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 […]
A young man with HIV (latest CD4 count = 148 cells/cubic millimetre of blood) presented with diarrhoea of 2 weeks after traveling to Bangkok, Thailand for a holiday. There was no fever and no blood in the stool. A short course of oral antibiotics had not helped, and routine stool work-up – involving stool culture […]
A man in late middle-age, who in his youth had traveled extensively around the region, presented with nagging right upper abdominal discomfort for 2 weeks. He had no fever. The chest X-ray is shown below. Question: What is the abnormality seen and what infectious disease could this possibly be? [Updated 6th June 2015] There is a […]
An elderly (in her 60’s) woman went to the beach with her grandchildren, accompanying them as they dug for crabs and picked shells near a creek. Three days later, she presented with high fever accompanied by severe right lower limb pain and redness. She has a background history of diabetes mellitus which was not well controlled. […]
A young woman (in her 30’s) presented with a 3-day history of severe headache, low-grade fever (37.8 degrees Celsius) and photophobia. Clinical examination was unremarkable except for mild photophobia and mild neck stiffness. A CT head (non-contrast) done at the Emergency Department was normal, as was her full blood count and renal function panel. She […]
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