A middle-aged man presented with acute lymphoblastic leukemia (initial white cell count of 150,000 per cubic millimetre of blood – mostly blasts). After completing a course of hyper-CVAD, he developed persistent febrile neutropenia that was unresponsive to antibiotics. On the 6th day of fever, CT thorax was performed which was normal. On the 8th day […]
The same young man from Myanmar mentioned in Vignette 4 was extensively worked up for his fever. Blood cultures were negative. A CT of his abdomen, however, showed the following lesion in his liver. What is the most likely diagnosis and what test(s) would help to confirm it? [Updated 1 November 2014] The CT image […]
A 36-year-old man from Yangon, Myanmar who had worked at a shipyard in Singapore for 2 years (without ever traveling out of Singapore during this time) presented with fever. A blood film was done for malaria which picked up the several incidental “worms”. Questions: What is the identity of the “worms” and what are the current treatment […]
A young man from Joydepur, Bangladesh who had worked in Singapore for a year presented with fever for 2 weeks associated with weight loss of 5 kg. The main significant finding on clinical examination was an enlarged spleen and liver. A full blood count was done, showing anemia (Hb = 11.3 g/dL) and mild thrombocytopenia […]
A traveler from Tanzania who had spent a week on a safari tour presented with a large boil over his thigh which had not resolved with oral antibiotics. A small white lump popped out of the boil during the surgical incision and drainage of the “abscess”. What is this 3 mm “lump” and what is the […]
A previously healthy young man from Myanmar who works in the IT industry in Singapore. Presented with a left neck lump that increased gradually in size over the past 10 weeks, associated with a low-grade fever (up to 37.9 degrees Celsius) over the past month. No other systemic symptoms or such as cough or weight […]
MIPHIDIC 