A middle-aged (late 50’s) housewife presented with fever for 4 days, associated with headache and photophobia. There was no significant contact or travel history, and her only chronic medical condition was hypertension for which she was on atenolol (a beta-blocker). Brought in to the emergency department by her husband and son, she was found to […]
A young woman who was 33 weeks pregnant presented with 2 weeks of low-grade fever associated with an enlarged right cervical lymph node. Fine needle aspiration of the lymph node had been performed by an ENT surgeon, showing an epithelioid granuloma and reactive follicular hyperplasia. TB PCR was negative. Serological testing results are shown below: EBV […]
A man in his late 50’s presented with generalised lethargy and low-grade fever for 3 days. He had a history of pulmonary tuberculosis 20 years ago, and had completed a 9-month course of therapy. The only other significant history was that of alcoholism and smoking. He was found to be hypotensive at the Emergency Department […]
A middle-aged man (in his fifties) presented with recurrent right upper quadrant abdominal pain for 5 weeks, associated with nausea, night sweats and low-grade fever. His work involved frequent travel to Indonesia, China and parts of Latin America, although mainly confined to the big cities rather than to rural parts of these countries. He had […]
A healthy man in his late middle age presented with sudden onset of fever. This was associated with back and muscle ache, as well as mild lower limb weakness and lethargy. He saw a general practitioner and obtained relief from his symptoms with the prescription of antipyretics (including a shot of NSAIDs). However, his muscle aches […]
A teenager spent a few days at a regional resort, visiting the beach and trekking around the nearby waterfalls. Two days after returning, a unique rash appeared over the left foot, associated with an intense itch. Question: What is the diagnosis and treatment of the rash? [Updated 11 July 2015] Quite a number of people on […]
A young local man in his late 20’s, previously well, was found on pre-employment screening to have abnormal chest X-ray. He was otherwise asymptomatic. He underwent sputum induction for tuberculosis work-up (sputum microscopy and cultures for acid-fast bacilli, and PCR for Mycobacterium tuberculosis complex), and both sputum samples were negative for acid-fast bacilli on microscopy and MTC on PCR. […]
A middle-aged man underwent non-myeloablative allogeneic hematopoietic stem cell transplantation for acute myeloid leukemia, receiving alemtuzumab just prior to the transplant. Recovery during the immediate post-transplantation period was unremarkable, but he remained on tacrolimus, mycophenolate and low-dose prednisolone for chronic graft-versus-host disease involving the skin, gastrointestinal tract and oral/conjunctival mucosa. Routine cytomegalovirus (CMV) screening of […]
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