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A Case of the Week

Case 97

 A seventy six-year-old male was lying down at the supine position on the floor when a visiting nurse entered his house. Smell of alcohol was found around him. He was transported to our hospital by ambulance. It was unknown when he fell down by himself or when he got the latest meal. The previous chart in our hospital revealed he had virus B hepatitis and received surgical operation for lumbar hernia. He suffered from depression and mild dementia. He had habits of drinking alcohol and smoking. He had severe disorders of orientation, cognition, speaking, and convulsion at admission. He could not answer us about questions: what is his name, where he was, what time it is. Glasgow coma scale 11, E3V3M5. Laboratory test: White blood cells 12140/mm3, neutrophils 88.5 %, CRP 2.34 mg/dL, LDH 316 U/L, troponin I 594.4 pg/mL Brain MRI was taken for further investigation (Fig.1).

What is your diagnosis ?

1. Septic emboli

2. Herpes encephalitis

3. Limbic encephalitis

4. Brain infarction

5. Wernicke encephalopathy


2018.3.21



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