A 65-year-old female diabetic patient with wet gangrene on left great toe developed skin eruptions and blebs over her limbs and lower abdomen after receiving three doses of tablet linezolid + cefuroxime (600mg+500 mg). The skin eruptions and blebs completely resolved fourteen days after discontinuation of tablet Linezolid + Cefuroxime. Based on her presentation (Skin eruptions and blebs), we consider that the condition was a result of linezolid+ cefuroxime administration. While the pathophysiology of these cutaneous reactions is not completely understood, clinicians should be vigilant to allow early detection of these problems. The causality of this adverse reaction was determined by using Naranjo's criteria and World Health Organization Probability scale and was found to be possible and the severity of this reaction was determined by using the Modified Hartwig and Siegel scale and was found to be moderate (Level 3b) reaction. Although, Linezolid is known to cause dermatological reactions like rashes but the reports of leucocytoclastic vasculitis are rare. Thus, our case report of linezolid + cefuroxime induced leucocytoclastic vasculitis add newer information. Physician should be vigilant for the potential of drug to cause some rare side-effect like leucocytoclastic vasculitis on similar age groups, so that a safer alternative treatment can be started.

Multisystem inflammatory syndrome-children is considered as a paediatric hyper inflammatory condition prompted by severe acute respiratory system coronavirus 2, which has multi-organ involvement. Among them cervical lymphadenopathy is an unusual presentation in multisystem inflammatory syndrome-children. A case study of 17 year old post coronavirus disease 2019 male patient, whose clinical presentation and elevated inflammatory markers on blood tests lead to the diagnosis of multisystem inflammatory syndrome-children is explained here. Evidence from computed tomography, ultrasonography and fine needle aspiration cytology revealed the rare presentation of multisystem inflammatory syndrome-children with cervical lymphadenopathy. Standard guidelines were followed in the treatment of the condition and the prognosis was closely monitored clinically, the available objective evidences manifested progressive response and outcome.

A 49-year-old male who is a RT recipient since 2020, came with dyspnea and fever is a known case of insulin-dependent T2DM. The patient was on immunosuppression with tacrolimus, mycophenolate mofetil and prednisolone and RT-PCR tested positive. In view of COVID-19 infection mycophenolate mofetil dose was reduced and prednisolone dose (10 mg) was increased to 15 mg, other medications include cotrimoxazole, aspirin-atorvastatin, silodosin, rabeprazole-domperidone, metoprolol, cilnidipine and insulin. On day 10, the rapid antigen test detection turned negative and the patient did not experience any other complaints. Hence mycophenolate mofetil dose was increased, tacrolimus dose was adjusted based on tac level and prednisolone dose was tapered to 10 mg OD. The patient was symptomatically improved and discharged on day 12. Case 2A 50-year-old male who had live donor RT on 2017 with history of T2DM and HTN, presented to hospital with headache and fever. His treatment included tacrolimus, mycophenolate mofetil and prednisolone. He was diagnosed with COVID-19 infection on October 27. Mycophenolate mofetil was stopped and the rest continued. Further management included azithromycin 500 mg OD, calcium-vitamin D3 500 mg BD, zinc acetate 50 mg OD and heparin 5000 IU. His chest X-ray detected bilateral pulmonary infiltration. Oxygen saturation improved to 95% with 4 litres oxygen from 86%. On day 11, he tested negative for SARS-COV-2 and transferred to ward on day 12. Case 3A 56 years old male RT recipient (2010) with the history of T2DM and diabetic ketoacidosis since 20 years was shifted to our hospital on day 10