MyMedR

Randhawa HS

Mycopathol Mycol Appl, 1970;41(1):75-89.

Matched MeSH terms: Diagnosis, Differential

New Genus of Blood Fluke (Digenea: Schistosomatoidea) from Malaysian Freshwater Turtles (Geoemydidae) and its Phylogenetic Position Within Schistosomatoidea

Roberts JR, Platt TR, Orélis-Ribeiro R, Bullard SA

J Parasitol, 2016 08;102(4):451-62.

PMID: 27042972 DOI: 10.1645/15-893

: Baracktrema obamai n. gen., n. sp. infects the lung of geoemydid turtles (black marsh turtle, Siebenrockiella crassicollis [type host] and southeast Asian box turtle, Cuora amboinensis ) in the Malaysian states of Perak, Perlis, and Selangor. Baracktrema and Unicaecum Stunkard, 1925 are the only accepted turtle blood fluke genera having the combination of a single cecum, single testis, oviducal seminal receptacle, and uterine pouch. Baracktrema differs from Unicaecum by having a thread-like body approximately 30-50× longer than wide and post-cecal terminal genitalia. Unicaecum has a body approximately 8-12× longer than wide and terminal genitalia that are anterior to the distal end of the cecum. The new genus further differs from all other accepted turtle blood fluke genera by having a cecum that is highly convoluted for its entire length, a spindle-shaped ovary between the cirrus sac and testis, a uterine pouch that loops around the primary vitelline collecting duct, a Laurer's canal, and a dorsal common genital pore. Phylogenetic analysis of the D1-D3 domains of the nuclear large subunit ribosomal DNA (28S) revealed, with high nodal support and as predicted by morphology, that Baracktrema and Unicaecum share a recent common ancestor and form a clade sister to the freshwater turtle blood flukes of Spirorchis, paraphyletic Spirhapalum, and Vasotrema and that, collectively, these flukes were sister to all other tetrapod blood flukes (Hapalorhynchus + Griphobilharzia plus the marine turtle blood flukes and schistosomes). Pending a forthcoming emended morphological diagnosis of the family, the clade including Spirorchis spp., paraphyletic Spirhapalum, Vasotrema, Baracktrema, and Unicaecum is a likely placeholder for "Spirorchiidae Stunkard, 1921 " (type genus Spirorchis MacCallum, 1918 ; type species Spirorchis innominatus Ward, 1921 ). The present study comprises the 17th blood fluke known to infect geoemydid turtles and the first proposal of a new genus of turtle blood fluke in 21 yr.

Matched MeSH terms: Diagnosis, Differential

Dermoid cyst simulating recurrent dacryocystitis in a toddler

Tengku-Fatishah A, Abdullah B, Sanjeevan N, Nurul-Shuhada AH, Sharifah-Emilia TS, Haron J, et al.

Can J Ophthalmol, 2019 08;54(4):e196-e199.

PMID: 31358169 DOI: 10.1016/j.jcjo.2018.10.006

Matched MeSH terms: Diagnosis, Differential

Trisomy 21 and hydrops fetalis: parvovirus B19 or transient abnormal myelopoiesis?

Tan LN, Cheung KW, Kilby MD

J Obstet Gynaecol, 2019 May;39(4):556-557.

PMID: 30634881 DOI: 10.1080/01443615.2018.1530740

Matched MeSH terms: Diagnosis, Differential

Fulltext Concurrent juvenile myelomonocytic leukemia with thalassemia in a case with Plasmodium knowlesi infection from Sabah, Malaysian Borneo

Abdullah MA, Abdullah SM, Kumar SV, Hoque MZ

Hematol Rep, 2019 Sep 18;11(3):8167.

