Photo Quizzes

A 38-year-old man with HIV, virally suppressed on antiretroviral therapy, presented with 5 days of discrete raised, circular skin lesions with erythematous, raised borders over the right knee, buttocks, and groin ( Figure 1 ). He had been sexually active with male partners before his visit. The ...

A 21-year-old female with no known past medical history presented with acute onset right eye vision loss. Preceding the acute loss of vision she noted 3 days of centralized blurry vision and pain with movement of her right eye. She denied any other symptoms including headache, fever, and neck pain. ...

A 25-year-old male from Guatemala presented to the clinic with a 5-year history of sore throat, associated with odynophagia and dysphagia for solids. He reported a history of agricultural work related to coffee crops during childhood. The patient stated that, 5 years ago while still in Guatemala, ...

A 34-year-old man without significant past medical history presented to a New England hospital with 1 week of left foot pain, myalgias, subjective fever, and rash. The rash was nonpruritic, nontender, with pustular eruptions most pronounced over the extremities (including the palms and soles) with ...

A 47-year-old man underwent a right middle lobectomy for a lung abscess caused by methicillin-sensitive Staphylococcus aureus with a ruptured pseudoaneurysm. He initially received meropenem (1 g every 8 hours), followed by de-escalation to ampicillin-sulbactam (3 g every 6 hours) for a total of 4 ...

Resistance is more often reported in a minority of patients who have undergone long-term therapy (at least 9 months) [ 16 ]. Mutations in the UL54 gene confers resistance to ganciclovir, valganciclovir, foscarnet, and cidofovir, whereas mutations in the UL97 gene confers resistance to ganciclovir ...

Supplementary materials are available at Clinical Infectious Diseases online. Consisting of data provided by the authors to benefit the reader, the posted materials are not copyedited and are the sole responsibility of the authors, so questions or comments should be addressed to the ...

This Photo Quiz article presents a case of acute dengue fever in an American traveler returning from Puerto Rico. In addition to the relevant epidemiologic and medical history, a key finding that allowed clinical diagnosis of the infection was the characteristic rash (“isles of white in a sea of ...

Scopulariopsis spp. belong to the ascomycete family, which are commonly found in nature [ 2 ]. Our patient likely contracted this condition while working on his hobby farm, particularly through handling mulch and soil. No other patients were identified in the hospital unit with a similar ...

A 5-month-old Dutch male infant from non-consanguineous parents was referred to an academic children's hospital in the Netherlands because of a fever of unknown origin for 2 weeks and progressive pancytopenia. His previous medical history was unremarkable. He had been adequately vaccinated for his ...

Question: A 27-year-old man, who had grown up on a livestock farm in Mexico, presented to the hospital with a 3-month history of left neck pain, abdominal pain, and weight loss. Computed tomographic (CT) imaging showed widespread lymphadenopathy and mild abdominopelvic ascites. Human ...

This case highlights varicella complicating KVE in an adult with AD caused by VZV, a rare occurrence in immunocompetent individuals. Prompt diagnosis through serological and PCR testing for VZV enabled successful treatment with intravenous acyclovir and immunoglobulin therapy. Early recognition and ...

What is your diagnosis? Diagnosis: Pott's puffy tumor with associated Streptococcus intermedius ( Streptococcus milleri group) abscess. Bacterial cultures from the abscess fluid demonstrated pure growth of Streptococcus intermedius . Owing to her frailty, the patient and family elected for no ...

A 25-year-old male who immigrated to New York City from Ecuador 1 year ago, and with no known past medical history, presented to the emergency department after an episode of syncope. The patient had been at work at his construction job when he became acutely lightheaded and flushed before losing ...

A. algerae infection should be considered in patients with RA and other immunosuppressive conditions who present with muscle weakness, fever, and myalgia. A biopsy is needed to confirm the diagnosis and allow the urgent commencement of directed therapy. Immunosuppressed patients who are exposed to ...

A 33-year-old woman with chronic autoimmune thyroiditis managed with levothyroxine presented to the emergency department with a rash and fever after a 2-week trip to Gaborone, Botswana. One week prior to presentation, the patient had noted a tender pink papule on her left upper back; over the ...

A 40-year-old female with factor V Leiden deficiency on chronic aspirin therapy presented to her dermatologist for evaluation of a chin lesion. Two weeks prior to the onset of the skin lesion, she had returned from a 10-day trip to Costa Rica for an eco-adventure with her husband and their ...

