Jas (Jazz)
speaker
90 appearances
1 recordings
1 series
first heard Jul 2026
last heard 31 Jul
Jas (Jazz)’s voice in public audio — every appearance, attributed to the second.
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recordings per month · last 12 monthsRecordings per month over the last 12 months — 1 in all, peaking in Jul 2026 with 1.
Appearances
Yeah, it's been fun, but June's been a very tiring month.
How about you, Mukund?
Awesome.
Great aliquot and such a great job in aliquot one by both Enmal and Mukund.
So I think when I seen these two aliquots so far, I think my reflex thought of like something I cannot miss is an acute CNS infection.
Why am I thinking that?
Well, a patient has a high-grade fever, headache, neck pain, and profound confusion with the recent episode of Otitis Media, which I'll touch upon in a second.
You can easily say that initial symptoms...
Why can this not be an acute ischemic stroke, especially with a rapid progression?
However, I think one thing I will say is that in how many times I've seen strokes, agitation and coma are not typical, especially the agitation part.
That, to me, is a clue that there's more of a diffuse meningoencephalopathic process going on.
And why is the recent otitis media such an important clue?
It could be the potential source of a continuous intracranial spread of infection.
Recall that streptococcal pneumonia is the most common cause of community acquired pneumonia, acute bacterial otitis media, and sinus infections.
bacterial sinus infections.
Because those are very common causes of community-acquired infections, streptococcal pneumonia is also the most common community-acquired bacterial meningitis.
So does this relatively benign or normal otoscopic examination exclude this?
No, because the patient was already getting amoxicillin clavulanic acid.
And it's possible that that could have partially treated or obscured the original ear findings.
Plus, I'll be honest, sometimes I miss certain things on the ear exam.
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