Neonatal invasive Group A Streptococcus (GAS) infection is a rare occurrence nowadays. Prior maternal vaginal colonization is an important factor in early neonatal disease. We report a case of invasive and fatal infection in a neonate. At Day 1 of life, a term baby was found to be lethargic, with poor feeding, and later became unresponsive. Consequently, the baby was immediately brought to the Emergency Department of Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan via ambulance. Despite the active resuscitation efforts in the hospital, the baby died. An autopsy was carried out to determine the cause of death. The mother was noted to have puerperal pyrexia secondary to vaginal discharge. Her high vaginal swab culture was positive for GAS. GAS was also isolated from the intracardiac blood, pleural fluid, peritoneal fluid, and umbilical swab of the baby, giving evidence to the aetiology of the mortality. Vaginal colonization of GAS is an important factor for high morbidity and mortality for both mother and infant due to its invasiveness and virulence.
Giant cell tumors (GCT) of bone are a benign aggressive tumor with features of frequent local recurrence. It has the potential for metastasis and malignant transformation. GCT of bone represents about 4-9.5% of primary bone tumors. Metachronous GCT happen in less than 1% while metastatic spread in these lesions is very uncommon. Furthermore, reports of multicentric metachronous GCT are very rare in literature. We present a case of a 35-year-old male patient, who suffered from multicentric metachronous GCT, which involved the radius, humerus, femur, and pelvic with pulmonary metastasis. Local control by multiple resections of the tumor and chemotherapy for pulmonary metastases was able to control the disease with long-term survival and good functional outcome. These tumors had a typical radiological appearance and the diagnosis was confirmed on histopathology. Long follow-up needed in this case in view the illness occurs for long period.