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How should you manage chloramphenicol toxicity?

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A 62-year-old male presents to the ED with bilateral lower extremity weakness. He states that for the last few months, he has had an increasingly difficult time climbing stairs. He notes progressively worsening neck pain and stiffness for the past year. This morning, his wife urged him to come in
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Multiple sclerosis

Immune-mediated, demyelinating disease, separated in time and space, females > males

 

Presents with exacerbations, med complications, or some other condition (most common)

 

New neuro symptom = true exacerbation -> steroids

 

Worsening of prior neuro symptoms = pseudoexacerbation -> find and treat underlying trigger (infection)

 

Avoid fever; worsens symptoms

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