We report a case of rare, Mullerian vaginal cyst with intracystic haemorrhage in the absence of endometrial components. To date, this is the second case reported in the literature. A 51-year-old post-menopausal woman with history of anterior vaginal wall cyst was misdiagnosed to have cystocele. The cyst was excised and the content was old blood mixed with mucous. Histopathological examination revealed a Mullerian vaginal cyst without endometrial component. Thus, diagnosis and management of vaginal cyst was revisited and discussed.
Melioidosis is endemic in Southeast Asia, including Malaysia. Liver abscess is not uncommon in melioidosis, but it is usually associated with bacteremia. We presented a case of a 55-year-old gentleman with underlying end-stage renal failure who presented with non-specific abdominal pain for three months. Initial blood investigations showed leukocytosis and increased C-reactive protein. Computed tomography (CT) of the abdomen revealed multiple hypodense lesions in the liver and spleen. The culture of the liver specimen obtained through the ultrasound-guided isolated Burkholderia pseudomallei. He was given an adjusted dose of intravenous ceftazidime due to underlying renal failure. Melioidosis serology also returned positive for IgM with titer >1:1280. His blood cultures were reported negative three times. Despite on antibiotics for five weeks, there was no significant improvement of the liver abscesses was observed. He was unfortunately infected with the SARS-CoV-2 virus during his admission and passed away due to severe COVID-19 pneumonia.