Another young man from South Asia, who had been working in the construction industry in Singapore for a few years, was incidentally found to have a painless mass over the left upper quadrant of his abdomen during a routine medical examination. He mentioned that it had appeared over the past week, gradually increasing in size. He was […]
A young man (in his 30s) from South Asia presented with progressively worsening headache over 4 weeks. This was associated with low-grade fever over a week, followed by diplopia (double vision) over the past 4 days. He had previously been well, with no medical co-morbidities. There was no significant contact history. He had received some […]
Happy Chinese New Year of the Fire Monkey! I am privileged to have a second contribution by another fellow (non-infectious diseases) colleague. Although I suppose in some ways a respiratory specialist is close… A middle-aged non-smoking local woman had cough associated with whitish sputum for 2 months. No significant contact or travel history. No other […]
A contribution by a fellow (non-infectious diseases) colleague, with an offer of a small prize for one local (i.e. Singapore) medical student who provides the correct answer. Question: What is the clinical sign demonstrated in the photo and what are possible underlying causes? [Updated 11th February 2016] The patient in question had chemotherapy resulting in […]
A young woman was recently diagnosed with Stage II breast cancer. Post-resection, she was started on adjuvant 3-weekly docetaxol, doxorubicin and cyclophosphamide. Ten days after the second cycle, she developed fever and headache, with temperature of up to 38.5 degrees Celsius. She had nausea, but no vomiting or diarrhoea. There was no contact or other significant history of […]
A late middle-aged man presented with high fever for a day. He had been hospitalized for acute gastroenteritis a week ago, receiving intravenous fluids and oral fluoroquinolones. Clinical examination was unremarkable except for erythema around the previous IV plug site – there were no cardiac murmurs and lung auscultation revealed normal breath sounds. He was […]
A photograph from a Gram stain of a urethral swab. The young man, recently married, had presented with penile discharge and a burning sensation during micturition for 2 days. He denied promiscuity. Question: What is the diagnosis and what is an appropriate course of management? [Update 30 Oct 2015] The Gram stain shows Gram-negative diplococci […]
A middle-aged man who had a biventricular pacemaker inserted 3 weeks ago presented with fever as well as pain over the left upper chest wall. Clinical examination revealed erythema and tenderness over the pacemaker body insertion site, with just a small amount of pus expressed from the incision scar. Blood cultures and a swab of the […]
A teenaged girl presented with high fever (up to 40 degrees Celsius), headache, and a dry cough for 4 days. She did not have prior symptoms of an upper respiratory tract infection such as sore throat or runny nose. None of her friends or family members were recently ill, and she has not traveled out of […]
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