This man "blanks out" and stops talking to his family. You could describe him as being almost "shellshocked". Further possible treatments are available at www.quizdoc.com

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Male 33 Years Old

This patient has an acute frontal lobe brain injury with a "blanking" effect typical of PaillSpectrum infection. There is suspicion of deep brain involvement with the loss of ability to speak in the acute phase. The patient recovered very well on anitbiotic therapy and resumed his normal life.

1st September, 2003
Presented acutely ill, in the company of his wife

There is a 4 day history of : irritability, personality change: he has been staring and not answering.

He is aggressive to family members which is totally out of character
He complains of headache
Yesterday, he had trouble keeping awake

He is not understanding any conversations around him
He has had some trouble reading : words are jumbled
He apparently could not hear or seemed to act like he was not hearing things said around him.

The wife was worried enough about him to take him to hospital, but they gave up after a 5 hour wait.
They went to another Medical centre. Here he had a CT scan of his head. This was reported to me by the patient and his wife as being normal.

A similar event happened about three years ago. It faded over a few days.

Patient agrees:
He sleeps 8.30pm – 6.30am for the last 1-2 months
At work has been feeling a bit sluggish
Slight depression

.On examination:
Eyes red
He has a moderately red and infected throat with some evidence of bacterial infection.
Ears : impression of bilateral of acute middle ear problems (Eustachian tube insufficiency), with scarred and slightly red tympanic membranes.

Treatment:
Chloramphenicol (antibiotic) eye drops
XXXXX Oral (Antibiotic) daily

5th September, 2003
Has finally started to get a bit better in the last day
Still a bit confused, irritability faded
Headache Gone
CT reviewed : seems fairly normal : maybe  some deep changes but cannot be sure: report says all OK

On Examination:

Pulse Rate 84 regular (normal)
BP 130/80 (normal)
Slightly red throat only: better than previously.
Looks sort of a bit flat

Depressed : No
Confusion: No
Bruises : No

.Discussed with Wife approximately two week later: after new treatment.
He is very well
Mood and irritability back to normal. He is no longer aggressive.
Starting to do things around the house

Has returned to work at last under his own steam
Not sleeping so much
Looking and acting much better

He is speaking and communicating quite well.