Multifactorial non-cirrhotic hyperammonaemic encephalopathy

Katherine Elizabeth Triplett, Ronan Murray, Matthew Anstey

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)

Abstract

A 51-year-old female presented with acute confusion associated with a non-specific headache and lethargy. The patient's history included bipolar disorder on valproate and recent travel to northern Vietnam. The patient was subsequently found to have hyperammonaemia as well as a urinary tract infection and bacteraemia withKlebsiellapneumoniaeThe patient was presumed to have a multifactorial non-cirrhotic hyperammonaemic encephalopathy due to a combination of a urinary tract infection and bacteraemia withK. pneumoniae, a urease-producing bacteria, and also valproate use, a medication known to interfere with ammonia elimination. The patient's treatment included supportive care, ceasing valproate, empiric then rationalised antibiotics, N-acetylcysteine and L-carnitine. We present a case of non-cirrhotic hyperammonaemic encephalopathy and explain why it is multifactorial in origin.

Original languageEnglish
Article number223245
JournalBMJ Case Reports
Volume2018
DOIs
Publication statusPublished - 9 Mar 2018

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