MedBugs: SAQ #135

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Case: HSV transverse myelitis

A 22-year-old woman presents to your Emergency Department with bilateral lower limb weakness that has progressed within the last 24 hours. She has a history of rheumatoid arthritis and is on methotrexate. On examination she has a vesicular rash on the right upper limb.

1. Other than transverse myelitis, complete the table providing (2) examples of conditions that could result in respiratory distress or respiratory failure under the following categories: spinal cord / peripheral nerve / neuromuscular junction disease. (6 marks) 6 marks

You suspect HSV transverse myelitis.

2. What is an appropriate antimicrobial therapy including drug name, dose and route? (1 mark) 1 mark

You want to assess her need for mechanical ventilation.

3. List and justify (5) signs and/or bedside investigations that you can utilise to guide this assessment. (5 marks) 5 marks

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Case: HSV transverse myelitis

1. Other than transverse myelitis, complete the table providing (2) examples of conditions that could result in respiratory distress or respiratory failure under the following categories: spinal cord / peripheral nerve / neuromuscular junction disease. (6 marks) 6 marks

2. What is an appropriate antimicrobial therapy including drug name, dose and route? (1 mark) 1 mark

3. List and justify (5) signs and/or bedside investigations that you can utilise to guide this assessment. (5 marks) 5 marks

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