A 69-year-old female with type 2 diabetes (A1C 12.4%), hypertension, and hyperlipidemia presented to her dentist with a 2-day history of left-lower jaw pain (worse when chewing) and swelling. Her dentist identified pulpitis and periodontitis under the crown of her first molar (tooth number 19) and ...

Diagnosis: Possible primary cutaneous coccidioidomycosis with dissemination to adrenal glands. A skin punch biopsy was performed on a nodule on his right upper chest. The specimen was sent for cultures and histopathological examination. Three of 4 surgical culture media and 1 of 2 fungal media grew ...

Our patient's clinical course was characterized by slow improvement. Podiatry performed extensive debridement of grossly infected soft tissues. Therapy with azithromycin and ethambutol began after the biopsy stain results were obtained, 10 days after initial presentation. Further doses of ...

A 47-year-old man was admitted in our hospital for intractable fever, respiratory symptoms, and skin lesions. Two months previously, the patient started experiencing fever up to 39.3℃ associated with fatigue, cough, and phlegm. Soon, skin lesions were noted as indurated erythematous patches on the ...

Treatment of disseminated cryptococcosis (ie, involvement of at least 2 noncontiguous sites) is similar to treatment of CNS disease. Current guidelines divide treatment into 3 phases: induction, consolidation, and maintenance. The induction phase consists of intravenous (IV) liposomal amphotericin ...

A 56-year-old Caucasian retired powerplant operator from regional Australia was admitted after an unwitnessed collapse with head-strike at home. The collapse occurred suddenly without any preceding symptoms with no associated neurological or cardiac symptoms. However, he reported an 18-month ...

A 22-year-old male originally from Puerto Rico presented to his provider with left shoulder pain. The pain had been ongoing for 4 months and was exacerbated by movement. He reported pain with range of motion but had no other symptoms. A left shoulder X-ray demonstrated an approximately 6.5-cm mass ...

What is the diagnosis? Diagnosis: Treponema pallidum presenting with cerebral gumma as a feature of early neurosyphilis. The diagnosis of syphilis was confirmed by serological testing of peripheral blood, including a reactive syphilis total enzyme immunoassay, treponemal pallidum particle ...

Acknowledgments. The authors thank Dr Julia Shelburne and her Pediatric Hospital Medicine team at Texas Children's Hospital for assistance in caring for this patient and Dr Denver Niles for providing the pathology image displayed. They thank Dr Andrew Abbott at the CDC for advice concerning ...

What is your diagnosis? Diagnosis: cutaneous phaeohyphomycosis caused by Pleurostomophora richardsiae . Surgical excision of the 3 subcutaneous nodules was performed ( Figure 3 ). Histological examination showed chronic inflammation with granuloma and hematoxylin-eosin–positive conidia and hyphae ...

Acknowledgments. Written informed consent was obtained from the patient to publish this case and the clinical images. Financial support. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. A 79-year-old female presented to ...

Diagnosis: Disseminated Acanthamoebiasis with Granulomatous Amebic Encephalitis. We conducted multidisciplinary discussions among specialists in infectious diseases, clinical microbiology, pathology, and hematology/oncology for comprehensive evaluation of this complex case. Our differential ...

A 63-year-old male with mental illness and a history of bilateral intraocular lens implantation was found on the street by the local police and taken to the emergency department. The man had severe left ocular pain with associated edema and foul-smelling purulent discharge. Maggots were present ...

Informed consent statement. Case details have been anonymized, and the patient signed a consent form permitting publication of this case and clinical images. Histoplasmosis in solid organ transplant recipients is relatively rare, with a 12-month cumulative incidence rate of. 102% reported in the ...

The first-line treatment for DGI is ceftriaxone (1 g given daily for 7 days, intramuscularly or intravenously) plus either oral azithromycin (a single 1 g dose given orally) or doxycycline (100 mg given orally, twice daily for 7 days) to provide additional coverage for N. gonorrhoeae as well as ...

In our patient, chest CT showed that the posterior basal segment of the lower lobe of the right lung contained a pulmonary cavity, but the blood culture was negative. It is possible that penetration of the blood‒brain barrier through the lymphatic system led to the intracranial infection. Most ...