PMID: 31579124 DOI: 10.4081/hr.2019.8167

A 3-year-old male child was presented with worsening abdominal pain, abdominal distension, lethargy, pallor and hepatosplenomegaly. The patient had multiple outpatient visits in the past and was treated with oral antibiotics, oral anthelmintic agents, albeit with minimal benefit. The patient also had non-neutropenic pyrexia spikes and oral ulcers. The patient was an adopted child; hence details about his biological parents' previous history were unclear. Differential diagnosis of Chronic Myelomonocytic Leukemia (CMML), Juvenile Myelomonocytic Leukemia (JMML), Gaucher's disease, Thalassemia and discrete pancreatic pathology was considered. Hemoglobin electrophoresis was indicative of thalassemia. Also, molecular detection method by polymerase chain reaction confirms a concurrent infection with Plasmodium knowlesi malaria. The BCR-ABL fusion gene was found to be negative. Correlating with peripheral monocytosis, bone marrow aspiration and trephine biopsy with blasts only 3-4% and hepatosplenomegaly, a diagnosis of JMML was established. We present a rare phenomenon with an overlap of signs and symptoms between JMML, underlying thalassemia, and Plasmodium knowlesi, posing a diagnostic challenge to physicians.

Matched MeSH terms: Diagnosis, Differential

Fulltext Mesenchymal chondrosarcoma of maxilla in paediatric patient

Choo CS, Wan Abdul Rahman WF, Jaafar H, Ramli RR

BMJ Case Rep, 2019 Mar 09;12(3).

PMID: 30852518 DOI: 10.1136/bcr-2018-228969

Chondrosarcoma (CS) is a malignant tumour of long and flat bone characterised by the formation of cartilage. Mesenchymal chondrosarcoma (MCS) is a rare subtype of CS that is more aggressive and may lead to erroneous diagnosis in a limited biopsy. The diagnosis is mainly based on the histopathological appearance of biphasic pattern of undifferentiated small round cells separated by islands of well-differentiated hyaline cartilage. We report a case of 13-year-old boy who initially presented with gum swelling and the biopsy result suggested a benign fibrous lesion. Following an extensive lesion shown in radiologic findings, the tumour excision was done and finally was diagnosed as an MCS of the maxilla. The patient was given postoperative chemotherapy (EURO-EWING 99 regimen), and now on regular follow-up for monitoring of local recurrence or tumour metastasis.

Matched MeSH terms: Diagnosis, Differential

Fulltext New concepts of hepatic amoebiasis

Balasegaram M

Ann Surg, 1972 Apr;175(4):528-34.

PMID: 4259839

Matched MeSH terms: Diagnosis, Differential

Large breast lump with bloody nipple discharge: benign intraductal papilloma

Cheah SD, Imi Sairi AH

BMJ Case Rep, 2020 Nov 04;13(11).

PMID: 33148555 DOI: 10.1136/bcr-2020-236818

A 32-year-old woman presented with a 3 cm×3 cm left breast lump associated with bloody nipple discharge during her early pregnancy. Examination and ultrasonography showed benign features, whereas core needle biopsies revealed a benign papilloma. Six months after her delivery, a 6 cm×6 cm benign papilloma was completely excised via circumareolar incision. The majority of intraductal papillomas are small; however, they can also present as a large mass rarely. We should be wary of a malignant papillary lesion when there is the presence of atypia on core needle biopsy or imaging-histology discordance. A concordant benign papilloma with benign imaging findings is otherwise reassuring. Clinicians need to be aware of this uncommon presentation of large intraductal papilloma as a complete curative excision can be achieved through a cosmetically placed incision.

Matched MeSH terms: Diagnosis, Differential

Emphysematous gastritis after metastatic malignant melanoma: a radiological surprise

Ng CY, Hayati F, Nadarajan C

BMJ Case Rep, 2020 Sep 09;13(9).

