Relevant past medical history and interventions for a 33 years old male with a past medical history of nasal polyp removal and recurrent sinusitis in the last 8 years.
| Dates | Summaries from initial and follow-up visits | Diagnostic testing (including dates) | Interventions |
|---|---|---|---|
| 07-18/10/2016 | This is a case of a 33 years old male complaining of severe headache, neck pain, photophobia, vomiting and high grade fever of several days. On examination patient was conscious, GCS15/15, normal limbs power but positive Babinski sign | CT brain with and without contrast, Lumbar puncture, HIV, P-ANCA, C-ANCA (07-08/10/2016) | Intravenous Ceftriaxon, Vancomycin, Acyclovir, Anti-tuberculus medications and Amphotricin |
| 19-20/10/2016 | Developed sever headache, dizziness, blurred of vision with right 3rd nerve palsy | CT brain showed signs of increased intracranial pressure with hydrocephalus (19/10/2016) | Patient seen by neurosurgery and taken immediately to operation room for external ventricular drain insertion |
| 21-23/10/2016 | Decreased level of consciousness | MRI brain with and without contrast and MRV brain showed acute multiple arterial infarctions mostly on posterior territories (21-23/10/2016) | Shifted to ICU and intubated.Seen by ENT and turbinectomy was carried out and samples sent to histopathology. |
| 24-25/10/2016 | Patient developed unequal pupils | CT brain carried out showed increaswd diffuse brain edema on posterior fossa (24/10/2017) | Taken immediately for urgent decompressive craniectomy |
| 26-30/10/2016 | Patient had more spikes of fever | Histopathology results showed Aspergillosis species. EEG carried out to rule out any seizure showed mild to moderate encephalopathy (30/10/2017) | Same management |
| 02-05/11/2016 | Patient started to be weaned | None | Tracheostomy carried out |
| 06/11/2016 | Patient developed cardiac arrest then pulseless electrical activity | None | Cardiopulmonary resuscitation done and patient revived |
| 07-08/11/2016 | Patient on inotropes | None | Same management |
| 09-10/11/2016 | Patient developed cardiac arrest | None | Cardiopulmonary resuscitation carried out but patient died |
HIV - Human Immunodeficiency Virus, P-ANCA - Perinuclear Anti-Neutrophil Cytoplasmic Antibodies, C-ANCA - Cytoplasmic Anti-Neutrophil Cytoplasmic Antibodies, GCS - Glasco Coma Scale, ENT - Ear, Nose, Throat