Browsing by Author "Tilakaratna, P.M.Y.I."

Filter results by typing the first few letters
Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Case Report: Dengue hemorrhagic fever with ischemic stroke.
    (American Society of Tropical Medicine and Hygiene, 2022) Basnayake, B.W.M.K.E.; Somaratne, K.G.S.K.; Goonetilleke, C.U.; Tilakaratna, P.M.Y.I.; Ranawaka, U.K.
    Several neurological manifestations are recognized in dengue infection, but stroke is a rare complication. We report a case of ischemic stroke in a patient with dengue hemorrhagic fever. A 52-year-old previously healthy male presented with a history of fever for 2 days, and left-sided weakness and numbness of sudden onset. MRI scanning showed a right-sided thalamic lacunar infarct. Diagnosis of dengue fever was made based on leuco-thrombocytopenia, positive dengue nonstructural protein-1 (NS-1) antigen, and positive dengue IgM antibodies. Severity of limb weakness correlated with the critical phase of dengue hemorrhagic fever (DHF). He was discharged home with good recovery from neurological symptoms and disability. Strokes are rare in dengue, and are mainly hemorrhagic strokes related to thrombocytopenia. Ischemic stroke is even rarer. More evidence is needed for confirmation of dengue as a pathogenic mechanism of ischemic stroke.
  • No Thumbnail Available
    Item
    Retrospective analysis of Pyrexia of Unknown Origin (PUO) among adult patients in a Tertiary Care Hospital in Sri Lanka
    (Sri Lanka Medical Association, 2021) Premathilaka, L.H.R.A.; Darshana, L.G.T.; Liyanage, I.K.; Nishshanka, N.A.S.; Gamage, M.P.; Gunasena, J.B.; Sajeethan, P.; Mendis, B.M.I.U.; Shashiprabha, W.M.M.; Tilakaratna, P.M.Y.I.; Premawardhena, A.P.
    Introduction and Objectives Pyrexia of “unknown origin” remains a clinical entity universally despite advances in diagnostic technologies. There are few if any systematic studies on PUO conducted in Sri Lanka. We retrospectively analysed data of patients with PUO from a tertiary care hospital. Methods Records of PUO patients admitted to Colombo North (Teaching) Hospital during the period of January 2015 – January 2020 were extracted from the archives. Details of etiology, diagnosis and usage of medication of each patient was recorded. Results A total of 100 PUO patients were recruited. Majority were males (n=55;54.5%). Median ages of male and female patients were 53.0 and 50.0 years respectively. A final diagnosis had been reached in the majority (n=65;65%). Mean number of days of hospital stay was 15.16 (SD; 7.81). Median of the total number of fever days among PUO patients was 30.5. Out of 65 patients whose etiology were identified, the majority were diagnosed with an infection (n = 47; 72.31%) followed by noninfectious inflammatory conditions (n=13; 20.0%) and malignancies (n=5; 7.7%). Tuberculosis was the commonest infection detected (n=15; 31.9%). Mean number of days taken to reach the final diagnosis was 11.57 (SD: 11.42). Contrast enhanced CT scan (CECT) pelvis/abdomen (n = 15; 23.1%) was the commonest investigation leading to the final diagnosis. Antibiotics had been prescribed for the majority of the PUO patients (n=90; 90%). Conclusion Infections, mainly tuberculous, was the commonest cause for PUO while a third of patients remained undiagnosed despite a prolonged hospital stay.