COVID-19 is a novel virus which causes a variety of clinical manifestations in the body some of which are still yet to be discovered. The main aim of our study is to highlight the neurological manifestations of COVID-19 as it is still new to the medical world and to emphasize the fact that the physicians have to be vary of the possibility that patients affected with COVID-19 can present with encephalitis. Only a few studies are available so far regarding the neurological manifestations of this novel virus which highlights the need of this study. We present a case series of four patients who were found to have COVID-19 encephalitis. There is still no disease defining test for diagnosis so the mainstay of diagnosis is exclusion of all the common causes of encephalitis. Brain MRI and CSF analysis performs an ancillary in the diagnostic tools. Our study also supports the use of IV Tocilizumab (4-8 mg/kg) and IV methylprednisolone (0.5-2 mg/kg) as possible treatment options with good results as the patients described in our case series responded well to these medications.
We present a case series of 5 patients who were found to have COVID-19
encephalitis. There is still no disease defining test for diagnosis so
the mainstay of diagnosis is the exclusion of all common causes of
encephalitis. Brain MRI and CSF analysis perform an ancillary in the
diagnostic tools.
Scleroderma renal crisis with left ventricular diastolic dysfunction can lead to significant mortality. We presented the case of a 32-year-old female with anuria for 2 days. On further inquiry, she had joint pain, difficulty turning her head sidewise, and associated difficulty in finger movement. Also, hyperpigmentation with superimposed hypopigmentation was reported, which reduced during her pregnancy and worsened post-partum. Her family history suggested similar complaints in her mother. In addition, she had a blurring of vision. She had hypertension, microangiopathic hemolytic anemia, deranged renal function, and retinopathy on ophthalmologic examination. Radiological investigations revealed pulmonary edema, pleural effusion, and left ventricular diastolic dysfunction. Hence, a diagnosis of scleroderma renal crisis complicated by left ventricular diastolic dysfunction was made. She was managed conservatively using anti-hypertensive medications and hemodialysis, which resulted in gradual improvement. Our case highlighted the management approach to this rare presentation with anti-hypertensives and hemodialysis in a resource-limited setting.
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