Diagnostic challenge – West Nile encephalitis mimicking stroke – case report

West Nile virus (WNV) is widely distributed around the world. The WNV is maintained in nature by a cycle involving mosquitoes and birds, which are presumed to be the most important amplifying hosts. We present the case of a 75 years old male patient admitted to the neurology department for several symptoms that could be attributed to a stroke. The symptomatology had an acute onset. The computed tomography and the magnetic resonance imaging revealed lacunar stroke in right semioval center. The final diagnosis was established by the lumbar punction: West Nile virus was highlighted in the cerebrospinal fluid,clinical evolution was favorable, the patient was discharge with minimal neurologic deficits

Severe Intentional Corrosive (Nitric Acid) Acute Poisoning: A Case Report and Literature Review

Despite being one of the most debilitating conditions encountered in the field of toxicology, there is a lack of neutralization measures for the toxins involved in acute corrosive poisoning, and this promotes progressive contact injury of deep tissues after poisoning has occurred. Multiple controversies still surround management strategies during the acute phase of poisoning and the long-term follow-up of the patient. Here, we report a severe case of intentional poisoning with nitric acid complicated by extensive injury of the upper digestive tract, multiple stricture formation, and complete dysphagia. Serial endoscopic dilation and insertion of a jejunostomy feeding tube were necessary, and underlying psychiatric illness negatively affected the outcome of the patient. We conclude that an interdisciplinary approach is necessary to properly reduce the extent of lesions and sequelae induced by corrosion. Early endoscopic mapping of injuries is of major importance to better predict the evolution and possible complications of poisoning. Interventional and reconstructive surgical procedures may significantly improve the life expectancy and quality of life of patients following intoxication with corrosive substances