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A Recipe for Delirium: Community-Acquired Pneumonia and Sickle Cell Anemia With Moyamoya Disease

Franklin Alier1, Lyanne Santana2, Waiz Wasey3

  • 1Psychiatry, Southern Illinois University School of Medicine, Springfield, USA.

Cureus
|November 30, 2022
PubMed

Insights

Moyamoya disease (MMD) is a rare cerebrovascular disorder causing brain artery obstruction. This case highlights MMD

Area of Science:

  • Neuroscience
  • Vascular Neurology
  • Genetics

Background:

  • Moyamoya disease (MMD) is a rare, progressive cerebrovascular disorder characterized by stenosis of the terminal internal carotid arteries and the development of abnormal collateral vessels.
  • MMD can affect individuals of various ethnicities worldwide, often presenting with stroke or transient ischemic attack symptoms.
  • Chronic cerebrovascular changes in MMD can lead to neurological and cognitive deficits.

Observation:

  • A young African American female with a history of sickle cell anemia (SCA) presented with community-acquired pneumonia (CAP).
  • The patient exhibited psychiatric symptoms including paranoia, delusional guilt, and mutism.
  • Undiagnosed Moyamoya disease was identified as a contributing factor to her presentation.

Findings:

  • The co-occurrence of Moyamoya disease and sickle cell anemia presents unique diagnostic and management challenges.
  • Cerebrovascular compromise in MMD can exacerbate neurological symptoms, including psychiatric manifestations.
  • Prompt diagnosis and management of MMD are crucial in patients with complex medical histories.

Implications:

  • This case underscores the importance of considering MMD in patients with unexplained neurological and psychiatric symptoms, particularly those with underlying conditions like SCA.
  • Early recognition and treatment of MMD can potentially prevent severe neurological sequelae.
  • Further research is needed to elucidate the interplay between MMD, SCA, and psychiatric comorbidities.
Keywords:
and transient ischemic attack (tia)community aquired pneumoniainfection induced deliriummoyamoya disease (mmd)stroke

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