Though commonly encountered, extrapulmonary tuberculosis (TB) can sometimes present with variable clinical picture intricating the diagnosis (Avasthi et al., 2010). The nonspecific symptoms include pyrexia of unknown origin, hepatosplenomegaly, lymphadenopathy, meningitis, and, rarely, variety of hematological abnormalities, namely, anemia, pancytopenia, and leukemoid reaction (Avasthi et al., 2010). When it presents with bone marrow (BM) involvement, prognosis is usually poor (Avasthi et al., 2010, Qasim et al., 2003, and Singh et al., 2001). We, hereby, report a case of extra-pulmonary TB with a six-month history of fever associated with dizziness, fatigability, and cough. During the hospital stay, the patient showed a spectrum of interesting hematological findings, including severe pancytopenia on peripheral smear, necrotizing caseating granulomas consistent with TB on bone marrow examination. The patient showed a good clinical as well as hematological response to antituberculosis treatment. This paper highlights the significance of a hematological picture in the final confirmation of TB, which may otherwise be passed off as nutritional or other unrelated causes.

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Background:Little is known about the factors that influence the choice of medical specialty by male and female senior medical students at King Abdulaziz University in Jeddah so this study was conducted to investigate these factors. Methods: In this cross sectional study, data was collected through a questionnaire that was adapted to the Saudi culture from. It was distributed to three hundred male and female medical students in their sixth year and the response rate was 79.6%. Data analysis was carried out by using the Statistical Package for the Social Science (SPSS) version during the years 2013-2014. The percentages and the significances of the most and the least factors that influence the choice of medical specialties by the sample of the study were computed. Results: Study showed that 91 out of 121 senior male students and 88 senior female students out of 118 agreed that joining medical school was their first interest. Results illustrated that helping patients is the most considerable reason to choose medicine by the majority of the students (93% of senior male students and 91% of senior female students) whereas family enforcement was the least influential reason to choose medicine (28% of senior male students and 23% of senior female students). Internal medicine was chosen by the majority of the sample of the study as their first interest after graduating from medical school (43 male and female senior students). While only one male medical student chose community medicine. Conclusions: Medicine was the first choice for the majority of both male and female medical students who entered university. Internal medicine was the most desirable specialty following graduation. Most of the graduates have no plan in pursuing a career in general practice. It is advocated to establish a career advising committee at KAU. The committee should focus on medical students during their final clinical years. The lack of physicians in some specialties and its effect on the community should be addressed.

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