Submit Manuscript | http://medcraveonline.com and a witnessed grandmal seizure. Physical examination, electrocardiogram, urinalysis, chest X-ray, and cranial computed tomography were unremarkable. Serum Na was measured at 119mmol/L (136-145mmol/L) compared to 131mmol/L last week prior to antibiotic use. Other labs included TSH 0.94U/L, glucose 109 mg/dl , K 3.9 (3.5-5.1mmol/L), SOsm 245mOsmL/ kg (280-303mOsm/Kg), BUN 10mg/dL (7-18mg/dl), SCr 0.9mg/ dL (0.4-0.9mg/dL), BUN: SCr 11.1 (10.0-20.0)

more »

... d creatinine clearance 52.2 mL/min using Cockcroft-Gault equation. Urinary indices showed UOsm 205mOsm/kg (50-800 mOsm/kg), UNa 22mmol/L, UCr 24.5mg/dL and FENa 0.7%. TMP-SMX and Lisinopril-HCTZ were discontinued. The patient received hypertonic saline. Serum Na gradually improved to 131mmol/L over 24 hours and the patient's confusion resolved without further seizures.