This is an interesting story of a 40 year old man who developed severe hip pain after tripping on the pavement. From the opening description one would suspect a pathological fracture and the authors proceed to meticulously describe the pathology behind the fracture. Interestingly in this case the pathology was not just confined to the […]
Category: Editors choice
Comments from Dr Dean Jenkins on the Editor’s choice case report of the week.
Torsades de Pointes Associated with Methadone and Voriconazole
The authors describe in detail the presentation of this patient with Torsades de Pointes tachycardia. They go on to argue the case that the interaction of methadone and voriconazole led to the presentation. An excellent case with good ECG recordings. Dean Jenkins Editor at Large Torsades de Pointes Associated with Methadone and Voriconazole […]
Death of an infant after contacting a telephone triage call centre: is telephone triage really safe?
This case report has spent a long time in review because it has been a challenge to strike a balance in the conclusions between acknowledging the risk of a particular model of health care and how that risk compares with other models. The authors have worked hard to focus the report on the particular case […]
Ineffective chronic illness behaviour in a patient with long-term non-psychotic psychiatric illness
The authors of this case report, “Ineffective chronic illness behaviour,” illustrate how difficulties in treatment interactions need analysis beyond the patient’s presumed diagnosis or disorder – especially when patients’ behaviour during treatment is unusual or unexpected related to the primary symptoms. The authors describe their patient’s behaviour as “a form of ineffective chronic illness behaviour […]
Clinical Safety of 1500mg Oral Naltrexone Overdose
This case report raises some very interesting observations of overdose of Naltrexone. It seems to be the largest recorded overdose of the drug. The authors, with detailed clinical observations, report the effects in the patient but go on to make important points about the actions of Naltrexone. There have been recent papers, cited by the […]
The hazards of honey: infantile botulism
Smith and colleagues present a fine piece of detective work around a 2 month old infant with an initially puzzling neurological presentation. They unearth valuable learning points: Young infants are particularly vulnerable due to the susceptibility of their gut to colonisation due to immature intestinal flora and lack of clostridium-inhibiting bile acids. This is in […]
Fulminant hepatic failure in a patient with advanced extragonadal germ cell tumour
This is a heartening report which reflects what a diligent team of clinicians can achieve in terms of patient management. It is about a 36 year old man who noticed swelling in his right lower limb and eventually he was found to have not only a deep vein thrombosis to explain the right limb swelling […]
Malabsorption of antimycobacterial drugs as a cause of treatment failure in tuberculosis
The case raises very interesting questions: I wonder how commonly is this problem noticed in the developing world where treatment failure with antitubercular therapy ATT is not uncommon? Why does ATT get selectively malabsorbed even without any other signs of malabsorption? Malabsorption of antimycobacterial drugs as a cause of treatment failure in tuberculosis […]
Bilateral acute angle closure glaucoma associated with Guillain-Barre syndrome variant
I found this a fascinating case as it spanned disciplines of emergency medicine, neurology, ophthalmology and intensive care so well. It is an excellent reminder of the applied anatomy of the eye. Bilateral acute angle closure glaucoma associated with Guillain-Barre syndrome variant […]
An unusual case of relapsing remitting mononeuritis multiplex
There is an important reminder in this case report that if a condition does not appear to behave as expected then the diagnosis should be reconsidered. The authors describe quite a complex case and reveal some important learning points. An unusual case of relapsing remitting mononeuritis multiplex […]