Acute Hemorrhagic Leukoencephalitis: Multimodal Diagnosis and Treatment

  We report a case of a previously healthy 26 year old male, admitted to the intensive care unit due to cerebral oedema. The patient was admitted 3 days earlier to the neurological department because of sudden onset of headache and vision disturbances. The brain MRI on admission revealed an extended right parietooccipital lesion with marginal contrast enhancement and extension towards the corpus callosum. The patient quickly deteriorated, became comatose and was intubated and transferred to the intensive care unit. In order to control intracranial hypertension, decompressive craniectomy was decided which also allowed for a brain biopsy. According to clinical, radiological and laboratory data, acute disseminated encephalomyelitis was the working diagnosis. The patient was treated with high dose corticosteroids and plasmapheresis sessions and gradually improved and transferred to a rehabilitation center. Brain biopsy concluded to acute hemorrhagic leucoencephalitis or Hurst disease, a variant of acute disseminated encephalomyelitis. 

Fever and multilobular mass of the right lung in a young adult with asthma

We report a case of a 37-year-old mild asthmatic male presenting with fever, productive cough and chest pain. The chest x-ray showed a multilobular perihilar shadow of the right lung with a mass-like appearance, confirmed by the CT-scan. He was diagnosed with allergic bronchopulmonary aspergillosis (ABPA). ABPA usually manifests as chronic asthma, recurrent pulmonary infiltrates and bronchiectasis. However, it can rarely be seen in patients with mild asthma and with an unusual radiological presentation of a solid mass

Acute generalized livedo racemosa caused by Capnocytophaga canimorsus identified by MALDI-TOF MS

Independent of the size of the dog and the type of injury, serious infections may follow a dog bite and these may result in the abrupt onset of multiorgan failure. Early recognition of the warning signs with regard to the underlying severity of the infection is of the utmost importance. Reticulate skin eruptions constitute a precursory phenomenon

Regulation of breathing pattern by IL-10

Proinflammatory cytokines like interleukin-1 beta (IL-1 beta) affect the control of breathing. Our aim is to determine the effect of the anti-inflammatory cytokine IL-10 on the control of breathing. IL-10 knockout mice (IL-10(-/-), n = 10) and wild-type mice (IL-10(+/+), n = 10) were exposed to the following test gases: hyperoxic hypercapnia 7% CO2-93% O-2, normoxic hypercapnia 7% CO2-21% O-2, hypoxic hypercapnia 7% CO2-10% O-2, and hypoxic normocapnia 3% CO2-10% O-2. The ventilatory function was assessed using whole body plethysmography. Recombinant mouse IL-10 (rIL-10; 10 mu/kg) was administered intraperitoneally to wild-type mice (n = 10) 30 min before the onset of gas challenge. IL-10 was administered in neonatal medullary slices (10-30 ng/ml, n = 8). We found that IL-10(-/-) mice exhibited consistently increased frequency and reduced tidal volume compared with IL-10(+/+) mice during room air breathing and in all test gases (by 23.62 to 33.2%, P < 0.05 and -36.23 to -41.69%, P < 0.05, respectively). In all inspired gases, the minute ventilation of IL-10(-/-) mice was lower than IL-10(+/+) (by -15.67 to -22.74%, P < 0.05). The rapid shallow breathing index was higher in IL-10(-/-) mice compared with IL-10(+/+) mice in all inspired gases (by 50.25 to 57.5%, P < 0.05). The intraperitoneal injection of rIL-10 caused reduction of the respiratory rate and augmentation of the tidal volume in room air and also in all inspired gases (by -12.22 to -29.53 and 32.18 to 45.11%, P < 0.05, respectively). IL-10 administration in neonatal rat (n = 8) in vitro rhythmically active medullary slice preparations did not affect either rhythmicity or peak amplitude of hypoglossal nerve discharge. In conclusion, IL-10 may induce a slower and deeper pattern of breathing