Not so much a clinical but a radiological vignette – a CT image from more than a decade ago. Question: What is the radiological sign and what is the diagnosis? [Updated 20th  September 2016] The CT cut of the lungs shows a “water lily” sign (and thanks for those who suggested that it is an […]

An outbreak of canine leptospirosis in Singapore made it to the news yesterday. There were 17 suspected and 1 confirmed case for the year to date (up from 2 cases in 2015), 12 of which were linked to a single dog daycare centre. There may also have been a case of dog-to-human transmission – According […]

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 […]

There is always time a first time for everything – I made my first ProMED post a couple of days ago. A fellow ID physician in private practice and I recently encountered two persons who were diagnosed with malaria and who had both returned from a camping trip in Brunei. Their infections were not caused by any of […]

A middle-aged man presented with fever and dysuria for 5 days. He worked as a gardener at a large private housing estate, and suffered from both hypertension and type 2 diabetes mellitus. A CT pelvis was performed, with a representative image shown below. Question: What is the diagnosis and what is the bacterial aetiology? The CT […]

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 […]