Introduction:
A 67-year-old female with no significant past medical history presented to the critical care department with symptoms of encephalopathy.
Case presentation:
The patient’s main concerns and important clinical findings-The patient had a history of COVID -19 vaccination [recombinant ChAdOX1 nCoV-19] 14 days prior to the symptoms. The patient underwent MRI brain and cervical spine and lumbar puncture.
The primary diagnoses, interventions, and outcomes- The patient was examined and was sent for MRI brain and cervical spine followed by underwent extensive blood and CSF investigations to rule out any infective, paraneoplastic, connective tissue disorder, or inflammatory disorder. Patient was given steroids and showed good response .Primary diagnosis was kept as vaccine induced ADEM.
CONCLUSION:
The clinical exam, location, sparse contrast enhancement, and CSF findings were all consistent with an acute demyelinating event, and the history of vaccination toghter with clinical situation was favourable for the development of acute disseminated encephalomyelitis.
Colo-renal fistulas are uncommon presentations in the pediatric population and usually have an underlying insult, which can be vascular, infective, inflammatory, penetrating trauma, tumor, or iatrogenic in postintervention or postoperative procedures. Although few cases of such fistulae are published earlier, there is extreme paucity of literature on colo-renal fistulas in association with acute lymphoblastic leukemia (ALL). A thorough literature search revealed only one similar case report in a 15-year-old patient, to the best of our knowledge. Here, we present another case of a 6-year-old female patient, a known case of T-cell ALL with febrile neutropenia, uncontrolled hypertension, and fever spikes. The patient developed a colo-renal-duodenal fistula subsequent to a vascular and infective insult to the right kidney.
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