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Related Concept Videos

Urea Cycle01:23

Urea Cycle

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The urea cycle describes how liver cells convert ammonia to urea. Ammonia is a toxic waste product of protein catabolism. Land animals must convert ammonia into the less toxic urea which can be safely eliminated by the kidneys through urine. Marine animals excrete ammonia directly, and the surrounding water dilutes the ammonia to safe levels.
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Altered States of Awareness01:06

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Altered states of consciousness represent significant deviations from one's normal mental state. These deviations can range from subtle changes in awareness to profound transformations in perception, thought processes, and sensory experiences. Altered states of consciousness can be triggered by various factors, including drug use, meditation, hypnosis, illness, or even intense fatigue.
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Amnesia01:13

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Amnesia is a condition marked by long-term memory loss, which impairs the ability to recall past events or create new memories.
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Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
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Hyperpnea and Hyperventilation01:25

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Hyperventilation refers to a higher-than-normal rate and depth of breathing, often associated with anxiety attacks. This excessive breathing surpasses the body's need to expel CO2, leading to a condition known as hypocapnia - an unusually low level of carbon dioxide in the blood. Hypocapnia can constrict cerebral blood vessels, reducing blood flow to the brain, which may result in dizziness or fainting. Early signs include tingling and muscle spasms in the hands and face, caused by falling...
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Local Anesthetics: Adverse Effects01:12

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While local anesthetics are generally safe and well-tolerated, they can occasionally cause adverse effects that vary in severity. Local anesthetics can induce toxicity at two distinct levels. They can either produce local effects through direct contact with the neural elements or be absorbed into the bloodstream from the injection site, leading to systemic effects.
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Related Experiment Video

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Recording Brain Electromagnetic Activity During the Administration of the Gaseous Anesthetic Agents Xenon and Nitrous Oxide in Healthy Volunteers
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[Reduced consciousness levels caused by hyperammonaemia].

Lisa M Driessen1, Bastiaan C du Pré1, Stephanie C E Schuit1

  • 1Erasmus MC, afd. Interne Geneeskunde, Rotterdam.

Nederlands Tijdschrift Voor Geneeskunde
|October 15, 2019
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A rare, fatal cause of hyperammonaemia (elevated ammonia) is a urinary tract infection by urea-splitting bacteria. Early recognition and treatment of this infection lead to complete recovery.

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Area of Science:

  • Nephrology
  • Infectious Diseases
  • Biochemistry

Background:

  • Hyperammonaemia is a significant clinical sign often associated with lethargy.
  • Urea cycle defects are a common cause of hyperammonaemia, but other causes exist.

Observation:

  • A 27-year-old woman presented with lethargy due to hyperammonaemia.
  • Initial treatment for urea cycle defects worsened her condition, necessitating intensive care.
  • Urine culture revealed Proteus mirabilis, a urea-splitting bacterium responsible for the hyperammonaemia.

Findings:

  • Prompt antibiotic treatment and urine drainage led to complete recovery.
  • Proteus mirabilis, a urea-splitting bacterium, was identified as the cause of hyperammonaemia.
  • Lethargy can be the sole presenting symptom of this condition.

Implications:

  • Urinary tract infections with urea-splitting bacteria represent a potentially fatal, yet treatable, cause of hyperammonaemia.
  • Patients with structural bladder abnormalities are at increased risk.
  • Early diagnosis and appropriate management, including antibiotics and urine drainage, are crucial for a good prognosis.