![]() She was discharged to her home taking furosemide 40 mg/d, enoxaparin 40 mg/d, vitamins, and alimentary supplements (folic acid, B-complex vitamins, and ferrous sulfate). Moreover, she presented anemia secondary to the nephrotic syndrome and pyelonephritis by Enterococcus sp. On examination, an abdominal ultrasonography revealed dilated portal system veins, hepatomegaly with left lobe predominance, and splenomegaly.ĭuring the same hospitalization, a feces exam was performed ( Table 1), and the diagnosis of portal system hypertension and nephrotic syndrome due to schistosomiasis was made. ![]() The patient had had 2 previous hospitalizations in the previous 2 months for investigation of anasarca. According to her husband, approximately 3 hours earlier that morning soon after she woke up, the patient was confused and repeatedly uttering inappropriate words. 2 We report a case of a 37-year-old pregnant woman who developed septic encephalopathy for whom the initial symptom was confusion that evolved with motor deficit and subsequently to coma.Ī 37-year-old woman, 27-weeks pregnant, was transferred to the emergency department of Hospital das Clínicas de São Paulo due to altered mental status. 1 In some cases, SAE may precede other manifestations of sepsis. This large range derives from the different definitions of sepsis and encephalopathy used in the current literature. Sepsis-associated encephalopathy has been reported to occur in 8% to 70% of septic patients. Several conditions commonly associated with sepsis (hepatic or renal dysfunction, electrolyte abnormalities, acid-base disturbances, glycemia disturbances, hypotension, hypoxemia, sedation, body temperature disturbances, and neuroendocrine dysfunction) make SAE evaluation difficult. Email: encephalopathy (SAE) is a poorly understood and underdiagnosed neurological complication of sepsis. ![]() Intensive Care Unit, Emergency Department, Hospital das Clinicas, São Paulo University Medical School - São Paulo/SP, Brazil. Juliana Hiromi Silva Matsumoto Bello Marcelo Park #Altered mental status differential plusSepsis-associated encephalopathy as a differential diagnosis with motor deficit plus altered mental status ![]()
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