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This case is an instructive reminder for clinicians to take a detailed medical history, consider the likelihood of leptospirosis and anticipate JHR before initiating antibiotics, so that supportive care can be optimized as soon as possible

Of note, mitochondrial abnormalities are present in biopsies of dysferlinopathy patients (Sunitha et al, 2016)

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Adv Pharmacol 76 : 1337 This paper offers a masteful synthesis of how kynurenine pathway metabolties influence glutamatergic activity through direct effects on ionotropic and metabotropic glutamate receptors, vesicular glutamate transport and indirect effects at other recognition sites