Borneo Journal of Medical Sciences (BJMS)

Tropical Primary Pyomyositis of The Right Calf Muscle: A Rare and Unexpected Complication of Jump Squat Exercise

2024-11-12T20:06:54+08:00

Diagnosing pyomyositis in its initial or invasive stages can pose a challenge due to its vague initial symptoms, which may mimic other conditions such as muscle strain, localized myositis, hematoma, deep vein thrombosis, cellulitis, or thrombophlebitis. A high index of suspicion for possible pyomyositis necessitates confirmation through radiographic imaging. A delayed diagnosis directly correlates with the time taken to commence treatment, thereby increasing the risk of patient morbidity and mortality. We present a case of a diabetic male who experienced bilateral calf muscle pain and right calf swelling after participating in jumping squat exercises, eventually developing right calf myositis and abscesses over a two-week period, which were initially overlooked by several general practitioners. This case underscores the crucial role of radiographic imaging in confirming the diagnosis, whether in the Emergency Department or any primary care setting. Prompt diagnosis and intervention, as demonstrated here, are imperative for minimizing the risks associated with this potentially severe disease. Knowledge of this condition and its diagnostic methods is highly advantageous for emergency physicians, primary care providers, and family physicians.

A Case of Disseminated Tuberculosis with Atypical Presentation In An Older Person

2024-11-12T20:10:56+08:00

Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. It is a significant health concern, with millions of new cases and deaths reported each year. Disseminated tuberculosis (dTB) is a serious condition which can affect various organs and tissues, leading to widespread symptoms and complications. The diagnosis of dTB can be challenging due to its atypical presentations. We present a case of dTB in a robust older person who presented with musculoskeletal pain, weight loss, and loss of appetite. Initially, he was treated for age-related spine disease, and pain management was provided. However, his subsequent visit raised suspicion of TB, prompting further work up. The diagnosis was revised to dTB, and anti-TB treatment was initiated. The near miss or delay in diagnosis and treatment may have played a role in dissemination of disease, increased frailty and reduction of function in this patient. Healthcare workers must maintain a high index of suspicion and remain vigilant for TB as starting early treatment will prevent dissemination in the patient, reduce risk to the public and improve outcomes.

A Young Girl with Recurrent Fallopian Tube Carcinoma (FTC): An Interesting Case Report

2024-11-12T20:28:03+08:00

Primary fallopian tube carcinoma (FTC) is a rare disease which frequently occurs among post-menopausal women. It is often grouped under the epithelial ovarian cancer umbrella. The treatment of choice is surgery and chemotherapy. Our patient was a young teenage girl with recurrent FTC who responded well to surgery and chemotherapy. We discuss on the epidemiology, risk factors, principles of management and prognosis of FTC.

Subcutaneous Mycoses on The Face Of A Child; A Case Report

2024-11-12T19:59:33+08:00

Skin infections is a common presentation at primary healthcare clinics. It may be caused by a variety of pathogens, including viruses, bacteria, fungi, or parasites. The most common skin infections are caused by bacteria, namely Staphylococcus aureus and Group A beta-haemolytic streptococci. Fungal infections, particularly subcutaneous mycoses, may exhibit similar clinical features as bacterial infections. In this case report, we highlight the importance of considering subcutaneous mycoses as a differential diagnosis for patients presented with skin infections, especially if the condition did not improve with antibiotic. This case report also emphasised the importance of considering the potential side effects of systemic antifungal medications before initiating the treatment in children. Accurate diagnosis through culture testing is essential to guide the treatment, rather than relying solely on empirical treatment based on clinical symptoms.

A Tenacious Trio of Retropharyngeal Emphysema, Pneumomediastinum and Subcutaneous Emphysema Secondary to Pulmonary Tuberculosis: A Case Report

2024-11-12T20:37:23+08:00

Retropharyngeal emphysema (RPE) is the presence of air in the retropharyngeal area. It may occur due to various etiologies or sometimes spontaneously due to an underlying lung pathology. This report describes a case of a 26-year-old gentleman with pulmonary tuberculosis on treatment who presented with acute breathlessness and dysphagia. His neck and chest radiograph showed retropharyngeal emphysema with pneumomediastinum and subcutaneous emphysema. This was further confirmed by a CT neck and thorax. The patient was managed conservatively with analgesia, antibiotics, IV corticosteroids and oxygen supplementation. Repeat chest radiograph after 17 days showed resolution of retropharyngeal emphysema. Clinicians should have a high index of suspicion for RPE in patients who present with unexplained acute breathlessness and dysphagia of a diseased lung.

Short-term Outcomes of a Dedicated Pelvic Exenteration Unit in a Tertiary Hospital in Malaysia

2024-11-11T19:24:58+08:00

Background : Pelvic exenteration offers potentially curative resection for locally advanced pelvic malignancy. A dedicated unit performing this complex surgery is recommended to achieve optimal outcomes.
Objectives : The aim of this paper is to show that pelvic exenterations can be performed with acceptable oncological and safe perioperative results in an appropriately resourced specialist centre. Methods : Patients undergoing pelvic exenteration in the Colorectal Unit, Hospital Kuala Lumpur between January 2017 and January 2024 were included. Patients operated in the initial setup period of the unit (January 2017 – July 2020) were compared to the second half (August 2020 – January 2024) with univariate analysis. Results : A total of 30 patients were included, with a significant increase in the unit caseload over the study period (n = 11 versus n = 19). There was an increased use of neoadjuvant therapy and an increase in stage of disease at presentation (p = 0.014) in the second half of the study period. More complex procedures were performed in the latter period, involving both bony and pelvic side wall resections. There was no difference in complication severity (Clavien Dindo) (p = 0.257) and R0 resection was achieved in 76.7% of operated cases. Conclusion : The development of a dedicated pelvic exenteration unit, leads to an increase in patient volume and an increase in the complexity of the procedures performed, without compromising short term outcomes and safety.