Brandy McKelvy

Acute disseminated encephalomyelitis following seasonal influenza vaccination in an elderly patient

ABSTRACT Although such occurrences are rare, it should be recognized that certain vaccines might trigger serious neurological immune phenomena such as Guillain-Barre syndrome, seizures, cranial neuropathy, and acute disseminated encephalomyelitis (ADEM). Here we report on an elderly woman with ADEM following seasonal influenza vaccination who recovered after plasma exchange.

Recurrent spontaneous pneumothorax.

The patient, a 26-year-old woman, also has many nodular lesions on her face, a hypopigmented lesion on her thigh, and a fleshy plaque on her back. What is the diagnosis?

Lactate gap as a tool in identifying ethylene glycol poisoning

Ethylene glycol toxicity is a known cause of anion gap metabolic acidosis, with the presence of an osmolar gap and the right clinical context suggesting to the diagnosis. Rapid recognition and early treatment is crucial. Unfortunately, ethylene glycol levels are not readily available and must be performed at a reference laboratory. We present a case where recognising the significance of the ‘lactate gap’ assisted in identifying ethylene glycol poisoning.