A 25-year-old white woman presented at our outpatient clinic with a 36-month history of abdominal discomfort associated with relapsing fever (with spikes at 39°C) and weight loss (20 kg in 3 years). Before symptom onset, her medical history was unremarkable. She has 2 children in good health. ...

A 58-year-old male with a past medical history of metastatic clear cell renal cell carcinoma (RCC) treated with nephrectomy and adjuvant pharmacotherapy presented to his primary care clinic with 1-and-a-half-year history of dysphagia, odynophagia, and hoarseness. He noticed progressive symptom ...

Since the first report of EPDS in 1979, the number of relevant cases and studies has increased gradually, implying that EPDS is likely to be more common than previously imagined [ 4 ]. The diagnosis of EPDS mainly depends on clinical manifestations because of negative microbial investigations and ...

The patient was referred to ophthalmology where she was noted to have abnormal findings in her conjunctiva ( Figure 2 ). She underwent a computed tomography scan of the orbits that showed right-sided preseptal soft tissue swelling with a 0.6-cm × 0.8-cm fluid collection with foci of gas in the ...

QUESTION Timely administration of appropriate antibiotic therapy is critical to avoiding its progression. The scrub typhus immunoglobulin M (IgM) test further confirmed the diagnosis. The patient was treated with supportive measures and a 1-week course of doxycycline 100 mg twice daily. The fever ...

A 43-year-old man was referred for screening colonoscopy as part of evaluation for lung transplantation. He denied any abdominal pain, diarrhea, melena, hematochezia, or change in his stools. He had no weight loss, night sweats, or loss of appetite. His past medical history was significant for ...

What is your diagnosis? Diagnosis: Rasmussen aneurysm due to pulmonary tuberculosis. Question: A 45-year-old man with a history of illicit drug dependence on heroin and opiate presented with complaints of progressive shortness of breath and chronic productive cough for the previous 3 months. The ...

A 30-year-old man without a significant medical history presented to the emergency department with 5 days of worsening left hand pain and swelling. The patient denied fevers or chills. He also denied recent trauma to his finger or travel, sick contacts, or pets at home. He was sexually active with ...

Polymerase chain reaction (PCR) testing for herpes simplex virus type 1 (HSV-1) was positive from lesion fluid. Peripheral blood HSV-1 immunoglobulin M (IgM) and immunoglobulin G (IgG) were positive. A diagnosis of herpes simplex vegetans was made. The patient received 4 weeks of oral valacyclovir ...

Photobacterium damselae causing necrotizing soft tissue infection. Necrotizing skin and soft tissue infections can be caused by a variety of organisms including Staphylococcus aureus , beta-hemolytic streptococci, and clostridial species including Clostridium perfringens and Clostridium ...

A 27-year-old woman presented to the emergency department with a 5-month history of abdominal pain and a 7-kg weight loss. She had no medical or surgical history and did not take medications. She immigrated to Canada from the Philippines 11 months before symptom onset. The month before ...

A 72-year-old man presented with elephantiasis and multiple large plaques covered with white scales over his right lower extremity that have been present for the past 30 years. The lesion started as a small papule on the right thigh; it has steadily grown in size to involve the entire limb and ...

A 34-year-old woman with congenital human immunodeficiency virus (HIV)/AIDS presented with a 10-day history of intermittent right arm and leg shaking movements. The movements happen multiple times during the day, last seconds to a minute, occurred at rest but mostly with intention and did not ...

A 2-year-old boy presented in September 2020 with a 3-day history of fever associated with a “bug bite–like” lesion on his left knee that enlarged and, because of pain, progressed to non–weight bearing despite treatment for 2 days with clindamycin and mupirocin. His medical history was notable for ...

Question: What is your diagnosis? Answer: Protothecosis, Prototheca wickerhamii . P. wickerhamii is a rare disease caused by achlorophyllic algae of the genus Prototheca . Prototheca are ubiquitous in the environment and are found in soil, decomposing flora, water, and may colonize human ...

Mollicute septic arthritis is rare [ 1 , 8 ]. Although M. hominis or Ureaplasma spp. single organism septic arthritis and periprosthetic joint infections have been reported in immunocompromised hosts [ 7 , 15–21 ], there are very few case reports involving immunocompetent patients [ 5 , 15 , ...

