A previously healthy young man (early 20’s) presented with severe left-sided sore throat, followed a day later by fever with chills, for 4 days. This was accompanied by lethargy and complete loss of appetite. He had seen a family doctor on the first day and was prescribed painkillers and antipyretics without significant relief. On clinical […]

A late middle-aged gentleman presented with painful left knee swelling for 2 weeks. He had recently been diagnosed with primary autoimmune hemolytic anaemia, for which he was on the final week of a 12-week tapering course of high-dose prednisolone. There was no associated fever or other systemic symptoms. He had not traveled in the preceding […]

More a spot diagnosis than a vignette per se. Urine in the urine bag and tubing. There is no overt bleeding. Question: What condition is being treated here? [Updated 29th September 2017] This is quite a classic – bright orange urine as a result of rifampicin ingestion (for tuberculosis). Sweat and tears may also be […]

Off food-related illnesses for a while, owing to reader complaints… A healthy young man spent 3 weeks in northern Vietnam, traveling from Hanoi to Haiphong City, trekking for 3 days in Cat Ba National Park. He and his two companions remained well other than for mild bouts of traveller’s diarrhoea. Although he had fallen a […]

A healthy 6-year-old girl was referred for a single day of diarrhoea (2 episodes) along with 3 episodes of involuntary anal orangey discharge that stained her trousers. Her stool was also remarked to be watery, orange-brown and oily. She complained of having some abdominal cramps, but was otherwise well, with no nausea, fever or dehydration. […]

A teenager developed persistent high fever (up to 39.5 degrees Celsius) two weeks after returning from a trip to a national park in Brunei. The other nine students and teacher-counsellor remained well other than occasional bouts of gastroenteritis. The school excursion had lasted a week, with two days spent camping in tents within the national […]

A middle-aged man with newly diagnosed diabetes mellitus presented with sudden onset right eye pain and tearing 2 days ago. This was associated with fever a day later, and he was unable to open his right eye fully because of the eyelid swelling. He had no history of trauma to the eye, no contact history […]