Subcutaneous nodule in the chest – Uncommon presentation of a common disease

We report a case of pyrexia of unknown origin in a 35 yr old male . He presented to us with fever since 2 months which was associated with chills and rigor . He is non alcoholic , non smoker . Mild Hepatosplenomegaly was found on initial physical examination. Before he was referred to our hospital, he was investigated in outside hospital . The serial Rapid Diagnostic Test and microscopic peripheral blood smears for plasmodium were negative . He was treated symptomatically . In view of non subsiding fever patient was referred to higher centre . He presented to our institute for further evaluation . His laboratory findings found pancytopenia. Bone marrow aspiration(BMA) was done. BMA showed Gametocytes of P. falciparum. The presence of gametocytes of P.Falciparum in the bone marrow ,not in peripheral smear and presenting as PUO is rare .

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Necrotizing pneumonia due to Mycoplasma in children: an uncommon presentation of a common disease

Advances in respiratory medicine ◽

10.5603/arm.a2018.0049 ◽

2015 ◽

Cited By ~ 1

Author(s):

Isabel San Martin ◽

Sada Elena Zarikian ◽

Mercedes Herranz ◽

Laura Moreno-Galarraga

Keyword(s):

Common Disease ◽

Necrotizing Pneumonia ◽

Uncommon Presentation

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Scrub typhus, a rare of cause of fulminant hepatic failure: A common disease with uncommon presentation

Indian Journal of Case Reports ◽

10.32677/ijcr.v7i12.3178 ◽

2022 ◽

pp. 526-528

Author(s):

Subramani Jagadeesan ◽

Pranav Patel ◽

Ajay Jain

Keyword(s):

Fulminant Hepatic Failure ◽

Hepatic Failure ◽

Scrub Typhus ◽

Kidney Injury ◽

Asia Pacific ◽

Common Disease ◽

Antibiotic Administration ◽

Elderly Male ◽

High Grade Fever ◽

Uncommon Presentation

Scrub typhus (bush typhus) is a potentially lethal mite-borne, acute febrile infectious illness caused by Orientia tsutsugamushi, reported precipitating frequent outbreaks in the Asia-pacific belt. Usual presentation after a median incubation period of 10–14 days, stretches from pathognomonic eschar, high-grade fever, centrifugal skin rash, jaundice, regional lymphadenopathy to frontal headache, nevertheless complicated at times with myocarditis, acute respiratory distress syndrome, acute kidney injury, encephalitis, and shock. Although patients with scrub typhus invariably do display mild liver injury, fulminant hepatic failure (FHF) is rarely reported. We describe herein, a case of FHF in an elderly male that responded well to antibiotics. Early diagnosis and sensitive antibiotic administration aids in mortality prevention of the former.

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High-Titre ANA Positivity in NAFLD: An Uncommon Presentation of a Common Disease

European Journal of Case Reports in Internal Medicine ◽

10.12890/2020_001714 ◽

2020 ◽

Author(s):

Asis Mitra ◽

Saswati Ray

Keyword(s):

Liver Disease ◽

Fatty Liver Disease ◽

Antinuclear Antibodies ◽

High Titre ◽

Common Disease ◽

Alcoholic Fatty Liver ◽

Uncommon Presentation ◽

Public Health Challenge ◽

Alcoholic Fatty Liver Disease ◽

Vitamin E Supplementation

Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease and has emerged as a serious public health challenge. About 20% of NAFLD patients may have low titres (<1:320) of antinuclear antibodies (ANA). However, we describe a patient with NAFLD whose ANA titre was high (>1:320) on presentation. After 3 months of diet, exercise and vitamin E supplementation,the patient was symptomatically better but her ANA titre had increased (>1:640). Her liver biopsy showed features of NAFLD with minimal fibrosis. High-titre ANA (>1:320) positivity is rare. Our patient showed a progressive rise in ANA titre from >1:320 to >1:640 within 3 months even though she was improving and histology showed minimal fibrosis.

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