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An 18 Year Old Girl with Recurrent Fever

Patient Name: ABELMOSCHUS160017ESCULENTUS 
 
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This is a HIPAA de-identified open-online-patient-record with initial information in patient's voice, posted here after collecting informed patient consent (form downloadable Click Here)

A 18 year-old-girl presents with the complaints of fever for 2 months and had an initial high grade fever for 15 days associated with chills and rigor for which antimalarial treatment and monocef was given for 8 days. After 10 days she also complained of low backache which was more in the left buttock (pain localized by us to sacra-iliac joints). 
 
Recently she started complaining of fever associated with chills and vomiting, headache and vertigo. She remains alright as long as she takes medicines. 
 
This girl has malaria smear and antigen negative fever which is recurrent (see attached charts) and the fever is responding to chloroquin. She also has skin lesions on forehead and forearms reportedly due to her own scratching (?pathergy).

 






 
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The optimal AEDs therapy of women with epilepsy who are of childbearing age is unclear because of a lack of conclusive data on the comparative teratogenicity of different antiseizure drugs and no antiepileptic drug has proven safe in pregnancy in terms of teratogenesis. Data on the comparative efficacy of various antiseizure drugs for controlling seizures during pregnancy are also quite limited, and there are no randomized trials in this setting. Treatment must be individualized for all patients. Women with epilepsy are classified as high risk during pregnancy and as there are no clear data indicating that any drug is without risk in pregnancy therefore, the antiseizure drug regimen should be optimized six months prior to planned conception.  Choice of antiepileptic drugs in women of childbearing age and  pregnant women with epilepsy:  1. T he antiseizure drug that stops seizures in a given patient is the one that should be used with an exception of valproate. 2.