Intracranial Infection Mimics Acute Stroke in an Adolescent Male

Abstract

An 18-year-old male adolescent was brought to the emergency department by ambulance from a residential substance use disorder treatment program. His chief complaint was weakness. Medics reported that approximately 2 hours prior to arrival at the emergency department, the patient told program staff that he had weakness in his right hand and a headache. The patient maintained normal vital signs during transport and demonstrated no objective neurologic deficits. The patient’s medical history included polysubstance use disorder (alcohol, marijuana, and benzodiazepines), migraine headaches, and a recent sinus infection. The patient reported that he recently completed treatment for the sinus infection with an unknown antibiotic. The medics reported that the patient had no known use of tobacco products, inhalants, cocaine, or methamphetamines but that previously he may have used IV drugs. The patient had no known history of immunosuppression, hospitalizations, surgeries, or trauma. Current medications included acetaminophen, ibuprofen, and gabapentin for chronic headache pain. Cristy L. Galvin, Member, Massachusetts ENA Mayflower Chapter, is Emergency Department Per Diem Staff Nurse, Tufts Medical Center and Floating Hospital for Children, Boston, MA, and Family Nurse Practitioner (MSN) Graduate, University of Massachusetts, Boston, MA. Patricia A. Normandin, Member, Massachusetts ENA Beacon Chapter, is Emergency Department Staff Nurse, Tufts Medical Center and Floating Hospital for Children, Boston, MA, and Adjunct Nursing Faculty, Massachusetts General Hospital Institute of Health Professions, Boston, MA. Karolyn S. Horn is Clinical Pharmacist Specialist, Tufts Medical Center and Floating Hospital for Children, Boston, MA. Justin C. Popso is Emergency Physician, Tufts Medical Center and Floating Hospital for Children, Boston, MA, and Member of the American College of Emergency Physicians.