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Item A Rare Case of Paraneoplastic Limbic Encephalitis leading to Epileptic Seizure in a Patient with Ovarian Carcinoma(EMERGENCY MEDICINE PHYSICIANS ASSOC TURKEY, 2022-01-01) Aytar, Murat Hamit; Kilickan, Levent; Ustun, Cemal; Akkilic, Elvan CevizciParaneoplastic limbic encephalitis (PLE), a rare and diagnostically-challenging encephalopathy, is frequently associated with an underlying malign neoplastic tumor. Epileptic symptoms are uncommon but can be the first sign of the disease. We present a patient admitted to our intensive care unit (ICU) unit with epileptic seizure and a Glasgow Coma Scale (GCS) of six. All tests and investigations that had been utilized for this patient's diagnosis, including blood tests, serological analyses, magnetic resonance imaging (MRI), electroencephalogram (EEG) and cerebrospinal fluid (CSF) test results were evaluated. The patient had been diagnosed with ovarian carcinoma within the last year. The patient's cancer history, her most recent complaints and MRI results were strongly suspicious for paraneoplastic limbic encephalitis. Her neurological condition improved rapidly in a few days with steroid therapy. This case showed that any neurological deterioration based on an ovarian oncologic disease can bring PLE to mind. The possibility of PLE must be taken into consideration in patients presenting with epileptic seizures after neoplastic diagnoses.Item Importance of Clinical Suspicion in Rapid Diagnostic Test Negativity in Malaria: Two Case Reports(EMERGENCY MEDICINE PHYSICIANS ASSOC TURKEY, 2020-01-01) Gun, Cem; Aldinc, Hasan; Yaylaci, Serpil; Ustun, Cemal; Barbur, ErolIntroduction: Malaria is a life-threatening disease caused by infection with Plasmodium parasites. Rapid diagnostic tests (RDTs) have been used for the diagnosis of malaria without special equipment by unskilled personnel over the last 15 years. The treatment should only be given after the clinical diagnosis confirmed by RDT or microscopy. RDTs' specificity and sensitivity have been reported as >95\% by the World Health Organization - Foundation for Initiative New Diagnostics (WHO-FIND). Case report: A 30-years-old male and a 23-years-old female presented to our emergency department with fever and history of a visit to a malaria-endemic country. Plasmodium trophozoites were seen in the blood smear samples via light microscopy. However, RDTs were negative. The patients were treated according to their pathogens. Conclusion: Rarely, RDT might result in a false negative in the diagnosis of malaria. People travelling to endemic areas should be closely monitored. Emergency department physicians should not neglect microscopy which is the gold standard for diagnosis of malaria.