Tönges, Lars

[["dc.bibliographiccitation.artnumber","6653"],["dc.bibliographiccitation.journal","Cases Journal"],["dc.bibliographiccitation.volume","2"],["dc.contributor.author","Tönges, Lars"],["dc.contributor.author","Pilgram-Pastor, Sara M."],["dc.contributor.author","Puls, Miriam"],["dc.contributor.author","Schmidt, Holger"],["dc.date.accessioned","2019-07-09T11:52:37Z"],["dc.date.available","2019-07-09T11:52:37Z"],["dc.date.issued","2009"],["dc.description.abstract","For prosthetic heart valves the risk of infection is much higher than for native heart valves. During the course of infective endocarditis 20-40% of all patients suffer from cerebrovascular complications such as ischaemic stroke or intracerebral haemorrhage. We present the case of a 57-year-old woman who had undergone surgery to mechanically replace an aortic heart valve 11 months ago and suffered from repeated ischaemic strokes with secondary haemorrhage. The initial antibiotic regimen was ineffective in treating the later diagnosed Staphylococcus aureus infection of the prosthetic valve. Escalation of the antibiotic treatment was not able to halt the clinical course that finally led to the patient's death. The case report emphasizes the importance of early identification of the aetiology of infection in patients with mechanical heart valve replacement. Without rapid and adequate treatment there is a considerable risk for the development of severe neurological sequelae and cardiac failure that can ultimately result in a fatal course of this clinical picture."],["dc.identifier.doi","10.4076/1757-1626-2-6653"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/5751"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/60238"],["dc.language.iso","en"],["dc.notes.intern","Merged from goescholar"],["dc.notes.intern","In goescholar not merged with http://resolver.sub.uni-goettingen.de/purl?gs-1/13214 but duplicate"],["dc.rights","CC BY 3.0"],["dc.rights.access","openAccess"],["dc.rights.holder","et al.; licensee BioMed Central Ltd."],["dc.rights.uri","https://creativecommons.org/licenses/by/3.0"],["dc.subject.ddc","610"],["dc.title","Septic embolic encephalitis after Staphylococcus aureus endocarditis of a prosthetic valve in a 57-year-old woman: a case report"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.artnumber","829"],["dc.bibliographiccitation.journal","Frontiers in Neurology"],["dc.bibliographiccitation.volume","10"],["dc.contributor.author","Ayzenberg, Ilya"],["dc.contributor.author","Ellrichmann, Gisa"],["dc.contributor.author","Schroeder, Christoph"],["dc.contributor.author","Tönges, Lars"],["dc.contributor.author","Klasing, Anja"],["dc.contributor.author","Pappa, Vaia"],["dc.contributor.author","Brück, Wolfgang"],["dc.contributor.author","Gold, Ralf"],["dc.date.accessioned","2019-11-27T10:45:37Z"],["dc.date.accessioned","2021-10-27T13:21:37Z"],["dc.date.available","2019-11-27T10:45:37Z"],["dc.date.available","2021-10-27T13:21:37Z"],["dc.date.issued","2019"],["dc.description.abstract","Objective: To report a rare case of brainstem encephalitis with low-titer acetylcholine receptor antibodies mimicking myasthenia gravis. Methods: The patient was investigated with repeated brain MRI, CSF examination, repetitive nerve stimulation, thoracic CT, and serologic screening. Our patient passed away and finally autopsy revealed a definitive diagnosis. Written informed consent was obtained from the relatives of the patient for access to clinical files for research purposes and publication. Results: We present a young woman with a subacute bulbar syndrome, who was initially diagnosed with myasthenia gravis based on clinical finding and elevated acetylcholine receptor antibodies. Episodes of numbness in the pharynx and tongue and moderate saccadic horizontal and vertical pursuits were atypical. Despite initial stabilization with intravenous immunoglobulins she developed acute asphyxia after regurgitation of food and had to be resuscitated with ultimately lethal outcome. Autopsy revealed an autoimmune T-cell mediated brainstem encephalitis. Serological screening revealed positive GAD and Ma2 autoantibodies, indicating its probable paraneoplastic nature. Conclusions: Brainstem encephalitis is an important differential diagnosis even in seropositive bulbar myasthenia gravis, as several autoimmune processes often co-occur. Sudden unexpected death must be taken into account in brainstem encephalitis, requiring prolonged monitoring of the patients."],["dc.identifier.doi","10.3389/fneur.2019.00829"],["dc.identifier.pmid","31428040"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/16749"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/92035"],["dc.language.iso","en"],["dc.notes.intern","Migrated from goescholar"],["dc.relation.eissn","1664-2295"],["dc.relation.issn","1664-2295"],["dc.relation.orgunit","Universitätsmedizin Göttingen"],["dc.rights","CC BY 4.0"],["dc.rights.uri","https://creativecommons.org/licenses/by/4.0"],["dc.subject.ddc","610"],["dc.title","Brainstem Encephalitis With Low-Titer Acetylcholine Receptor Antibodies Mimicking Myasthenia Gravis"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]