery, Vol. 17, No. 1, 2012, pp. 139-140
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Unusual Presentation of Meningitis following Stab Neck.
Motsitsi, N.S.
Abstract
Background:A case report of stab neck presenting at Kalafong Hospital, Pretoria, South Africa with atypical meningitis. The objective was to illustrate the challenge of diagnosing this unusual and late presentation of meningitis.
Case Report: A 48 year-old male patient presented to us two days after a stab neck.
He was restless and inebriated. The neurological picture was that of Brown – Sequard
syndrome. He was managed conservatively. He had two episodes of confusion and aggression.
He only had one episode of temperature spike. There were no localizing signs. Brain scans
were normal on both occasions. Cerebrospinal fluid analysis showed high neutrophils and
lymphocytes. No bacteria were demonstrated by microscopy, culture or agglutinin tests. Tests
and all investigations for tuberculosis were negative. HIV test was not done but the CD4
count was normal.
He was started empirically on intravenous ceftriaxone. He regained consciousness within 24
hours. He improved dramatically and is undergoing rehabilitation at our centre.
Conclusion: Meningitis must always be borne in mind as a serious complication in a
patient with stab neck. The clinical presentation may be unusual; the typical clinical
features may be absent.
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© Copyright 2012 - East and Central African Journal of Surgery
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