PMID: 32912885 DOI: 10.1136/bcr-2020-235174

Malignant melanoma is cancer of the skin which commonly metastasises to the stomach. There have been no reported cases of emphysematous gastritis secondary to metastasis of malignant melanomas, to date. However, a 61-year-old woman with metastatic malignant melanoma of the left great toe presented to us with symptoms of severe left hypochondrium pain associated with high-grade fever, gross abdominal distension and recurrent vomiting. Two months earlier, metastasis was observed to have spread to the stomach and inguinal lymph nodes. At this stage, the patient opted for traditional medication instead of definitive surgery and chemotherapy. Radiological imaging revealed an emphysematous change to the stomach which was radiologically consistent with gastric malignant melanoma. Unfortunately, the patient succumbed to this rare condition.

Matched MeSH terms: Diagnosis, Differential

Fine-needle aspiration cytology in Kimura's disease

Jayaram G, Peh KB

Diagn Cytopathol, 1995 Nov;13(4):295-9.

PMID: 8599911

Three patients presenting with parotid, submandibular, and/or lymph node masses were subjected to fine-needle aspiration cytology. Smears showed dissociated and clustered endothelial cells, eosinophils, lymphocytes, and Warthin Finkeldey giant cells. In two cases a diagnosis of Kimura's disease was suggested from the FNA cytologic smears. In the third case the presence of mononucleate cells with prominent nucleoli led to a suspicion of Hodgkin's disease. Excision biopsy and histopathologic study established a diagnosis of Kimura's disease in all three cases.

Matched MeSH terms: Diagnosis, Differential

Fulltext Infected aneurysm after returning from Southeast Asia: think Burkholderia pseudomallei!

Auvens C, Neuwirth C, Piroth L, Blot M

BMJ Case Rep, 2019 May 22;12(5).

PMID: 31122956 DOI: 10.1136/bcr-2018-228856

Melioidosis is a protean disease which is endemic to Southeast Asia and northern Australia. Here, we report a case of infected aortic aneurysm due to Burkholderia pseudomallei in an immunocompetent man 6 months after a trip to northern Malaysia. This patient initially received inappropriate surgical and antibiotic treatment, leading to a peri-prosthetic aortic infection with lumbar spondylitis and contiguous psoas muscle abscess. This case highlights the difficulty of diagnosing melioidosis given its diverse clinical manifestations and the limits of routine microbiological methods to identify B. pseudomallei Melioidosis should be considered a possible diagnosis in individuals with unexplained fever subsequent to travel in an endemic area.

Matched MeSH terms: Diagnosis, Differential

Haemolytic anaemia precipitated by dengue fever

Abdullah NH, Mohammad N, Ramli M, Wan Ghazali WS

BMJ Case Rep, 2019 Aug 28;12(8).

PMID: 31466966 DOI: 10.1136/bcr-2018-226760

We reported a case of a woman with no past medical illness who presented with a few days' history of fever, myalgia, arthralgia, hypochromic microcytic anaemia and thrombocytopaenia and who was nonstructural protein 1 antigen (NS1Ag)-positive. Haemolytic anaemia including full blood picture work-up revealed high reticulocyte count and haemolysis with positive direct Coombs test. She was started on prednisolone and was discharged well.

Matched MeSH terms: Diagnosis, Differential

Fulltext Analysis of the leprosy agents Mycobacterium leprae and Mycobacterium lepromatosis in four countries

Han XY, Aung FM, Choon SE, Werner B

Am J Clin Pathol, 2014 Oct;142(4):524-32.

PMID: 25239420 DOI: 10.1309/AJCP1GLCBE5CDZRM

To differentiate the leprosy agents Mycobacterium leprae and Mycobacterium lepromatosis and correlate them with geographic distribution and clinicopathologic features.

Matched MeSH terms: Diagnosis, Differential

Inverted left atrial appendage masquerading as a cardiac mass

Leong MC, Latiff HA, Hew CC, Mazlan SL, Osman H

Echocardiography, 2013 Feb;30(2):E33-5.

