Phenytoin-Induced Paradoxical Seizures and Blood Dyscrasias in a Patient Receiving Rapid Intravenous Infusion: A Case Report

2019 ◽  
pp. 089719001989486
Author(s):  
Pooja Sudarsan ◽  
Resia Varghese ◽  
Aneena Suresh ◽  
Arun Radhakrishnan
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Case Report ◽  
Normal Saline ◽  
Intravenous Infusion ◽  
Hematological Parameters ◽  
Serum Levels ◽  
Blood Parameters ◽  
Seizure Threshold ◽  
Dose Titration

Paradoxical seizure is an unusual reaction of seizure aggravation or change in its pattern due to antiepileptics. Decrease in seizure threshold with phenytoin is bound to occur with an increase in serum levels. We herein report a 51-year-old female, who was brought to the intensive care unit with complaints of episodic seizures and frothing. She is a known case of tonic–clonic epilepsy on oral phenytoin 100 mg for past 6 months. Rapid intravenous infusion of 700 mg phenytoin in 100 mL normal saline over a rate of 15 minutes was initiated on admission. This was followed by a sudden abnormality of her baseline blood parameters and an occurrence of paradoxical seizure. The dose of phenytoin was tapered which reversed her condition. The patient was followed up regularly and monitored for fluctuations in her hematological parameters. The mainstay treatment for phenytoin-induced paradoxical seizure and blood dyscrasias is to monitor the patient and dose titration. Dosing of phenytoin remains a challenge for all clinicians which increase the need for such reports.

scholarly journals Acute Human Immunodeficiency Virus (HIV) Infection Presenting With Bilateral Interstitial Pneumonia: Case Report and Discussion of Potential HIV-Induced Interstitial Pneumonia

2017 ◽  
Vol 4 (4) ◽  
Author(s):  
Anna Maria Peri ◽  
Laura Alagna ◽  
Serena Trovati ◽  
Francesca Sabbatini ◽  
Roberto Rona ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Human Immunodeficiency Virus ◽  
Intensive Care ◽  
Case Report ◽  
Interstitial Pneumonia ◽  
Antiretroviral Treatment ◽  
Pneumonia Case ◽  
Immunodeficiency Virus ◽  
Acute Hiv ◽  
Hiv 1

Abstract A 50-year-old man was admitted to intensive care unit because of acute respiratory failure due interstitial pneumonia; after admission, a diagnosis of acute human immunodeficiency virus (HIV)-1 infection was made. Clinical and radiological improvement was observed only after introduction of antiretroviral treatment. We discuss the hypothesis of interstitial pneumonia induced by the acute HIV-1 infection.

scholarly journals Lung parenchima changes in neurofibromatosis type 1

2016 ◽  
Vol 73 (2) ◽  
pp. 202-204
Author(s):  
Aleksandra Ilic ◽  
Snezana Raljevic ◽  
Tatjana Adzic ◽  
Vesna Skodric-Trifunovic ◽  
Jelena Stanimirovic
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Case Report ◽  
Neurofibromatosis Type 1 ◽  
Single Gene ◽  
Neurofibromatosis Type ◽  
Nerve Sheath Tumor ◽  
X Rays ◽  
Neurogenic Tumors

Introduction. Neurofibromatosis type 1 (NF1), also known as von Recklinghausen disease, is one of the most common single-gene disorders (mutation on chromosome 17q) and usually associated with cutaneous, musculoskeletal and neurological disorders in humans. NF1 is generally complicated with one or more neurobehavioral disorders or tumors located in the peripheral nervous system such as neurofibromas, peripheral nerve sheath tumor, pheochromocytoma, etc. In the available medical literature, the thoracic manifestations of NF1 have been rarely described in these patients. There are few reports about intrathoracic neurogenic tumors, kyphoscoliosis, pneumonitis and pulmonary fibrosis in patients with NF1. Case report. A 65-year-old female was admitted to the Intensive Care Unit at the Lung Clinic of Belgrade University Clinical Center of Serbia. The patient?s general condition was poor with shortness of breath and present cyanosis. At the same time, the skin changes similar to NF1 were noticed, which were additionally documented by her medical history and diagnosed as NF1. After the application of noninvasive mechanical ventilation and other emergency respiratory medicine measures, the patient soon felt better. The parenchymal changes were viewed by subsequent X-rays and CT scanning of the thorax. Conclusion. This is a case report presenting the NF1 associated with the abnormality of lung parenchyma established during diagnostic procedures at the Intensive Care Unit, Clinic of Pulmonology.