An otherwise healthy 2-year-old boy presented to the emergency department with a history of fever (100.3°F), edema, erythema, and purulent discharge in the right periorbital region for 1 week ( Figure 1A ). Visual acuity and ocular movements were preserved at presentation. The remainder of the ...

A 79-year-old male presented to the pulmonary service in April 2021 complaining of persistent, productive cough for 2 months, with fatigue and night sweats. His relevant past medical history included asbestos exposure in the 1980s, chronic obstructive pulmonary disease, emphysema requiring ...

Histologic sections demonstrated enlarged and dilated hair follicles lacking hair shafts, plugging at the follicular infundibula, expansion of the inner root sheath, and enlarged, eosinophilic trichohyalin granules ( Figure 2 ), consistent with a diagnosis of trichodysplasia spinulosa (TS). ...

A left-handed 51-year-old previously healthy man presented with progressively decreased motor skills (primarily writing) and mild right frontal headache. On physical examination, he was alert with no meningismus. Cranial nerve testing and fundoscopy were normal. Minimal left-sided weakness in an ...

NEC is a diagnosis of exclusion but should be considered in neutropenic patients with fever, abdominal pain, and diarrhea. The treatment is conservative [ 1–3 ], although surgery may be required if bleeding or perforation develops or conservative therapy fails [ 1–3 ]. Mortality rates of up to 22% ...

Treatment of sparganosis is by surgical resection. Biopsy, which kills the larva, is usually considered curative. The clinical features of sparganosis depend on the tissue location of the parasite. Pain or a migrating mass are the most commonly reported symptoms. Several reported cases of ...

Diagnosis: Necrotizing Herpetic Whitlow Specimens from both digital and genital ulcers were tested for herpes simplex virus (HSV) using a polymerase chain reaction (PCR) test, and all 3 sites were positive for HSV type 2 (HSV-2). He was diagnosed with necrotizing herpetic whitlow, and digit ...

A previously healthy 6-year-old girl of Canadian birth presented with a non-tender soft tissue swelling on the right cheek. The swelling initially began as a small pimple-like swelling that enlarged over 4 weeks with subsequent spontaneous discharge of “cream-colored” fluid. Examination revealed a ...

(See pages xx for the Answer to the Photo Quiz.) A 48-year-old man with living with well-controlled human immunodeficiency virus (HIV) and treated plasmablastic lymphoma presented with 3 weeks of left shin pain and 8 days of right shin and left forearm pain. There was no history of trauma. The pain ...

Financial support. The authors declare that no funding was received for this work. When epidemiological risk factors are present, empirical antibiotics that are active against B pseudomallei such as intravenous ceftazidime should be empirically initiated while diagnostic evaluation is under way ...

In August, a 55-year-old man presented with fever, progressive lethargy, body aches, joint pains, and intermittent confusion that lasted for 10 days. Past medical history included alcohol use and splenectomy. The patient was a resident of western Pennsylvania, lived in the countryside, and enjoyed ...

On the trunk and extremities, syphilis often presents as macular lesions, which can enlarge up to 20 mm [ 2 , 3 ]. The macular lesions recede with pressure may change color or enlarge, or become annular or thickened. Like on the face, papules can also occur at various sizes on the trunks and ...

When there is a suspicion or a confirmed case of mucormycosis, the antifungal drugs of choice in solid-organ-transplant recipients are liposomal amphotericin B or amphotericin B lipid complex at 10 mg/kg/day from day 1. Delayed initiation of appropriate therapy is associated with increased ...

Financial support. This work was supported by HCA Healthcare and/or an HCA Healthcare affiliated entity. The clinical manifestations of blastomycosis are variable and those with immunocompromising conditions such as HIV/AIDS will have more severe disease and increased mortality rates. ...

Orf virus lesion development follows a stereotypical pattern over a 4–8-week period of time, initially starting as a papule, then progressing to a vesicle, followed by shallow annular ulcer, which later scabs and heals with little or no residual scar formation [ 4 ]. The differential diagnosis ...

A 52-year-old man who had undergone cadaveric-forearm vascularized composite allotransplantation (VCA) presented to our hospital with fever and dyspnea 8 months after transplantation. He received immunosuppressive regimens of tacrolimus (2 mg twice daily), mycophenolate mofetil (250 mg twice ...

