Clinicopathological Evaluation of the Patients with Febrile Illness and Altered Consciousness Admitted in a Tertiary Level Hospital.

Abstract

This is important to note that altered mental status is not a disease in itself, but rather a symptom with a wide range of potential diagnoses. But a structured approach to assessing the patients with this symptom frequently leads to helpful information and can rule out worst-case scenarios. In cases where fever is followed by changes in consciousness, quick assessment of the patient's level of consciousness and potential causes is decisive. A focused history and physical assessment can help differentiate between structural or medical causes. Asymmetrical neurological findings, such as a dilated and fixed pupil, dysconjugated extraocular movements and asymmetrical motor findings, suggest brainstem dysfunction due to a structural lesion, while symmetrical neurological findings usually indicate a medical disorder. A recent study aimed to identify features of different etiologies, demographic patterns, and common causes of both acute and prolonged febrile illness in patients. This cross-sectional type of observational study was conducted in the Department of Medicine, Mymensingh Medical College Hospital, Bangladesh from April 2014 to October 2015. Over the study period patients admitted with satisfying the inclusion and exclusion criteria of study and purposively selected (non-probability) from the hospitalized patients. Total 100 cases with febrile illness and altered consciousness meeting the exclusion and inclusion criteria were examined and investigated to find out the actual etiology. Out of 100 patients, it was observed that 26(26.0%) of patients were suffering from pneumonia, 22(22.0%) urinary tract infection, 18(18.0%) meningitis, 14(14.0%) typhoid fever, 8(8.0%) meningo-encephalitis, 6(6.0%) cerebral malaria, 4(4.0%) tuberculosis and 2(2.0%) from tuberculoma. The result revealed that large number of patients with febrile illness and altered consciousness were suffering from pneumonia and urinary tract infection.