Background: Creutzfeldt-Jakob disease is a rapidly progressive, fatal, transmissible neurodegenerative disorder caused by a prion protein. It is characterized by cognitive decline, motor dysfunction, and eventually, death. It occurs globally with 1 case per one million population/year. And It is still considered rare in countries like the Philippines due to challenges in its diagnosis and the under recognition of its clinical features. As of now, the local prevalence or incidence of this disease in our country remains unknown, as only a single case report has been documented. As of now, the local prevalence or incidence of this disease in our country remains unknown, as only a single case report has been documented. Objective: To report a series of patients with probable sporadic CJD from a tertiary hospital in the Philippines. Materials and Methods: Patients with rapidly developing dementia fulfilling the diagnostic criteria for sCJD were included. All were investigated in detail to find out any possible treatable cause, including electroencephalography (EEG), magnetic resonance imaging (MRI) of the brain, and cerebrospinal fluid analysis. Results: A total of 3 patients with probable sCJD were diagnosed using the European diagnostic criterion from January 2022 to April 2023. The clinical features are consistent with other reported series. All 3 patients had the classical EEG findings, typical MRI features, and positive for 14-3-3 assay, and one was positive for RT-QuIC. Two patients died within 13 months from the disease onset. Conclusion This is the first reported case series of probable sCJD in the Philippines from a tertiary hospital in Metro Manila. Like in our patients, this disease should be considered in individuals with rapidly progressive dementia associated with myoclonus, neuropsychiatric symptoms, akinetic mutism, visual abnormality, and ataxia with signs of pyramidal and extra-pyramidal dysfunction. Although a definitive diagnosis must be histopathological, there are ancillary tests that are currently available that allow us to make a probable diagnosis of sCJD possible. Our study raises question about the prevalence of this disease in the Philippines which needs more validated studies from other parts of the country.
Creutzfeldt-Jakob Syndrome ; Neurodegenerative Diseases

Background and Objective: Stroke has remained one of the primary causes of significant morbidity and mortality. Among the therapeutic options for acute stroke management, endovascular thrombectomy is intended to remove the thrombi within the intracerebral vasculature and restore adequate perfusion to the surrounding penumbra. It is recommended up to 24 hours from onset of neurologic symptom. In the Philippines, only a few tertiary healthcare institutions are able to offer and perform endovascular thrombectomies. The aim was to describe the profile and discharge outcomes of endovascular thrombectomy for acute ischemic stroke at a tertiary hospital in our country. Methods: We conducted a retrospective records review among 924 patients admitted for acute ischemic stroke from October 2018 to August 2021 who underwent mechanical thrombectomy. Clinical and functional outcomes were measured using the National Institutes of Health Stroke Scale (NIHSS) and Modified Rankin Score (mRS). Results: Among 31 patients included in the study, 29 subjects (93.5%) had moderate to severe disability (mRS 3–5), and 25 (80.6%) had moderate stroke (NIHSS 6–21) on admission. The identified site of the cerebrovascular thrombi was within the M1 segment of the middle cerebral artery (41.9%, n=13). The stent retriever approach was performed in 19 participants (61.2%). Upon discharge, only 7 (22.6%) had favorable functional outcomes (MRS 0–2), and 9 (29.0%) resulted in mortality. Successful reperfusion was achieved in 92.3% of the patients. Conclusion Overall, endovascular thrombectomy is a possible treatment option for large vessel acute ischemic stroke in developing countries.
thrombectomy ; endovascular procedures ; ischemic stroke ; treatment outcomes

SYNOPSIS: Methicillin resistant staphylococcus aureus (MRSA) is not a common cause of meningitis in an immnuno-competent individual in the community setting. I report a case of a previously healthy 34 year old female who presented with the classic triad of meningitis secondary to community acquired MRSA infection.CLINICAL PRESENTATION: This is a case of a 34 year old female, Filipino from Caloocan City who presented with high grade fever on admission with a 2-day history of upper back pain, later accompanied by neck stiffness, intermittent headache and low grade fever. Except for a minor skin lesion described as scalp excoriations at parietal area of the head, there was no significant finding on systemic physical examination. Neurological examination initially showed a terminal nuchal rigidity becoming more pronounced and accompanied by positive Brudzinski and Kernig's signs on the second hospital day. Cranial CT scan showed no significant findings, blood and wound cultures showed Staphylococcus aureus resistant to oxacillin and other beta lactam antibiotics. Complete blood count showed elevated white cell count with neutrophilia. Initial chest radiograph showed pneumonia on the right middle lobe with progression of infiltrates and pleural effusion in the succeeding tests. Lumbar tap showed normal pressure but cerebrospinal flnid (CSF) analysis was typical of bacterial meningitis. She improved with the administration of Vancomycin in the earlier stages and Linezolid on the later stages. A skin infection secondary to community acquired MRSA infection with bacteremia and meningitis with concomitant pneumonia contributed to the rarity of this case.SIGNIFICANCE: This report aims to raise the importance of a more extensive study on CA-MRSA infections as well as encourage high index of suspicion for MRSA meningitis not only in the immunocompromised, hospitalized and post surgical patients, but also in immunocompetent patients with minor community acquired MRSA infections.
Human ; Female ; Adult ; Methicillin-resistant Staphylococcus Aureus ; Bacteria ; Endospore-forming Bacteria ; Gram-positive Endospore-forming Bacteria ; Gram-positive Endospore-forming Rods ; Staphylococcaceae ; Community-acquired Infections ; Immune System Phenomena ; Staphylococcus ; Staphylococcus Aureus ; Immunocompetence ; Meningitis ; Nervous System Diseases ; Central Nervous System Diseases ; Central Nervous System Infections