Diagnosis of cutaneous botryomycosis should be considered in patients with repetitive skin trauma who present with tumor-like nodules with a central draining sinus [ 3 ]. Although cutaneous botryomycosis can occur in immunocompetent patients, an immunodeficiency should raise suspicion [ 3 ]. Our ...

Acknowledgments. We thank the parasitology laboratory team at Cadham Provincial Laboratory (specifically Paul Li) for help enabling parasite photography and willingness to keep old salmon in his laboratory fridge. Potential conflicts of interest. All authors: No reported conflicts of interest. ...

Potential conflicts of interest. I. B. reports support from Gilead and ViiV for research, paid to their institution, and personal fees for serving on speakers bureaus for Gilead, ViiV, and Janssen, outside the submitted work. All other authors report no potential conflicts. All authors have ...

Due to the fact that proctitis with rectal ulcer was observed, an MRI was performed. This revealed a presacral collection with a fistula toward the posterior wall of the rectum ( Figure 3 ). Ultrasound-guided needle aspiration of the dorsal paravertebral collection was performed. This was ...

Potential conflicts of interest. The authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. Infections caused by R. ...

A 22-year-old man from Australia presented with right painless loss of vision and a vesicular rash. There was no history of systemic illness, medication use, or immunosuppression and no significant medical and ocular history apart from chickenpox as a child. No recent travel had been undertaken. ...

A 47-year-old parous, Hispanic woman who had undergone left mastectomy for ductal breast carcinoma in situ and right mastopexy for cosmesis presented for a 6-month follow-up breast magnetic resonance imaging (MRI). Images of the right breast showed ductal enhancement extending into the nipple and ...

The genetic test confirmed homozygous Q289X CARD9 mutation. Despite terbinafine, griseofulvine, amphotericin B, itraconazole, voriconazole, and posaconazole, there was progressive facial midline destruction. Currently the patient remains stable with itraconazole 400 mg / day. A 50-year-old Spanish ...

What is the diagnosis? A 70-year-old previously healthy man presented with fever (highest recorded temperature, 39 °C) and extreme fatigue that had persisted for 2 months. The patient had a slight cough and reported weight loss of 15 kg, but denied the presence of any other symptoms. On initial ...

A 64-year-old man noticed an insidious onset of throbbing pain in his right leg, just below the knee. He did not recall trauma, but he enjoyed playing pickle ball and kayaking. He did not have immunocompromising conditions, and he had no history of leg surgery or therapeutic injection in the knee. ...

All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. Potential conflicts of interest. The authors: No potential conflicts of interest. Ectopic cutaneous ...

A 51-year-old woman with eczema applying topical steroids presented to the infectious diseases clinic for right hand skin lesions. She reported progression of several nodules on the dorsum of her right hand over 3 months. The nodules were enlarging, becoming more painful and pruritic, and some had ...

Early recognition and proper treatment of IgG4-RD is paramount to adequately treat and prevent disease progression. Glucocorticoid therapy is usually the initial treatment. However, disease flares are common during glucocorticoid tapers and therefore additional immunomodulatory therapy such as ...

A 48-year-old man with diabetes mellitus presented to the emergency department with bilateral hand erythema, edema, and a large, purulent ulceration with eschar of the left hand ( Figure 1 ). He also had hyperpigmented, indurated plaques and subcutaneous nodules of the bilateral lower extremities ...

A 31-year-old male who is human immunodeficiency virus (HIV) seropositive and on stable antiretroviral therapy (ART) of abacavir, lamivudine, and dolutegravir was admitted to our hospital for investigation of dyspnea associated with progressive mediastinal lymphadenopathy and new pulmonary nodules. ...

A 49-year-old male with a remote history of alcohol use disorder presented to a tertiary hospital emergency department (Manitoba, Canada) with a 5-day history of subjective fever, nausea, vomiting, watery diarrhea, and right upper quadrant abdominal pain. Review of systems was otherwise negative. ...

A 28-year-old man with a past medical history of a multivisceral transplant (liver, pancreas, intestine, and stomach) 3 years prior, end-stage kidney disease, adrenal insufficiency, and recently diagnosed influenza-associated pulmonary aspergillosis (wild-type Aspergillus fumigatus treated with ...

A 35-year-old man with a history of anogenital herpes simplex virus 1 infection managed with episodic valacyclovir presented to the sexual health clinic in January with pruritis involving his chest, abdomen, and groin. He had noted some red spots in the same distribution, most of which had already ...

