Wednesday, July 20, 2016

#QuizTime: Female with weakness of lower limbs

#Quiz time
A 25 year old female who is a marathoner presented to the OPD with weakness of her lower limbs. She said she isn't able to practice as her legs feel very tired. This started with her foot , about a week back, And now her entire leg feels weak.
History is otherwise insignificant , but there is a history of mild fever with a very light maculopapular rash about 4 weeks back, within a span of 3 weeks after she returned from a Running Contest in Brazil.

Examination findings are significant for Decreased tone of both LL upto the muscles below the knee. There is reduction in reflexes.
There is no Myoglobinuria or any other signs of Focal neurological deficit.
After performing nerve conduction studies and CSF tap that revealed proteins 250 g% , Normal glucose , 5 WBCs/HPf a diagnosis was made and you started her on IVIg. She had an uneventful recovery.
She bore a child about a year after her recovery. However , the child's head circumference was lower than 2SD compared to  normal.
A karyotype scan came negative for any anomalies. TORCH screen came back negative. No inborn error of metabolism was detected.
Keeping in mind her history,  a specific RT-PCR was done and a diagnosis was reached.
The mother wants to know how this disease spreads.
The route(s) of transmission of the disease in question can be compared to routes of which of the following diseases ? (More than one correct )
1. Listerial sepsis of the neonate
2. Yellow Fever.
3. Congenital Rubella Syndrome.
4. Bacterial Vaginosis.
5. Pulmonary Tuberculosis.
6. Shigella dysenteriae
7. Gonorrhoea 

#Medicine #Microbiology #Neurology #InfectiousDisease #LongQuestion

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