A 3-year-old boy presented with mild left foot pain 6 weeks ago, which resulted in limping 3 weeks ago, followed by swelling over the dorsum of the foot less than a week ago. He was previously healthy except for perianal abscess which developed 1 week after birth.He had met (and exceeded several of) his development […]
A young local woman who was previously well went on a 9-day missionary trip to Pakistan, traveling between Karachi and Lahore as well as several villages in between. She had an episode of fever with chills midway through the trip, associated with diarrhoea two days later. Although the diarrhoea improved over the next two days, […]
I had the honour of being invited for the above event in Hong Kong (organised by the University of Hong Kong), held on 13th of March, with a small accompanying seminar on the next morning. The Ebola outbreak in West Africa in 2014 catalysed a lot of frustration with the global health system (which basically […]
For the past few days, I and many others have been riveted by the match between Google Deepmind’s AlphaGo and Lee Sedol – one of the top 5 Go players in the world (he is variously listed as world champion as well as current world no.2, but it’s not as easy to figure out the […]
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 […]
In the previous post, we discussed the situation where the fever has resolved. How long should antibiotics be continued? If the cultures are negative, antibiotics can be stopped immediately with neutrophil recovery (the situation where neutropenia remains persistent is controversial and was also discussed previously). There is a tendency locally to continue intravenous antibiotics for […]
Back to the febrile neutropenia management series. Two questions frequently arise during the course of management, particularly with regards to febrile neutropenia (FN) in patients with haematological malignancies where the duration of neutropenia may be very long: In the presence of neutropenia, can there be “de-escalation” of antibiotic therapy if a sensitive bacterium is cultured […]
Almost two weeks ago, Channel News Asia reported that terrapins may harbour non-typhoidal Salmonella bacteria. Non-typhoidal Salmonella, as the term suggests, are Salmonella species other than the exclusively human-adapted Salmonella spp. that cause enteric (i.e. typhoid and paratyphoid) fever. The former tend to cause gastroenteritis for the large part, although they may also cause severe infections in immunocompromised persons, including […]
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 […]
MIPHIDIC 