Alteration of mental state, a case report
Journal Title: Revista Cuarzo - Year 2016, Vol 22, Issue 1
Abstract
The altered state of consciousness is an issue that can be related with several entities, diagnosis and therefore the appropriate handling relays on the adequate approach to the patient who comes to ER services with such alteration. Here is a clinical case of a 37 patient who was indicted to ER services by a relative with deteriorate state of conscious-ness symptoms associated with dysthermias, visual and auditory hallucinations, general shaking, strong orally rejec-tion, coughing with hemoptoic expectoration, with alcohol consumption background. At the entry he showed general physical discomfort, tachycardia, polypneic, hypertensive, febrile, dehydrated, with low BMI; in neurological level, disoriented with hallucinatory attitude, predominance axial shivering. Therefore, the fi rst possibility was considered as alcohol withdrawal symptoms with delirium tremens. Pulmonary tuberculosis was considered so it was necessary benzodiazepine treatment including agonist a2 and thiamine. He showed improvement only in blood tension fi gures and shaking reduction. However, hallucinatory activities and state of consciousness fl uctuations persist. Complementary tests were taken and they showed cerebrospinal fl uid which suggest bacterial meningitis as well as tubercle bacillus so that a spread spectrum antibiotic cover was started and staggered according to isolation and antimicrobial susceptibility testing. Also meningeal tuberculosis tetra conjugate was made and it showed improvement of the beginning symptoms without neurological effects. CONCLUSION: An appropriate approach to the patient that comes to ER services with mental state alteration, is the most important guide in order to make an accurate diagnosis and start an adequate and effective treatment.
Authors and Affiliations
Monroy Pereira, S. , & Teherán Valderrama, A.
Keywords
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- EP ID EP694603
- DOI https://doi.org/10.26752/cuarzo.v22.n1.147
- Views 143
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