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  • Successful treatments of polyarteritis nodosa cerebral vasculitis and recurrent Elizabethkingiameningoseptica septicaemia in a dialysis patient

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Reminder of important clinical lesson
Case report
Successful treatments of polyarteritis nodosa cerebral vasculitis and recurrent Elizabethkingiameningoseptica septicaemia in a dialysis patient
  1. Nestor Velasco1,
  2. Sital Karki2 and
  3. Oscar Rafael Tenreiro1,3
  1. 1Renal Medicine, Treetop Hospital, Hulhumale, Maldives
  2. 2Department of Renal Medicine, Treetop Hospital, Hulhumale, Maldives
  3. 3Department of Radiology, Treetop Hospital, Hulhumale, Republic of Maldives
  1. Correspondence to Dr Nestor Velasco; nestorvelasco{at}hotmail.com

Abstract

We report a case of cerebral vasculitis in a 31-year-old woman who presented with chronic kidney disease stage 5, labile hypertension and severe headaches. The diagnosis of cerebral vasculitis made on magnetic resonance angiography (MRA) and late diagnosis of polyarteritis nodosa were made by conventional CT angiography. Immunosuppression was complicated by recurrent septicaemia due to Elizabethkingia meningoseptica. Treatment of the vasculitis resulted in marked improvement of MRA appearances, headaches and anxiety and stabilisation of blood pressure. The septicaemia required parenteral quinolone treatment and oral cotrimoxazole.

  • infections
  • renal system
  • diabetes
  • neuroimaging

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bcr-2019-231478

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    Footnotes

    • Twitter @sitalcoolk

    • Contributors NV diagnosed and treated the patient and wrote the case report. SK helped in the management of the patient and wrote the paper. ORT diagnosed the patient and wrote the case.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.