It is very rare uncommon for those above 60 years of age to contract either malaria or typhoid. These disease are prevalent only among those in the age group of 15-50 years of age, says Dr Rajesh Shankar Iyer, Consultant Neurologist and Epileptologist of KG Hospital.
In regard to a case study of a 64-year-old female patient presented recently for the Post-Graduate medical students in KG Hospital, Dr Rajesh Shankar Iyer said that pneumonia is the common affliction that hits children and those above 60 years of age.
In the present case, the patient was suffering from fever, on and off, for the past 10 days, particularly the temperature ran high in the evenings. She had lost her appetite, got headache and had 3 episodes of vomiting a couple of days ago.
She took self-medication for some time and got a brief respite from headache. As the headache persisted she got admitted to another hospital where she was diagnosed to be having low sodium level. When she started getting altered sensorium she was referred to KG Hospital.
Dr Rajesh Shankar Iyer pointed out that from the symptoms it could be surmised that the patient was suffering from one of the following four possibilities: febrile encephalopathy, meningitis or meningoencephalitis, metabolic abnormalities and stroke.
He noted that stroke could present itself as encephalopathy. He also noted that “strategic infarcts” lead to memory impairment. In the present case, the persisting fever indicated that it could be febrile encephalopathy.
He suggested carrying out a test to determine the CSF (cerebrospinal fluid) glucose level to ascertain whether there was a hypoglycorrhacia (a low glucose level in CSF). At the same time, blood glucose level should also be assessed for arriving at the right diagnosis, he added.