PMID: 23134298 DOI: 10.1111/echo.12044

An inverted left atrial appendage is a rare phenomenon post cardiac surgery. The lesion presents as an additional mass in the left atrium, which would trigger unnecessary concerns and frequently, a battery of tests. The lesion can be easily diagnosed using echocardiography. We report a case of inverted left atrial appendage in a patient post repair of common arterial trunk. Echocardiographic pictures and features which help to identify this lesion as well as to differentiate it from other possible left atrial mass are described. This article aimed to improve the awareness of sonographers toward this rare but possible post operative lesion.

Matched MeSH terms: Diagnosis, Differential

Fulltext Florid papillomatosis of the nipple

Dinesh BJ, Hayati F, Azizan N, Abdul Rashid NF

BMJ Case Rep, 2019 Sep 18;12(9).

PMID: 31537599 DOI: 10.1136/bcr-2019-231516

Florid papillomatosis (FP) of the nipple, or nipple adenoma, is a rare breast tumour, affecting middle-aged group population. A 46-year-old woman presented to us with a cauliflower-like FP of the right nipple with no blood stained discharge or breast lump. FP can be mistaken clinically for Paget's disease and occasionally misinterpreted as invasive ductal or intraductal carcinoma. Extensive intervention, correct diagnosis and prompt treatment are essential. Any breast pathology requires triple assessment including FP of the nipple. Once the diagnosis of ductal carcinoma is excluded, simple complete excision can be undertaken. This is to ensure complete obliteration of disease recurrence and preservation of cosmetic result. We discuss the pathology and psychosocial aspects of FP.

Matched MeSH terms: Diagnosis, Differential

Fulltext Case series of naturally acquired Plasmodium knowlesi infection in a tertiary teaching hospital

Azira NM, Zairi NZ, Amry AR, Zeehaida M

Trop Biomed, 2012 Sep;29(3):398-404.

PMID: 23018503 MyJurnal

Plasmodium knowlesi is a simian malaria parasite and is recently recognized as the fifth malaria parasite infecting humans. Manifestation of the infection may resemble other infection particularly dengue fever leading to inappropriate management and delay in treatment. We reported three cases of naturally acquired P. knowlesi in Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia. Clinical manifestations were quite similar in those cases. Microscopically, the diagnosis might be challenging. These cases were confirmed by polymerase chain reaction method which serves as a gold standard.

Matched MeSH terms: Diagnosis, Differential

Musculoskeletal lesions in yaws

Sengupta S

Clin Orthop Relat Res, 1985 Jan-Feb;?(192):193-8.

PMID: 3967422

Yaws, a spirochetal infection that is endemic in certain tropical countries, including Malaysia, may present with various orthopedic problems. As the condition is relatively unknown, diagnosis is often missed, which leads to poor management. There are initial, early, and late phases of the disease process. By involving skin, bone, and joints, yaws can produce deep ulcerations, joint deformities, and bone destruction. Within a ten-year period in Malaysia, 14 cases of serologically proven yaws have been treated for chronic ulcers, gross joint deformities, and pathologic fractures.

Matched MeSH terms: Diagnosis, Differential

Fulltext A Case Series of Malignant Otitis Externa Mimicking Malignancy

Selvamalar V, Othman NAN, Daud MK

Acta Medica (Hradec Kralove), 2021;64(1):36-41.

PMID: 33855957 DOI: 10.14712/18059694.2021.6

Malignant otitis externa is an inflammation of the external auditory canal with preceding osteomyelitis of the temporal bone and the adjacent structures that could be potentially lethal. Malignant otitis externa may present with cranial nerve involvements and massive spread of disease mimicking nasopharyngeal carcinoma or any other malignancies on imaging. Two elderly patients who presented with severe otalgia and significant facial nerve palsy and lower cranial nerve palsies showing extensive spread of disease are reported in this case series. They both had resolution of disease after a prolonged course of antibiotics and cortical mastoidectomy for disease clearance in one of them.

