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Case Report
From Confusional Syndrome to Korsakoff's Encephalopathy: Understanding, Detecting, Treating in a Case
Adolphe Mulumba Mbuyi*
,
Halladain Mpung Mansoj,
Marcellin Bugeme Baguma,
El Hadji Makthar Ba
Issue:
Volume 4, Issue 4, December 2025
Pages:
59-62
Received:
29 July 2025
Accepted:
13 August 2025
Published:
9 October 2025
Abstract: Wernicke-Korsakoff encephalopathy (WKE) is a severe neuropsychiatric complication resulting from thiamine deficiency, most often secondary to chronic alcoholism. It comprises two overlapping conditions: Wernicke’s encephalopathy, characterized by acute neurological dysfunction, and Korsakoff’s syndrome, marked by persistent cognitive deficits, particularly memory impairment. This case report describes a 34-year-old male, chronic alcohol consumer, admitted with acute mental confusion, spatiotemporal disorientation, incoherent speech, and episodes of wandering. Neurological examination revealed no focal motor or sensory deficits but showed severe anterograde amnesia, confabulations, and emotional blunting. Brain MRI demonstrated cortico-subcortical atrophy, and laboratory analysis confirmed thiamine deficiency. The patient received high-dose intravenous vitamin B1 for seven days, broad vitamin supplementation, neuropsychological monitoring, and psychosocial interventions targeting alcohol withdrawal. Within 10 days, orientation and coherence of speech partially improved; however, significant memory deficits persisted at discharge. Neuropsychological evaluation revealed marked impairment in executive function and fixation memory, consistent with Korsakoff’s syndrome. This case emphasizes the importance of early recognition of delirium as a warning sign of thiamine deficiency in at-risk individuals, even in the absence of the complete Wernicke triad. Timely administration of parenteral thiamine is critical to preventing irreversible neurological damage. Furthermore, the case underlines the role of structured neuropsychological assessment in documenting the extent of cognitive impairment, guiding rehabilitation, and monitoring recovery. A multidisciplinary approach involving neurology, psychiatry, nutrition, and social services is essential to optimize functional prognosis, reduce morbidity, and prevent recurrence. This report also supports systematic screening for WKE in chronic alcoholics and other at-risk populations, as well as continued education for healthcare providers to improve early detection and management strategies.
Abstract: Wernicke-Korsakoff encephalopathy (WKE) is a severe neuropsychiatric complication resulting from thiamine deficiency, most often secondary to chronic alcoholism. It comprises two overlapping conditions: Wernicke’s encephalopathy, characterized by acute neurological dysfunction, and Korsakoff’s syndrome, marked by persistent cognitive deficits, part...
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Case Report
Purpura Fulminans in an Immunocompromised Patient with Invasive Pneumococcal Disease: A Case Report
Paulo Fernandes*,
Ana Carina Baldino,
Sara Carvalho,
João Maia Oliveira,
José Vaz
Issue:
Volume 4, Issue 4, December 2025
Pages:
63-67
Received:
1 October 2025
Accepted:
14 October 2025
Published:
30 October 2025
Abstract: Background: Streptococcus pneumoniae is a leading cause of community-acquired pneumonia and invasive pneumococcal disease, particularly in patients with impaired immune function or asplenia. Pneumococcal infections remain associated with high morbidity and mortality, especially when complicated by septic shock and multiple organ failure. Purpura fulminans is a rare but catastrophic dermatologic and hematologic manifestation characterized by rapidly evolving purpuric skin lesions with central necrosis, reflecting underlying systemic coagulopathy. Case presentation: We report the case of a 41-year-old man with antisynthetase syndrome and a history of splenic infarction, who was receiving immunosuppressive therapy. He presented with septic shock, respiratory failure with lung infiltrates, and diffuse violaceous skin lesions. Laboratory findings revealed severe disseminated intravascular coagulation, and Streptococcus pneumoniae bacteremia was confirmed by polymerase chain reaction. Despite the immediate initiation of broad-spectrum antibiotics and intensive care admission for supportive care, his condition deteriorated rapidly, developing refractory multiorgan failure, and death occurred within 12 hours of hospital admission. Conclusions: This case highlights the fulminant and often fatal course of pneumococcal sepsis in high-risk patients. The immunosuppressive therapy and functional asplenia likely contributed to impaired bacterial clearance and overwhelming infection. While empiric antibiotic coverage was appropriate, the rapid clinical decline demonstrates the lethal synergy between severe bacterial sepsis and purpura fulminans associated consumptive coagulopathy. Preventive strategies, particularly pneumococcal vaccination, remain central to reducing the burden of invasive pneumococcal disease in immunocompromised and asplenic individuals.
