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Archive for November, 2012

Microbiology: Sepsis, meningitis and cerebral abscesses caused by Citrobacter koseri

28 Nov, 12 | by Emma

Neonates have the highest incidence of bacterial meningitis. Here the authors report the case of a neonate with Citrobacter koseri – a rare cause of meningitis and cerebral abscess.

Seema Biswas
Editor-in-Chief

Sepsis, meningitis and cerebral abscesses caused by Citrobacter koseri

Microbiology: Clinical aspects of congenital syphilis with Hutchinson’s triad

21 Nov, 12 | by Emma

This case from Brazil describes interstitial keratitis, deafness and dental defects characterising Hutchinson’s triad resulting from congenital syphilis in a seven year old girl.

Seema Biswas
Editor-in-Chief

Clinical aspects of congenital syphilis with Hutchinson’s triad

Patient communication skills with fMRI.

20 Nov, 12 | by Dr Dean Jenkins

Scott Routley – a man who has appeared to be in a persistent vegetative state for 10 years – has answered questions using a functional MRI scan. Canadian researchers asked him to think of playing tennis to answer ‘yes’ and to think of walking around his house to answer ‘no’. These thoughts stimulate different parts of the motor cortex which can then be detected by fMRI. The researchers have been evaluating these techniques in various patients but this is the first time it has been used for complex communication in a person in apparent persistent vegetative state. It was the subject of  a recent BBC Panorama programme “The mind reader: unlocking my voice“.

The ongoing research in this area demonstrates different types of techniques [1,2] for communication and is also confirming that there are different sub-types (or misclassifications) of vegetative state [2]. Some patients do have awareness of their surroundings, can understand speech but are unable to make any form of communication themselves. Functional MRI as a communication tool can be used in these patients to better understand their perspective, their symptoms, and their wishes.

 

1. Bardin JC, Schiff ND, Voss HU. Pattern classification of volitional functional magnetic resonance imaging responses in patients with severe brain injury. Arch. Neurol. 2012 Feb;69(2):176–181.

2. Cruse D, Chennu S, Chatelle C, Bekinschtein TA, Fernández-Espejo D, Pickard JD, Laureys S, Owen AM. Bedside detection of awareness in the vegetative state: a cohort study. Lancet 2011 Dec;378(9809):2088–2094.

Microbiology: A 12-day-old male newborn with extensive vesicles and fever

14 Nov, 12 | by Emma

Here a 12 day neonate presents with a fever and generalised vesicular rash. Fortunately, he recovers with intravenous acyclovir…

Seema Biswas
Editor-in-Chief

A 12-day-old male newborn with extensive vesicles and fever

Microbiology: Nosocomial meningitis caused by gas producing Klebsiella pneumoniae

7 Nov, 12 | by Emma

Here the authors describe a case of gas forming Klebsiella pneumonia causing fatal meningitis in a 40 year old woman.

Seema Biswas
Editor-in-Chief

Nosocomial meningitis caused by gas producing Klebsiella pneumoniae

BMJ Case Reports: publishing, sharing and learning through experience

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