Matched MeSH terms: Diagnosis, Differential

Uncovering the sleep disorders among young doctors

Yasin R, Muntham D, Chirakalwasan N

Sleep Breath, 2016 Dec;20(4):1137-1144.

PMID: 27535070 DOI: 10.1007/s11325-016-1380-6

PURPOSE: Sleepiness and tiredness are common complaints among young doctors. Sleep deprivation is believed to be the main culprit. However, we believe that there may be other sleep disorders which may contribute to these symptoms such as occult obstructive sleep apnea (OSA).

METHODS: A prospective cross-sectional study was performed among young doctors less than 40 years old, working at King Chulalongkorn Memorial Hospital, Bangkok, Thailand, and Hospital Kuala Lumpur, Kuala Lumpur, Malaysia, using questionnaires and home sleep apnea testing (Apnealink™Plus). The primary objective of this study was to evaluate the prevalence of OSA (apnea-hypopnea index (AHI) ≥5). The secondary objectives were to evaluate the prevalence of obstructive sleep apnea syndrome (OSAS) defined by AHI ≥5 + excessive daytime sleepiness (EDS), sleep deprivation (the difference of weekend (non-workdays) and weekday (workdays) wake-up time of at least 2 h), EDS (Epworth Sleepiness Scale score ≥10), tiredness, and perception of inadequate sleep as well as to identify their predictors.

RESULTS: Total of 52 subjects completed the study. Mean age and mean body mass index (BMI) were 31.3 ± 4 and 23.3 ± 3.6, respectively. The prevalence of OSA and OSAS were 40.4 and 5.8 %, respectively. One third of OSA subjects were at least moderate OSA. Prevalence of sleep deprivation, EDS, tiredness, and perception of inadequate sleep were 44.2, 15.4, 65.4, and 61.5 %, respectively. History of snoring, being male, and perception of inadequate sleep were significant predictors for OSA with the odds ratio of 34.5 (p = 0.016, 95 % CI = 1.92-619.15), 18.8 (p = 0.001, 95 % CI = 3.10-113.41), and 7.4 (p = 0.037, 95 % CI = 1.13-48.30), respectively. Only observed apnea was a significant predictor for OSAS with odds ratio of 30.7 (p = 0.012, 95 % CI = 2.12-442.6). Number of naps per week was a significant predictor for EDS with the odds ratio of 1.78 (p = 0.007, 95 % CI = 1.17-2.71). OSA and total number of call days per month were significant predictors for tiredness with the odds ratio of 4.8 (p = 0.036, 95 % CI = 1.11-20.72) and 1.3 (p = 0.050, 95 % CI = 1.0004-1.61), respectively. OSA was the only significant predictor for perception of inadequate sleep with the odd ratios of 4.5 (p = 0.022, 95 % CI = 1.24-16.59).

CONCLUSIONS: Our results demonstrated relatively high prevalence of OSA and OSAS among young doctors. Snoring, being male, and perception of inadequate sleep were significant predictors for OSA. Observed apnea was a significant predictor for OSAS. OSA was a significant predictor for tiredness and perception of inadequate sleep.

Matched MeSH terms: Diagnosis, Differential

Fulltext Salmonella spondylodiscitis of the thoracic vertebrae mimicking spine tuberculosis

Muhamad Effendi F, Ibrahim MI, Mohd Miswan MF

BMJ Case Rep, 2016 Jul 05;2016.

PMID: 27381996 DOI: 10.1136/bcr-2016-215909

Extraintestinal Salmonella infection involving the thoracic spine is very rare. It commonly presents with non-specific chronic back pain and can occur with no gastrointestinal manifestation. Blood test results and imaging findings are often indistinguishable from more common chronic spine infections such as spine tuberculosis. Culture studies remain the key to establishing a definitive diagnosis and subsequently successful treatment. We report a case in which a patient presented with symptoms and signs suggestive of spine tuberculosis, yet the culture examination revealed otherwise.

Matched MeSH terms: Diagnosis, Differential

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