Interesting Medicine Rabies is well known as a fatal infectious disease transmitted through the bites of rabid mammals. When it presents with paralysis, however, it may be clinically indistinguishable from Guillain- Barre syndrome. Here the authors describe this fascinating disease with some spectacular images. Seema Biswas Editor-in-Chief Atypical rabies with MRI findings: clue to the […]
Category: Editors choice
Comments from Dr Dean Jenkins on the Editor’s choice case report of the week.
Ulceronodular syphilis (lues maligna praecox) in a person newly diagnosed with HIV infection
An education in pathology The authors present a case of secondary syphilis complicated by HIV infection. The pictures and description of disease process form an engrossing lesson in pathology. Seema Biswas Editor-in-Chief Ulceronodular syphilis (lues maligna praecox) in a person newly diagnosed with HIV infection […]
Problems with the new born screen for galactosaemia
Adverse events A newborn screening test for galactosaemia is designed to identify affected infants and avert clinical effects with the prompt withdrawal of lactose and galactose from the diet. Failure of this test to detect the disease may have catastrophic effects. Here we learn from the factors that affect the effectiveness of the test in […]
Concomitant axillary mycobacteriosis and neuro-sarcoidosis: diagnostic pitfalls
Diagnostic pitfalls Here the authors discuss the difficulties in differentiating microbial (in particular tuberculous) causes of intrathoracic lymphadenopathy and sarcoidosis; indeed, sarcoidosis may occur in patients with previous microbial infection just as TB occurs in patients who are HLA B27 positive. Case reports are an excellent platform for diagnostic debate and the discussion of pitfalls. […]
Unilateral onycholysis in a patient taking erlotinib (Tarceva)
Rare side effect of treatment Here the authors present a case of unilateral onycholysis in a patient receiving an EGFR tyrosine kinase inhibitor. In addition to describing a possible mechanism for this side effect, the authors also highlight the benefits of targeted therapy. Seema Biswas Editor-in-Chief Unilateral onycholysis in a patient taking erlotinib (Tarceva) […]
The use of intraoperative PET probe to resect metastatic melanoma
Introducing novel methods of investigation and treatment Here the authors report two cases of metastatic melanoma resected with the assistance of an intraoperative handheld positron emission tomography (PET) probe. The probe was used to identify hypermetabolic lymph nodes and after resection the probe reading returned to background levels. At follow up the patients remained disease […]
The place of case reports in medical literature: Periorbital cellulits – a mistaken diagnosis!
Case reports offer level IV evidence ranked well below randomised control trials and meta-analyses. http://healthpolicyandreform.nejm.org/?p=14876&query=TOC What role do case reports have then in the medical literature? Certainly, the report of adverse events, the opportunity to discuss diagnostic pitfalls, present novel methods of investigation and treatment and, of course, present cases of enormous interest and concern. […]
Pathology: Primary bladder amyloidosis
An 89 year old lady presents with painless haematuria and is found to have an extremely unusual lesion of the bladder. The pathology is discussed in detail and microscopy reveals stunning images… Seema Biswas Editor-in-Chief Primary bladder amyloidosis […]
Pathology: Symptomatic malignant melanoma presenting as multiple gastrointestinal polyps
A 66 year old gentleman who presents with nausea and intermittent diarrhoea is found to be anaemic. Gastroscopy and colonoscopy show multiple polyps but these polyps are a manifestation of an unusual pathology discussed here in some detail. Seema Biswas Editor-in-Chief Symptomatic malignant melanoma presenting as multiple gastrointestinal polyps […]
Pathology: Spontaneous adrenal haemorrhage in pregnancy
Here, the authors describe the case of a 20 year old lady 38 weeks into her pregnancy who experiences sudden onset chest and abdominal pain and presents with hypovolaemic shock. She undergoes emergency caesarean section but the cause of shock is not the most obvious pathology… Seema Biswas Editor-in-Chief Spontaneous adrenal haemorrhage in pregnancy […]