False impressions from clear cerebrospinal fluid and a normal computed tomography scan: The pressure is still on for a diagnosis

Michaela Cartner, Anthony Holley and Anthony Allworth (2008) False impressions from clear cerebrospinal fluid and a normal computed tomography scan: The pressure is still on for a diagnosis. Emergency Medicine Australasia, 20 3: 276-279. doi:10.1111/j.1742-6723.2008.01095.x


Author Michaela Cartner
Anthony Holley
Anthony Allworth
Title False impressions from clear cerebrospinal fluid and a normal computed tomography scan: The pressure is still on for a diagnosis
Journal name Emergency Medicine Australasia   Check publisher's open access policy
ISSN 1742-6723
1742-6731
Publication date 2008-06-02
Year available 2008
Sub-type Article (original research)
DOI 10.1111/j.1742-6723.2008.01095.x
Open Access Status
Volume 20
Issue 3
Start page 276
End page 279
Total pages 4
Editor Anthony Brown
Place of publication Australia
Publisher Wiley-Blackwell Publications Asia
Language eng
Subject C1
920199 Clinical Health (Organs, Diseases and Abnormal Conditions) not elsewhere classified
110305 Emergency Medicine
Abstract We report the case of a 33-year-old man presenting with seizures following a 3 week, non-specific febrile illness characterized by progressive confusion. Despite the presence of risk factors, his HIV serology was negative and he had no premorbid suggestion of immunocompromise. We describe the difficulties in making the diagnosis of cryptococcal meningitis in the presence of cerebrospinal fluid analysis with the only abnormality initially being hypoglycorrhachia. This case also highlights the importance of measuring an opening pressure, a procedure which should be routine, but is often neglected in the performance of lumbar punctures. Finally, this case reinforces the maxim that cranial CT cannot be relied upon alone to diagnose intracranial hypertension, which also requires clinical examination, including fundoscopy.
Keyword Cryptococcus
diagnosis
intracranial hypertension
meningitis
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2009 Higher Education Research Data Collection
School of Medicine Publications
 
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Created: Thu, 19 Mar 2009, 20:24:45 EST by Sia Athanasas on behalf of Anaesthesiology and Critical Care - RBWH