We present two cases, women of 21 and 60 years old, who presented with deep vein thrombosis. Both cases had retroperitoneal para-aortic and iliac lymph node enlargement without any malignancy or other predisposing thrombophilic factors. Investigations revealed tubercular aetiology of the lymph nodes causing venae caval obstruction.
We report here the first case of disseminated Emmonsia pasteuriana infection in a patient with AIDS in India. The patient presented with weight loss, dyspnoea, left-sided chest pain and multiple non-tender skin lesions over face and body for 3 months. Disseminated emmonsiosis was diagnosed on microscopic examination and fungal culture of skin biopsy and needle aspirate of lung consolidation. It was confirmed by sequencing internal transcribed spacer region of rDNA, beta tubulin, actin, and intein PRP8. The patient responded to amphotericin B and itraconazole therapy.
Chikungunya fever is a benign and self-limiting disease caused by an RNA virus belonging to genus alphavirus and transmitted by infected Aedes mosquitoes. However, a number of atypical presentations involving various systems have been reported. Among the neurological complications, encephalitis, myelitis, Guillain-Barre syndrome and optic neuritis are commonly seen. However, its presentation as isolated inflammatory myositis causing quadriplegia is extremely rare. We report a 35-year-old woman with quadriplegia caused by chikungunya-induced inflammatory myositis. The diagnosis was confirmed with clinical examination, electromyography study, muscle biopsy findings and exclusion of other causes. There have been case reports of inflammatory myositis in association with various infections as well as in association with other neurological presentations in chikungunya. However, this may be the first case report of isolated inflammatory myositis associated with chikungunya fever.
Symmetrical peripheral gangrene (SPG) is an extremely rare complication of malaria that has been well described in multiple case reports of Plasmodium falciparum and mixed infection. We present a case of malaria with isolated Pl. vivax infection complicated by SPG. This index case is the first reported case of peripheral gangrene involving bilateral hands and feet in Pl. vivax infection in an adult.
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