Acta Scientific Clinical Case Reports

Case ReportVolume 3 Issue 10

A Case Report of Wernicke’s Encephalopathy in a Patient with Sepsis

A Deepa1 and Rajendra Prasad2*

1PG, Department of Clinical Case Reports, India
2Assistant Professor, Department of Clinical Case Reports, India

*Corresponding Author: Rajendra Prasad, Assistant Professor, Department of Clinical Case Reports, India.

Received: August 19, 2022; Published: September 02, 2022

Abstract

Thiamine (vitamin B1) deficiency is rare but if it occurs can cause vague symptoms like loss of appetite, fatigue, sleep disturbances to severe neurological disorders like polyneuropathy, Wernicke’s encephalopathy and korsakoffs syndrome and Cardiovascular manifestations like high output cardiac failure primarily in alcoholics. Many patients with sepsis, critical illness develop altered mental states, variously described as disorientation, confusion, delirium and encephalopathy without obvious explanation.

We report a case of wernickes encephalopathy in sepsis with acute kidney injury in a 36 year old male who is chronic alcoholic without other Comorbidities who presented with high grade fever, vomiting’s since 3 days, altered sensorium and difficulty in walking since 1 day. Leucocyte count was elevated on hemogram, renal function tests were abnormal suggesting acute kidney injury, ESR and CRP were raised. MRI findings were suggestive of Wernicke’s encephalopathy and there was significant improvement in symptoms after thiamine supplementation.

Keywords: Thiamine; Leucocyte; Wernicke’s Encephalopathy

Bibliography

  1. “Harrisons principles of internal medicine”. 20th edition pages 2080,2081,3279,2310,3112-3113.
  2. Attaluri P., et al. “Thiamine deficiency: An important consideration in critically ill patients”. The American Journal of the Medical Sciences 4 (2018): 382-390.
  3. Lacobone E., et al. “Sepsis associated encephalopathy and its differential diagnosis”. Critical Care Medicine 37 (2009).
  4. Sonneville R., et al. “Understanding brain dysfunction in sepsis”. Annals of Intensive Care (2013).
  5. Frontera JA. “Metobolic encephalopathies in the critical care unit”. Continuum (Minneap Minn)3 (2012): 611-639.
  6. Xin Y., et al. “Severe sepsis as an initial presentation in children with Wernickes encephalopathy :report of a case and literature review”. Zhonghua Er Ke Za Zhi8 (2011): 612-616.
  7. Branco de Oliveira MV., et al. “Encephalopathy responsive to thiamine in severe covid-19 patients”. Brain, Behavior, and Immunity – Health 11 (2021).
  8. Manzanares W., et al. ““Thiamine supplementation in the critically ill”. Current Opinion in Clinical Nutrition and Metabolic Care 6 (2011): 610-617.
  9. Wijnia JW., et al. “Severe infections are common in Thiamine deficiency and may be related to cognitive outcomes: A cohort study of 68 patients with wenickes korsakoff syndrome”. Psychosomatics (2016).
  10. Kohnke S., et al. “Don’t seek, don’t find: The diagnostic challenge of wernickes encephalopathy”. Annals of Clinical Biochemistry 1 (2021): 38-46.
  11. Galvin R., et al. “EFNS guidelines for diagnosis, therapy and prevention of wernickes encephalopathy”. European Journal of Neurology12 (2010): 1408-1418.
  12. Donnino MW., et al. “Myths and misconceptions of Wernickes encephalopathy: what every emergency physician should know”. Annals of Emergency Medicine6 (2007): 715-721.

Citation: A Deepa and Rajendra Prasad. “A Case Report of Wernicke’s Encephalopathy in a Patient with Sepsis". Acta Scientific Clinical Case Reports 3.10 (2022): 10-11.

Copyright: © 2022 A Deepa and Rajendra Prasad. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.



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