The mortality of mucormycosis is high, ranging from 31% to 68% depending on the site of involvement [ 5 ]. Mortality for disseminated mucormycosis is as high as 68% [ 5 ] to approximately 91% [ 10 ]. Successful management of mucormycosis requires a timely diagnosis, early initiation of antifungal ...

The clinical course of KFD is typically self-limited lasting less than 6 months and requires no specific therapy. More severe cases can be treated with steroids, for which there is some anecdotal evidence of benefit [ 2 ]. One study published suggested a mortality rate of 2.1%, though nearly all ...

On physical examination, she was found to have evidence of jugular venous distention and a worsening diffuse precordial murmur with radiation to her axilla. A transthoracic echocardiogram revealed new severe aortic regurgitation, a large vegetation on the noncoronary cusp of the aortic valve, ...

A 51-year-old Congolese patient presented with sicca syndrome, previously diagnosed panuveitis, headache, and a chronic dry cough. He had a weight loss of 20 kg over a 1-year period and denied any fever. Ophthalmological examination diagnosed bilateral granulomatous panuveitis. He had not travelled ...

Potential conflicts of interest. The authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. In the literature, the ...

Clostridium ventriculi (previously known as Sarcina ventriculi ) is a gram-positive, nonmotile, catalase-negative, spore-forming, anaerobic coccus that displays a classic cuboid-shaped tetrad or octet arrangement, which is a result of their cell division patterns occurring in at least 2 planes [ ...

Symptoms of intestinal schistosomiasis include abdominal pain, diarrhea, constipation, and occasionally hematochezia [ 7 ]. Chronic infection can lead to systemic complications including iron deficiency, anemia of chronic inflammation, malnutrition, cognitive impairment, and exacerbation of other ...

Acknowledgments. The authors thank Elisabeth Homassel for her technical assistance. Potential conflicts of interest. The authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. A 3-month-old child was referred to ...

A 70-year-old white man with a history of atrial fibrillation, hypertension, coronary artery disease with an automatic implantable cardioverter defibrillator (AICD) placement, and laparoscopic repair of a giant paraesophageal hernia in February 2019 presented to the emergency department in June ...

Supplementary materials are available at Clinical Infectious Diseases online. Consisting of data provided by the authors to benefit the reader, the posted materials are not copyedited and are the sole responsibility of the authors, so questions or comments should be addressed to the corresponding ...

A 57-year-old man with a medical history notable for hypertension presented with 10 days of blue skin discoloration on the bilateral arms and trunk. The discoloration was asymptomatic without any associated pain or itch. His medications included hydrochlorothiazide, olmesartan, and amlodipine with ...

Contributions . All authors were involved in the diagnosis and clinical care of the patient. J. F. C. wrote the first draft of the manuscript. All authors revised and approved the manuscript. The authors have obtained written parental consent for publication. Potential conflicts of interest. All ...

An 84-year-old woman presented with a blueish-gray coloration of the skin ( Figure 1A , B , C ). Her history included senile dementia and osteoporosis that was complicated with multiple fractures, including a displaced fracture of the neck of the right femur in 2012 that required total hip ...

Endoscopic extraction of the worms is usually sufficient, as symptoms regress usually within a few days [ 2 ]. A unique couple is found in most human cases. If extraction fails or if there is any doubt about the presence of other couples, some authors recommend treatment with benzimidazoles. ...

Radiographic assessment is instrumental to diagnosis of tuberculous spondylitis. Gadolinium-enhanced MRI is the most sensitive as it detects the earliest changes of infection and offers the best evaluation of soft tissue and neural involvement [ 5 , 6 ]. Key features suggestive of tuberculous ...

Tropheryma whipplei was detected in CSF and serum by polymerase chain reaction (PCR), confirming the diagnosis of Whipple disease (WD). The patient’s symptoms significantly improved with intravenous ceftriaxone for 2 weeks, followed by oral trimethoprim-sulfamethoxazole (TMP-SMX). He was ...

A 71-year-old Singaporean Chinese male presented to our institution (a public tertiary hospital in Singapore) with a 1-month history of an enlarging ulcerating perianal mass. Eight months before, the patient had suffered an acute stroke in the left middle cerebral artery territory and, due to poor ...