Clinical Reasoning: Clinical Manifestations and Diagnostic Challenges in a 16-Year-Old With Early-Onset Ataxia.

A 16-year-old adolescent girl presented with progressive walking imbalance, uncoordination of her limbs, impaired proprioceptive sensation distal to her wrists and ankles, and sensorineural hearing loss. Her evaluation revealed diffuse cerebellar atrophy, a demyelinating neuropathy, and hypergonadotropic hypogonadism. In this article, we present a systematic approach to a patient with early-onset ataxia, cerebellar atrophy, and demyelinating neuropathy.

Recurrent Cerebral Embolic Infarcts in a Patient With a Mechanical Valve: A Rare Case of Infective Endocarditis Caused by Parvimonas micra.

We present the case of a 60-year-old man with a history of mechanical mitral valve replacement and atrial fibrillation who developed infective endocarditis (IE) caused by (), resulting in recurrent cerebral infarctions. Despite increasing the intensity of anticoagulation therapy with warfarin and adding aspirin, the patient experienced four embolic cerebral infarctions. Following a single fever spike, blood cultures identified , although no other systemic features of IE were present.