Liver Transplantation for Hemoperitoneum Secondary to Huge Multiple Hemangiomatosis: A Case Report of a Tele-intensive Care Unit in Deceased-Donor Management

2015 ◽  
Vol 21 (6) ◽  
pp. 499-502 ◽  
Author(s):  
Salvatore Gruttadauria ◽  
Duilio Pagano ◽  
Gaetano Burgio ◽  
Antonio Arcadipane ◽  
Giovanna Panarello ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Liver Transplantation ◽  
Intensive Care ◽  
Case Report ◽  
Deceased Donor ◽  
Donor Management

scholarly journals Describing vancomycin serum levels in pediatric intensive care unit (ICU) patients: are expected goals being met

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Talita Muniz Maloni ◽  
Talita Rantin Belucci ◽  
Sandra Regina Malagutti ◽  
Guilherme Henrique Campos Furtado
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Serum Levels ◽  
Icu Patients

scholarly journals Long-Term Rehabilitation for Intensive Care Unit-acquired Weakness with Orthostatic Hypotension Following Severe Pneumonia：A Case Report

2018 ◽  
Vol 55 (6) ◽  
pp. 508-515
Author(s):  
Satoshi Endo ◽  
Michio Kobayashi ◽  
Takafumi Tani ◽  
Shohei Toyama ◽  
Ryota Seo ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Case Report ◽  
Orthostatic Hypotension

scholarly journals COVID-19-Associated Coagulopathy: A Case Report of Thrombosis despite Therapeutic Anticoagulation

2020 ◽  
Vol 2020 ◽  
pp. 1-4 ◽  
Author(s):  
Habiba Hussain ◽  
Matthew Sehring ◽  
Bhagat Singh Aulakh
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Case Report ◽  
Severe Acute Respiratory Syndrome ◽  
Hospital Stay ◽  
Inflammatory Markers ◽  
Morbidity And Mortality ◽  
Management Guidelines ◽  
Disease Prognosis ◽  
Therapeutic Anticoagulation

The Coronavirus disease (COVID-19) pandemic, caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has led to tremendous morbidity and mortality. Various inflammatory markers have been monitored and considered to be associated with disease prognosis. One of the major sources of comorbidity involved has been development of thrombosis alongside the infection. This prothrombotic phenomenon considered, COVID-19-associated coagulopathy (CAC), has been the center of discussion in dealing with this infection. There still remains ambiguity regarding management guidelines for thromboprophylaxis dosing and therapeutic anticoagulation. We present a case of severe SARS-CoV-2 infection complicated by thrombosis despite therapeutic anticoagulation contributing to prolonged intensive care unit and hospital stay.

scholarly journals Effect of Potassium Infusions on Serum Levels in Children during Treatment of Diabetic Ketoacidosis

2020 ◽  
Vol 09 (02) ◽  
pp. 113-118 ◽  
Author(s):  
Sangita Basnet ◽  
Rawan Musaitif ◽  
Aayush Khanal ◽  
Kimberly Powell ◽  
Giovanna Caprirolo ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Retrospective Study ◽  
Diabetic Ketoacidosis ◽  
Treatment Period ◽  
Pediatric Intensive Care ◽  
Serum Levels ◽  
K Value ◽  
Data Points ◽  
Low K

AbstractA retrospective study was done to determine the effect of potassium (K+) infusions on serum levels in children admitted to the pediatric intensive care unit (PICU) with diabetic ketoacidosis (DKA). Eighty-two percent of 92 cases studied received 40 mEq/L K+ infusion over the treatment period of median 13.0 (interquartile range [IQR]: 7–18) hours. The median K+ value at the end of this period was 3.9 (IQR: 3.4–4.2) mEq/L. There were 31 data points of low K+ values (<3.5 mEq/L) and 4 high values (>5.5 mEq/L) during this treatment period. The K+ infusions of 40 mEq/L may be sufficient to normalize serum K+ when treating DKA.

Sign in / Sign up

Export Citation Format

Share Document