The 50th post on this blog! And perhaps it is fitting to put up this case, which I reviewed as a fairly new trainee in infectious diseases slightly more than a decade ago… This young girl, who had just turned 18, developed upper respiratory tract symptoms and fever 4 days prior to hospitalisation. Her fever […]
A middle-aged (60-year-old) man with Type 2 diabetes mellitus and past history of tuberculosis presented with low-grade fever for 2 weeks and a 1.5 cm nodule over his left lower back (approximately L1 level). This was determined to be an abscess and creamy white pus was aspirated by his general practitioner. The Gram stain showed […]
A middle-aged man presented with a low-grade fever (37.8 degrees Celsius) and sudden pain over his right thigh for 3 days, which did not resolve with painkillers. He has a history of diabetes mellitus, and had a road traffic accident 30 years ago resulting in the fracture of his right femur. This was repaired (open reduction […]
An elderly man from Indonesia presented with loss of appetite and weight for 6 weeks, with fever and night sweats for the last 2 weeks. He had no contact history of note, and was previously well. Clinical examination was unremarkable except for a temperature of 38.3 degrees Celsius. His chest X-ray and a representative cut from the […]
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 […]
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