Enteric duplication is an uncommon malformation of the gastrointestinal tract which is either asymptomatic or presents with vague symptoms mimicking other more common pathology. It is most commonly diagnosed when complications such as bleeding, intestinal obstruction or perforation occurs. This is a case report of a patient with this condition presenting with right iliac fossa pain and localised peritonitis mimicking acute appendicitis.
Colloid cysts are rare intracranial tumors most commonly found in the third ventricle. We present a case of colloid cyst of the third ventricle that manifested as bilateral advance optic disc cupping, superior hemifield defects in the visual fields and normal intraocular pressure.
We studied 1,629 febrile patients from a rural area of Malaysia, and made a laboratory diagnosis in 1,025 (62.9%) cases. Scrub typhus was the most frequent diagnosis (19.3% of all illnesses) followed by typhoid and paratyphoid (7.4%); flavivirus infection (7.0%); leptospirosis (6.8%); and malaria (6.2%). The hospital mortality was very low (0.5% of all febrile patients). The high prevalence of scrub typhus in oil palm laborers (46.8% of all febrile illnesses in that group) was confirmed. In rural Malaysia, therapy with chloramphenicol or a tetracycline would be appropriate for undiagnosed patients in whom malaria has been excluded. Failure to respond to tetracycline within 48 hours would usually suggest a diagnosis of typhoid, and indicate the need for a change in therapy.
A 5-month-old boy had erythematous nodules over the left side of his trunk with a segmental arrangement since birth. Histopathologic examination revealed sheets of foamy histiocytes infiltrating the dermis and subcutaneous fat, admixed with multinucleated giant cells and lymphocytes, making this an unusual case of juvenile xanthogranuloma appearing in a segmental distribution.
Latent Autoimmune Diabetes in Adults (LADA) is an autoimmune form of type 1 diabetes mellitus presenting in adulthood. It is often confused with other types of diabetes and therefore the management is frequently inadequate. Acute hyperglycemic crisis in the form of diabetic ketoacidosis (DKA) or hyperglycemic hyperosmolar state (HHS) are unusual findings. We report a clinical case of a 66-year-old female who presented for the first time with DKA and was subsequently diagnosed as a case of LADA. Presumptive diagnosis of LADA was confirmed with the presence of autoantibody to glutamic acid decarboxylase 65 (Anti-GAD65 antibody).
Matched MeSH terms: Diabetes Mellitus, Type 1/diagnosis*; Diabetic Ketoacidosis/diagnosis*
Coronary arteries vasospasm (CAS) is commonly seen in invasive cardiology laboratory during diagnostic catheterization or coronary intervention. Though the incidence of Printzmetal angina is uncommon, coronary vasospasm resulting in acute myocardial infarct is rare, especially if there is no significant atherosclerotic plaque within the coronary vasculature.
Hepatic angiosarcoma is a rare primary mesenchymal malignancy. Prognosis is poor and mortality occurs early. The diagnosis is challenging. Our case was an asymptomatic 70 year-old man referred, with incidental ultrasonography finding of multiple liver nodules. Diagnostic laparoscopic liver biopsy and the histopathological examination reported a haemangioma. Six months later, he became symptomatic and his health condition deteriorated rapidly.
A 13-year-old boy presented with a 2 weeks history of tearfulness, childish behaviour, separation anxiety, hypersomnia, hyperphagia and sexual disinhibition following a brief episode of fever. He had been experiencing the episodes since he was seven. The episodes lasted from a few days to 3 weeks and would normally occur once in a year. Most of the time it started with fever and resolved spontaneously. In the past he described auditory hallucination but not this time. Examination revealed a slightly overweight adolescent male appearing appropriate to his age. During the session he was restless, sleepy and burst into tears frequently. He constantly asked his mother when he could go home to sleep. He was very childish and clung to his mother. He was given a trial of risperidone 1 mg to be taken once a day for 3 days. On follow-up he had completely recovered.
Foreign body aspiration in the adult airway is very rare. A neglected foreign body can occur when the patient is mentally challenged or is in an unconscious condition such as following trauma. The diagnosis can be delayed because there is no typical history of choking or breathing difficulty.
Ureteritis cystica is a rare, benign, proliferative condition. We report the case of a 51-year-old female who complained of dysuria and frequency for the last 10 years. The symptoms, however, increased in severity and frequency over the past one year. Urine culture and sensitivity showed presence of Escherichia Coli which was sensitive to augmentin and ciproflaxocin. The urinary tract ultrasonography and intravenous urography revealed bladder diverticula with multiple small, smooth well defects with sharp borders that protruded into the lumen along the proximal and mid left ureter. This finding was later confirmed by retrograde pyelogram. She was treated and currently is on long term antibiotic therapy. The diagnostic features and management of ureteritis cystic is being discussed in detail.
An Indian man from Malaysia presented with contracture of his hands. He is 55 years of age and has a history of chronic alcohol consumption. Examination revealed bilateral thickened structure at the palms.
Pain remains as one of the most common reasons for visits to a doctor. The paper by Zalinawati et all published in this issue of the Journal confirmed this in two primary care settings, showing that a complaint of pain was recorded in almost a third of patients, similar to the prevalence reported in European studies.
Parotid swelling is a common presentation in ENT clinic. Most of the cases involve pathology of the gland. There are not many reported cases about parotid duct pathology. We describe a case of a large parotid duct mucocele with a calculus. Excision of the mucocele and superficial parotidectomy was performed. The post-operative recovery was uneventful.