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International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations.IJCRI publishes Review Articles, Case Series, Case Reports, Case in Images, Clinical Images and Letters to Editor. Website: www.ijcasereportsandimages.com Miliary tuberculosis in an immunocompetent maleChidozie Charles Agu, Patolia Setu, Hiba Basheer ABSTRACT Introduction: Miliary tuberculosis (TB) is a disseminated form of tuberculosis which may involve the lungs and other organs. It is a rare but potentially lethal form of tuberculosis seen mostly in immunocompromised patients. It is, however, not commonly reported in immunocompetent hosts. Case Report: We present a case of a 67-year-old African-American male who presented with persistent non-productive cough for three weeks, diarrhea, fatigue and weight loss. There was no history of active TB contacts, HIV infection, or other predisposing factor for immunosuppression. Physical examination was also unremarkable. Chest X-ray and computed tomography scan revealed bilateral extensive small nodular infiltrates with negative serial acidfast sputum smears. Acid-fast bacilli were detected in sputum culture at four weeks and were identified by DNA probe as Mycobacterium tuberculosis. Conclusion: Miliary tuberculosis is a potentially lethal form of tuberculosis that mostly affects immunosuppressed patients, although in rare occasions can also affect immunocompetent adults.

International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations.IJCRI publishes Review Articles, Case Series, Case Reports, Case in Images, Clinical Images and Letters to Editor. Website: www.ijcasereportsandimages.com DRESS syndrome associated with allopurinolChidozie Charles Agu, Hiba Basheer ABSTRACT Introduction: DRESS syndrome (Drug Rash with Eosinophilia and Systemic Symptoms) is a severe drug reaction with an estimated mortality of up to 10% largely due to multi-organ dysfunction. Diagnosis is challenging because the extent of skin involvement does not always correlate with the extent of internal organ involvement and therefore early recognition of symptoms is vital to minimize morbidity and mortality. Management involves prompt cessation of the culprit drug, administration of corticosteroids and supportive treatment. Case Report: We report a case of an 87-year-old female with medical history significant for stage five chronic kidney disease, recently started on allopurinol for gout presented with dizziness, skin rash and eosinophilia which rapidly progressed to shock state followed by altered mentation, worsening renal failure, severe metabolic acidosis, deranged liver enzymes and gastrointestinal bleed requiring blood transfusion. Conclusion: Allopurinol is commonly used in clinical practice for the treatment of symptomatic hyperuricemia and gout. It has been associated with DRESS syndrome especially when used indiscriminately.

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