Encephalitis on deployment in Kenya: think beyond the infections.

Thompson, Daniel Cameron and Bailey, M S and Bowley, D and Jacob, S (2019) Encephalitis on deployment in Kenya: think beyond the infections. Journal of the Royal Army Medical Corps, 165 (5). pp. 374-376. ISSN 2052-0468.

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Official URL: https://militaryhealth.bmj.com/content/165/5/374.l...

Abstract

A 34-year-old female soldier presented with fever and behavioural changes while deployed in Kenya and was diagnosed with encephalitis. The patient underwent urgent aeromedical evacuation to the Queen Elizabeth Hospital, Birmingham for further management. Microbiology tests excluded common infectious causes that are endemic in the East Africa region. However, an autoantibody screen was positive for antibodies against the N-methyl-D-aspartate receptor (NMDAR). Full body imaging confirmed the presence of limbic encephalitis and an ovarian mass suggestive of a teratoma. The patient was diagnosed with ovarian teratoma-associated anti-NMDAR encephalitis, a potentially fatal disease. The patient underwent surgery to remove the teratoma and commenced immunotherapy with steroids, plasma exchange and rituximab. This case highlights the diagnostic challenges of fever with behavioural changes in military personnel deployed in a tropical environment.

Item Type: Article
Subjects: QW Microbiology. Immunology
WD Diseases and disorders of systemic, metabolic or environmental origin > WD350 Immunologic diseases
WO Surgery
Divisions: Ambulatory Care > Theatres
Planned IP Care > General Surgery
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Depositing User: Beth Connors
Date Deposited: 28 Jan 2020 11:20
Last Modified: 28 Jan 2020 11:20
URI: http://www.repository.uhblibrary.co.uk/id/eprint/2803

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