We report a rare case of encephalitis that is not often described in clinical settings in neurology. Our case was 11-year-old female patient who had presented with features of meningoencephalitis, but not responded to the conventional treatment. Her magnetic resonance imaging revealed lesions in thalami, cerebellum and brainstem. The differentials in this age were infective and inflammatory causes of meningoencephalitis and acute disseminated encephalomyelitis (ADEM). Paraneoplastic was another differential. Mycoplasma serology came out positive. As a result, diagnosis of mycoplasma pneumoiae associated Rhombencephalitis was made based on diagnosis of exclusion.

OBJECTIVES The study’s objective was to implement a methodological approach, "Acute Physiological and Chronic Health Evaluation II (APACHE-II),” to classify critically ill patients based on severity. METHODOLOGY A retrospective study design was conducted at Shaukat Khanum Memorial Cancer Hospital Lahore, Pakistan, from May 2019 to May 2020. A pilot study of 6 months was conducted by reviewing the medical record of 30 adult patients following convenient sampling after the approval of the proposal by ASRB/IRB of Shaukat Khanum hospital. The record of both male and female patients was studied, while no record of paediatric or adult patients outside the ICU was studied. Each patient’s severity score was obtained using the patient’s parameters with the help of the APACHE-II table. RESULTS Among the patients, three out of 30 scored 25, 29 and 30 on APACHE-II. These patients later passed away in ICU. This indicates that the mortality rate increases with an increase in the APACHE-II score. Thus, the scoring system is very beneficial in predicting adult ICU patients' mortality rate. CONCLUSION It is concluded that APACHE II is one of the best severity scoring systems in predicting the critical condition of patients.