Plantar fasciitis is a commonly occurring form of heel pain that affects many people once in their lifetime. Plantar heel pain is not inflammatory because it develops due to a gradual degenerative process. In most cases, plantar fasciitis affects runners, but sedentary people are also at risk. The condition occurs when repetitive microtrauma to the plantar fascia occurs, resulting in severe pain localized to the plantar foot and medial heel that interferes with daily life activities. Common risk factors contributing to plantar fasciitis include standing or sitting for prolonged periods, increased body mass index (BMI), and limited ankle dorsiflexion. In 80% of the cases, the symptoms of acute plantar fasciitis improve within a year of proper treatment. A clinical diagnosis is required to detect the symptoms of plantar fasciitis, which include non-radiating, dull, and aching pain experienced in the medioplantar surface of the foot. The pain is mostly experienced in the morning, but it also worsens at the day's end. Besides physical examination and patient's medical history, ultrasonography is a valuable diagnostic tool for diagnosing plantar fasciitis. Usually, a physician starts the treatment by stretching the plantar fascia, ice massaging, and prescribing non-steroidal anti-inflammatory drugs. Other treatment modalities include orthoses and night splints. If a patient is diagnosed with recalcitrant plantar fasciitis, surgical procedures, corticosteroid injections, and extracorporeal shockwave therapy become necessary. If a patient with plantar fasciitis continues to experience pain that limits the function of plantar fascia and activity, then the condition is treated with endoscopic fasciotomy.
Brucellosis is a common infection that rarely causes cerebral venous sinus thrombosis (CVST). In this case, a 23-year-old male presented to the emergency department with status epilepticus. With a past medical history of drinking unpasteurized camel milk, elevated inflammatory markers, and evidence of brucellosis in the serum, the patient was diagnosed with brucellosis. Further investigations revealed left transverse sinus thrombosis extending to the jugular vein. The patient was treated with enoxaparin and a combination of doxycycline, ceftriaxone, and trimethoprim-sulfamethoxazole. This regimen led to rapid and significant clinical improvement in the signs and symptoms of the patient. CVST is a rare complication of neurobrucellosis that might present with signs and symptoms of meningitis. This case report highlights the importance of keeping neurobrucellosis as a possible cause of CVST in patients living in an area endemic to brucellosis.
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