A late middle-aged man presented with high fever for a day. He had been hospitalized for acute gastroenteritis a week ago, receiving intravenous fluids and oral fluoroquinolones. Clinical examination was unremarkable except for erythema around the previous IV plug site – there were no cardiac murmurs and lung auscultation revealed normal breath sounds. He was […]

The Society of Infectious Diseases (Singapore) has organised an annual infectious diseases clinical practice update for ID trainees and GPs/family medicine trainees for years. These practice updates are invariably organised by the trainees themselves, who have the liberty therefore to set the topics and invite the local consultants they would like to listen to. Somehow, I […]

A middle-aged woman underwent chemotherapy after being diagnosed with acute lymphoblastic leukaemia (ALL). She was re-admitted 4 days post-completion of #1A and #1B hyperCVAD with septic shock requiring dopamine support. Her absolute neutrophil count (ANC) was 0.02 and her initial chest X-ray was normal. She was treated with intravenous (IV) imipenem as per protocol, and blood cultures grew Pseudomonas […]

A middle-aged man with Type 2 diabetes mellitus and hypertension developed extensive subarachnoid haemorrhage acutely, and underwent a 4-vessel cerebral angiogram during which an anterior communicating artery aneurysm was found and coiled. He recovered gradually with inpatient rehabilitation, and was sent home after 2 weeks of hospitalisation. However, he had developed a cough with mild […]

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 […]