Spot diagnosis. The patient was otherwise asymptomatic, but was somewhat appalled when the object in the first image passed out per rectum. Questions: What is the diagnosis? How did the patient acquire this? [Updated 2nd July 2016] This is clearly a tapeworm – there are no other human parasites that grow to such length. The […]
A middle-aged man was recently diagnosed with poor prognosis myelodysplastic syndrome (MDS). He was prescribed a course of subcutaneous azacitidine. One week after the first cycle (7 days) of the drug, he presented with pain over the injection sites (over his anterior abdominal wall), associated with high fever and weight loss. He was admitted to […]
A late middle-aged man with advanced lung cancer was switched to 3-weekly pembrolizumab after his malignancy progressed through multiple courses of chemotherapy. Pet CT at 12 weeks showed stable disease. However, he presented with sudden onset fever, worsening cough, and breathlessness after 6 months of immunotherapy. There was no contact or travel history of note, […]
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, […]
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 […]
MIPHIDIC 