Praxis
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Case Reports Comparative Study
[44 year old gardener with lower back pain, myalgia and fever].
We report the case of a 44 year old female gardener who presented to our emergency ward with lumbago, myalgia and fever of 39 degrees Celsius. She also reported acholic stools, darker looking urine and ikteric skin complexion. The patient was suffering from acute hepatitis A virus induced liver failure and was rapidly announced to a liver transplant centre. ⋯ As a source of infection to possibilities were identified. Eating shellfish at the East Sea 4 weeks prior to admission or handling natural animal dung during her work as a gardener. One year after the event the patient once again is healthy and well.
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The trigeminal neuralgia is characterised by paroxysmal appearing fulgurous stabbing pain. Its medical condition is caused through a local-circumscribed demyelinisation of the trigeminal nerve with consecutive conduction of salting impulses on afferent pain fibres. It is essential to differentiate the symptomatic from the idiopathic trigeminal neuralgia. ⋯ Thereby, causal surgery in form of microvascular decompression is not only the operative treatment of choice, but because of the excellent results also a fundamental support of the theory of vascular compression. A comprehensive knowledge about diagnosis and management of trigeminal neuralgia is essential to treat patients efficiently and successfully. This synopsis summarises the current recommendations concerning diagnostics and therapeutic options.
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Ramsay Hunt syndrome (RHS) is defined as a peripheral facial nerve palsy accompanied by an erythematous vesicular rash on the ear (zoster oticus) and hard palate. It is known that varicella zoster virus (VZV) causes RHS. ⋯ We report on a 14-year-old boy who had RHS accompanied by meningitis. Polymerase chain reaction identified VZV in exudates from the geniculate zone of the ear, the hard palate and in the CSF.