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We report the case of a 47 year-old female with Streptococcus agalactiae (Group B beta-hemolytic streptococcus) meningitis complicated by hemorrhagic stroke. The patient presented to the emergency department with altered mental status, agitation, confusion, respiratory distress and fever of one-day duration. Labs showed left shift leukocytosis. CSF exhibited a high white blood cell count with a predominant population of polymononuclear cells, high glucose and protein concentration. CSF cultures grew S. agalactiae. Despite appropriate antimicrobial treatment, her mental status did not improve and head CT showed two hemorrhages, diffuse cerebral edema and a right to left midline shift. After completing the course of her therapy, her mental status improved and the patient was discharged.
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http://dx.doi.org/10.1016/j.idcr.2015.10.002 | DOI Listing |
JAMA Pediatr
September 2025
Department of Pediatrics and Emergency Medicine, Children's National Hospital, George Washington University, Washington, DC.
Importance: Adolescents account for almost half of the 2.5 million diagnosed sexually transmitted infections in the US annually, and the emergency department functions as the primary source of health care for many adolescents. No recommendations exist for emergency department gonorrhea and chlamydia screening.
View Article and Find Full Text PDFJAMA Netw Open
September 2025
Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan.
Importance: Previous studies have suggested that social participation helps prevent depression among older adults. However, evidence is lacking about whether the preventive benefits vary among individuals and who would benefit most.
Objective: To examine the sociodemographic, behavioral, and health-related heterogeneity in the association between social participation and depressive symptoms among older adults and to identify the individual characteristics among older adults expected to benefit the most from social participation.
J Telemed Telecare
September 2025
School of Medicine, The University of Queensland, St Lucia, QLD, Australia.
In this case, we describe the remote telehealth leadership of emergent tube thoracostomy in a patient with a critical respiratory status. The patient had presented to a small rural health care facility with breathlessness and hypoxia despite supplemental oxygen. A subsequent chest x-ray revealed a large pneumothorax requiring emergent treatment to prevent respiratory demise.
View Article and Find Full Text PDFClin Auton Res
September 2025
Faculty of Medicine, Department of Medicine, Ageing and Age-Associated Disorders Research Group, Division of Geriatric Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
Background: Orthostatic hypotension (OH) is prevalent in older adults and is often associated with falls. However, the presence or absence of symptoms in OH may be mediated by cerebral autoregulation, which helps maintain cerebral perfusion during blood pressure fluctuations.
Methods: We recruited 40 older adults (aged ≥ 55 years) from the Malaysian Elders Longitudinal Research (MELoR) cohort.