Abstract
The Sri Lanka Journal of Psychiatry (SLJP) is a peer-reviewed, open access journal published bi annually by the Sri Lanka College of Psychiatrists.The Journal publishes original papers, brief reports including case reports and commentaries relevant to psychiatry and allied sciences. The Sri Lanka Journal of Psychiatry is committed to maintaining and conforming to the editorial and ethical standards recommended by the International Committee of Medical Journal Editors.Cover: Doorways: When one is ill, having somewhere to stay, where one is looked after, is usually a relief to the patient who is not well and his/her family. The picture shows the doorway to what remains of an ancient hospital in Mihintale, said to date back two millennia. Thilini Rajapakse, Department of Psychiatry, Faculty of Medicine, University of Peradeniya, Sri Lanka.
Highlights
Acute rigidity presenting together with confusion and fever, can be a potentially life threatening, rare condition
We describe three patients who presented with similar symptoms and signs to a medical unit, and who were later diagnosed with three different medical conditions
Muscular rigidity is defined as the increase in muscle tone causing resistance to externally imposed joint movements (1)
Summary
Acute rigidity presenting together with confusion and fever, can be a potentially life threatening, rare condition. A 60-year old male, a diagnosed patient of depression, had been started on haloperidol by a general practitioner due to recent altered behaviour He was subsequently admitted to the hospital with a five-day history of high grade fever, muscle rigidity and confusion. Four hours into the hike, he had complained of exertional dyspnoea, faintishness and excessive fatigue On admission, he was drowsy with a GCS of 7/15, was tachypnoeic with an oxygen saturation of 78%, blood pressure of 80/25mmHg, and pulse rate of 150/min. He was drowsy with a GCS of 7/15, was tachypnoeic with an oxygen saturation of 78%, blood pressure of 80/25mmHg, and pulse rate of 150/min He was febrile with a temperature of 40.5 °C and was rigid with opisthotonus. The patient was extubated on day 2, and was sent to a general medical ward on day 5, and his laboratory parameters gradually returned to normal
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