Initially, the patient complained of headaches accompanied b | Figure 1

Initially, the patient complained of headaches accompanied by vomiting. A few days later, they developed altered consciousness and psychomotor agitation.

CSF: Xanthochromia

Leucocytes 1200/ mm3

Lymphocytes 97%

Albumin = 0.76 g/l

Glucose = 0.36 g/l

The author made an update to this case

Update 1

We administered a combination anti-tuberculosis treatment to the patient, consisting of 4 pills containing Rifampicin 150 mg, Isoniazid 75 mg, Pyrazinamide 400 mg, and Ethambutol Hydrochloride 275 mg. The patient showed significant improvement, with recovery of memory and resolution of altered mental status. He has since been discharged.

A 46-year-old female admitted to Fever Hospital complaining of a 3-week history of a progressively yellowish discoloration of sclera and darkening of urine. Recurrent attacks of fever were noticed on the same period as well. Furthermore, prolonged vaginal bleeding for 10 days were found few days earlier to the onset of the jaundice; controlled on supportive treatment. No past medical history of DM or HTN. On admission:

•Vital signs : BP 90/60 HR 90 RR 19. Temp 37 •OE: GCS: SEO/Oriented/Obey H&N: Deeply icteric, pale and dehydrated Chest: Clear, BEAE Heart: S1, S2 heard Abd: Lax not tender and splenomegaly Extremities: Diffuse purpura all over upper and lower limbs. No LL edema

•Work-up for jaundice for Ix. was done as follows: TSB 28 DSB 20 AST 2084 ALT 3833 Albumin 3.4 PA 65% INR 1.3 WBCs 0.7 neutrophils 44% lymphocytes 46% Hb 7.3 Plt 44000 ALP 81 GGT 86 Urea 16. Creat 0.8 HAV IgM -ve, HBsAg -ve, HCV Ab -ve Total anti HBc +ve, ANA -ve, AMA -ve, ASMA -ve, LKMA -ve EBV IgM -ve, CMV IgM -ve, Immunoglobulins IgG and IgM normal, Leptospira IgM equivocal US abdomen: no cirrhosis, no FHL, no IHBD, PV dilated 15 mm, Enlarged spleen 15 cm

3 days after admission; vaginal bleeding along with on-coughing subconjunctival hemorrhage were developed. Hb dropped to 4, Plt 14000 WBCs 0 Bone marrow aspirate and biopsy: Severe aplastic anemia Your thoughts ..

A 55-year-old female presented with acute dorsal pain (T10-T12, left paraspinal), onset 36h ago, lasted ~8h, subsided, then recurred, with Intensity 9/10, not movement-related. No CV risk factors, no neuro/urinary/bowel symptoms. Brief fever/chills 22h ago. Exam normal, negative inflammatory biology, lipase normal. Angio-CT thoraco-abdomino-pelvic + US: normal. Differentials: ruled out dissection, visceral or any visible spine-bone cause.

A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis. He had a history of hypertension, long-term smoking, and a sedentary lifestyle. On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.

A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets. Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.

A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.

A patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this EKG that would warrant further work-up or is this just a pediatric EKG?