Abstract: Background: Streptococcus pneumoniae is a leading cause of community-acquired pneumonia and invasive pneumococcal disease, particularly in patients with impaired immune function or asplenia. Pneumococcal infections remain associated with high morbidity and mortality, especially when complicated by septic shock and multiple organ failure. Purpura fu...
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Case Report
Analysis of Myeloid Hypertension in the Treatment of Lumbar Disc Herniation by Uni-portal Bi-channel & Dual-media Spinal Endoscope Lumbar Discectomy
Issue:
Volume 4, Issue 4, December 2025
Pages:
68-74
Received:
26 September 2025
Accepted:
10 October 2025
Published:
31 October 2025
Abstract: Background: The Uni-portal Bi-channel & Dual-media Spinal Endoscope (UBD) is a recently developed, minimally invasive spinal endoscopic technique. This article reviews the mechanism, clinical manifestations, diagnosis, treatment, and prevention of UBD-induced myeloid hypertension-like syndrome (MHI). Case presentation: A 44-year-old man was admitted for low back pain lasting >2 years and progressive left-leg pain for 3 months. Under general anaesthesia, L5/S1 discectomy was performed via an interlaminar approach using the UBD system. Fifteen minutes after extubation he developed head-and-neck and low-back pain, lower-limb numbness, immobility, and agitation. Intravenous midazolam 5 mg, dexmedetomidine 1 μg/kg, methylprednisolone sodium succinate, and mannitol were given for sedation and oedema control. Within 1 h the symptoms improved; they resolved completely after 3 h. Twelve hours post-operatively VAS scores were 1 for low back pain and 0 for leg pain. One month later both VAS scores were 0 and the patient reported no dizziness. Conclusions: MHI is a rare but potentially serious complication of water-medium spinal endoscopy. Prevention, early recognition, and prompt symptomatic and supportive care usually produce symptom relief within 1 h and complete resolution within 24 h. The UBD technique, which allows switching between air and water media, appears effective in preventing and treating MHI.
Abstract: Background: The Uni-portal Bi-channel & Dual-media Spinal Endoscope (UBD) is a recently developed, minimally invasive spinal endoscopic technique. This article reviews the mechanism, clinical manifestations, diagnosis, treatment, and prevention of UBD-induced myeloid hypertension-like syndrome (MHI). Case presentation: A 44-year-old man was admitte...
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Case Report
A Case of Herpes Zoster with Bilateral Double-Striped
Lin Fei,
Shi Jianping*,
Wu Haotian,
Lu Xiaojuan,
Zheng Shuiying
Issue:
Volume 4, Issue 4, December 2025
Pages:
75-78
Received:
13 October 2025
Accepted:
26 October 2025
Published:
3 December 2025
DOI:
10.11648/j.ijmcr.20250404.14
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Abstract: This report presents a case of a patient with bilateral double herpes zoster. This case report details a 60-year-old man who had herpes zoster duplex bilateralis with a history of Hepatitis C, advanced hepatocellular cancer (BCLC stage C), and continuous chemotherapy (bevacizumab, sintilimab, mFOLFOX6). He had a bilateral vesicular lesion that was dispersed throughout the face, neck, chest, and upper arm, which are the locations where nerves are distributed. The eruption began as painful, zosteriform vesicular lesions on the left neck and chest and developed dynamically to include non-contiguous dermatomes on the contralateral trunk and upper arms, accompanied by clusters of blisters, pustules, and blood blisters over the upper arms. Management included intravenous acyclovir, immunoglobulin, and immunomodulation with thymopentin. While the cutaneous lesions showed significant improvement, with blisters crusting over within six days, the patient's condition deteriorated due to a severe pulmonary infection. After treatment with antiviral medication, nerve-nourishing therapy, and immune-function-adjusting medications, the skin lesion improved, but the patient died due to secondary severe pneumonia. This report also analyzes the inducement, pathogenesis, clinical manifestation, treatment, prognosis and cause of death of the disease and the patient in this case. Bilateral zoster is a biomarker of impending systemic collapse rather than just a widespread mucocutaneous incident, it mandates early combination antiviral-immunomodulatory therapy, vigilant surveillance for secondary infections and, whenever feasible, reduction of iatrogenic immunosuppression.
Abstract: This report presents a case of a patient with bilateral double herpes zoster. This case report details a 60-year-old man who had herpes zoster duplex bilateralis with a history of Hepatitis C, advanced hepatocellular cancer (BCLC stage C), and continuous chemotherapy (bevacizumab, sintilimab, mFOLFOX6). He had a bilateral vesicular lesion that was ...
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