RESUMEN
Mycobacterium szulgai (MS) is a species of non-tuberculous mycobacterium (NTM), which very rarely is identified as the causative pathogen of pulmonary infections. Due to its rarity, there are limitations in the existing literature regarding the diagnosis, investigation and treatment of MS pulmonary infection. Our case report provides further information regarding the clinical, microbiological and radiological findings associated with MS pulmonary infection with suggestions provided on its long term management.
RESUMEN
Amelanotic melanoma (AM) is a subtype of melanoma where the lesion demonstrates no pigmentation. This can lead to delays in referral with studies showing a higher mortality rate. To determine the characteristics of AM lesions, we conducted a retrospective analysis of patients with confirmed AM. Of the 16 patients, 68.75% were male and the mean age at diagnosis was 78 years. The most common location for AM was the head (37.5%) which also demonstrated a higher mitotic rate (10.67 mm2) compared to the average (7.31 mm2). More than half of the lesions (56%) had been present for more than 1 year. With a misdiagnosis rate of 87.5%, the likelihood of delays were evident. There was no unifying feature on clinical assessment, however conspicuous vessel findings were noted on 62.5% of lesions. We have demonstrated that AM continues to remain a missed diagnosis with the potential for a more lethal cancer to form.
RESUMEN
Bleeding from enoxaparin is a recognized side effect; however, the formation of rectus sheath and retroperitoneal haematomas is a rare and potentially life-threatening complication. Patients may present insidiously and without symptoms; therefore, high clinical suspicion of a bleeding intra-abdominal haematoma should be suspected in patients with a combination of clinical and biochemical evidence of bleeding. Treatment is patient dependent and is either interventional or conservative in approach. Clinicians should be mindful when prescribing high-dose enoxaparin with further caution advised for at-risk patients.