Brain Abscess in Alcoholic Male

A 45 year old male presented with generalized tonic clonic seizures. At presentation, vitals were stable, the patient was unconcious with flexor limb response to painful stimuli, there were no signs of meningitis; systemic examination was normal. A MRI Brain obtained at another facility prior ...

Pulmonary nodules

A 35 year old woman presented with right sided pleuritic chest pain since 1 year. She did not report weight loss, cough, or hemoptysis. She had migrated from Bihar 2 years previously. Her spouse was a construction worker; she had 2 children and she reported no history of ...

Post-operative cystitis

A 72 year old male with diabetes mellitus was admitted with acute coronary syndrome and left ventricular failure. He was HIV-Positive and was adherent to anti-retroviral therapy (TDF/FTC/EFV) since past 8 years. A HIV viral load done 3 months earlier showed virologic suppression and the CD4 ...

Abscesses in immunosuppressed host

A 27 year old woman from rural Ahmednagar district presented with multiple soft tissue abscesses, fever and weight loss of 5 kg since 1 month. The patient had been diagnosed with systemic lupus erythematosus 2 years earlier and was on prednisolone 20 mg/day, methotrexate and ...

FUO in a healthcare worker

A 45 year old woman presented with fever since 10 days. She did not report cough, diarrhea, arthralgias or urinary symptoms. History was notable for hospital admission 1 month prior for similar symptoms treated with antibiotics. She worked as a microbiology technician in a hospital ...

A 16 year old girl with fever and hepatitis.

A 16 year old girl presented with high grade fever, skin rash and cervical lymphadenopathy since 2 weeks. She was seen in another hospital where workup for hepatitis (Hepatitis A, B, C,and E), leptospirosis, malaria, and rickettsial disease was non-conclusive ...

A 20 year old man with buttock pain

A 20 year old man went to his general practitioner with symptoms of fever, malaise and coryza. Symptomatic treatment was advised and intramuscular diclofenac was administered in the right buttock. The patient developed pain in the right buttock next day and was ...

Pneumonia in a 64 year old man

A 64 year old man was admitted to the intensive care unit with cough and dyspnea since 4 days. He reported fever and upper respiratory symptoms lasting 2 days prior to onset of his symptoms. At admission patient was severely tachypneic and hypoxemic ...

16 year old male with fever and altered sensorium

A 16 year old boy from Tamil Nadu was admitted with fever, altered sensorium and generalised clonic tonic seizures since 3 days. On examination, the neck was stiff with a GCS score of 4. Both pupils were sluggishly reactive to light ...

HIV infected man with pulmonary infiltrates

A 40 year old man from Assam presented with low grade fever, cough and 20 kg weight loss over the past 1 year. Nine months prior to presentation, the patient was diagnosed with smear negative pulmonary tuberculosis. Antituberculous therapy (HRZE) was started, however hepatitis ...

Encephalitis in a 54 year old woman after dog-bite

A 54 year old woman presented with a history of dyspnea, and vomiting since 2 day, and altered sensorium since 1 day. There was no history of seizures. Vitals were stable. At presentation, the patient was stuporous; however no focal neurologic ...

A 38 year old man with endocarditis of the prosthetic mitral valve

(presented to another hospital)
A 38 year old man presented with low grade fever and acute onset right leg numbness and weakness, 2 months following aortic valve replacement (bioprosthetic valve) and permanent pacemaker implantation for bicuspid aortic valve ...

Fever of unknown origin in a 58 year old man

A 58 year old man from Kolkata presented with high grade fever since 4 months with weight loss of 20 kilograms. There was no history of cough, diarrhea, abdominal pain, GI bleeding, skin rashes, joint pains or neurological symptoms. Physical ...

A 26 year old woman with shortness of breath

A 26 year old woman from rural West Bengal presented with dyspnea on exertion, gradually progressing since 1 year, with an occasional dry cough. She reported no fever, weight loss, hemoptysis, orthopnea or wheezing. She reported being treated for hydatid disease ...

A 29 year old woman with jaw swelling

A 29 year otherwise healthy woman presented with left jaw swelling since 1 month. She had a history of multiple dental procedures including dental extraction and root canal treatments since 3 years. Symptoms started with a right jaw swelling 4 months prior ...

A woman with fever, vesicular rash and hypoxemia

A 35 year old woman from West Bengal presented with fever and dry cough since 1 week. 1 month prior to presentation, she had developed a boil on the buttock that healed after treatment with oral amoxicillin-clavulanate. At presentation, the patient had ...

Meningoencephalitis in an African woman

58 year old woman from Tanzania presented with fever and altered sensorium. She had been previously diagnosed with HIV infection, however adherence with anti-retroviral therapy was poor. She had been started on a protease inhibitor based antiretroviral regimen approximately 1 month prior to presentation.

MRI ...

Hemoptysis, Low back pain and upper mediastinal widening

52 year male presented with increasing hemoptysis, low grade fever and back pain since 2 weeks. Medical history included diabetes since 14 years and recurrent boils on thighs since past 1 year. CXR showed widened upper mediastinum.

CT scan of the chest ...

A 30 year old female with SLE presenting with tricuspid endocarditis

A 30 year female diagnosed with systemic lupus erythematosus and lupus nephritis presented with low grade fever and malaise since 1 month. A 2D echocardiogram showed multiple tricuspid valve vegetations. Erysipelothrix rhusiopathiae was isolated from three sets of blood ...

Multiple abscesses in a patient with membranous glomerulonephritis

A 50 year old male presented with right palm swelling, low back pain, and cough since 2 weeks. History was notable for membranous glomerulonephritis since 10 years on steroids. Examination revealed a fluctuant right palm swelling and a fluctuant anterior abdominal wall ...

A young man with fever and hip pain.

A 30 year old man presented with fever since 4 weeks. He was treated in another hospital for enteric fever. Salmonella typhi and coagulase negative staphylococci were isolated from blood cultures drawn at the previous admission. However fever had relapsed after a ...