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BMJ Case Rep. 2019 Nov 28;12(11). pii: e231478. doi: 10.1136/bcr-2019-231478.

Successful treatments of polyarteritis nodosa cerebral vasculitis and recurrent E lizabethkingia meningoseptica septicaemia in a dialysis patient.

Author information

1
Renal Medicine, Treetop Hospital, Hulhumale, Maldives nestorvelasco@hotmail.com.
2
Department of Renal Medicine, Treetop Hospital, Hulhumale, Maldives.
3
Renal Medicine, Treetop Hospital, Hulhumale, Maldives.
4
Department of Radiology, Treetop Hospital, Hulhumale, Republic of Maldives.

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.

KEYWORDS:

diabetes; infections; neuroimaging; renal system

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