1.Pulmonary actinomycosis masquerading as aspergilloma
Rosdina Zamrud ; Nurul Yaqeen Mohd Esa ; Mohammad Hanafiah ; Nor Salmah Bakar
The Medical Journal of Malaysia 2017;72(2):147-149
We report a case of a 34-year-old man who was initially
treated as community acquired pneumonia following a
three-month-history of productive cough, loss of weight and
loss of appetite. However, three months after discharged
from the hospital, he presented again with worsening
respiratory symptoms and radiological evidence of a lung
cavitation with intracavitary lesion resembling an
aspergilloma associated with surrounding consolidation.
Unfortunately, he remained symptomatic despite on
antifungal therapy. The repeat computed-tomography
demonstrated persistent cavitating lesion with development
of necrotising pneumonia. He underwent lobectomy and the
histopathological analysis of the resected specimen
however revealed the diagnosis of actinomycosis.
KEY WORDS:
Actinomycosis, Aspergillosis
Actinomycosis
2.Acanthamoeba encephalitis in an immunocompetent child and review of the imaging features of intracranial acanthamoebic infections in immunocompetent patients
Mohammad HANAFIAH ; Azura Mohamed Mukhari Shahizon ; Mohd Farhan HAMDAN ; Sau Wei WONG ; Yoganathan KANAHESWARI
Neurology Asia 2018;23(2):179-184
Granulomatous amoebic encephalitis caused by Acanthamoeba is a rare entity mainly affecting immunocompromised patients. We reported a case of Acanthamoeba encephalitis of a 1-year-old immunocompetent child and described the CT and MRI findings of the brain, while reviewing the relevant literatures. The imaging findings of Acanthamoeba meningoencepalitis in immunocompetent patients are non-specific and pose a diagnostic challenge.
3.Avascular Necrosis of the Hip in Primary Care
Nurul Nadia BAHARUM ; Farnaza ARIFFIN ; Mohammad HANAFIAH ; Shahrul Hisham SULAIMAN
Korean Journal of Family Medicine 2021;42(1):84-87
Avascular necrosis, or osteonecrosis of the femoral head, is a debilitating condition which leads to the destruction of the hip joint due to an interruption in the blood supply to the bony region and is most commonly due to trauma. The case discussed here has been highlighted as it presented as non-traumatic osteonecrosis of the femoral head with an absence of risk factors in a healthy adult male. A 37-year-old male presented with a 4-month history of recurrent left hip pain, which worsened with initiation of movement and weightbearing on the affected side. The patient was overweight but normotensive with a full range of movement of the hips bilaterally. There were no abnormalities detected on initial X-ray images of the left hip. However, due to the persistent pain and sclerotic changes in a subsequent X-ray, a magnetic resonance image of the bilateral hips was obtained, leading to the diagnosis of osteonecrosis of the bilateral femoral heads. Due to the lack of improvement with physiotherapy and analgesia, the patient was subjected to conservative surgery of the symptomatic left hip with concurring evidence of avascular necrosis based on intraoperative anatomical biopsy. This case emphasizes the importance of identifying underlying issues during history taking and physical examination in adults without risk factors. The early diagnosis of osteonecrosis assists in preventing joint collapse and can delay the requirement of joint replacements. High levels of suspicion are necessary to instigate investigation in persistent cases without the presence of risk factors.
4.Avascular Necrosis of the Hip in Primary Care
Nurul Nadia BAHARUM ; Farnaza ARIFFIN ; Mohammad HANAFIAH ; Shahrul Hisham SULAIMAN
Korean Journal of Family Medicine 2021;42(1):84-87
Avascular necrosis, or osteonecrosis of the femoral head, is a debilitating condition which leads to the destruction of the hip joint due to an interruption in the blood supply to the bony region and is most commonly due to trauma. The case discussed here has been highlighted as it presented as non-traumatic osteonecrosis of the femoral head with an absence of risk factors in a healthy adult male. A 37-year-old male presented with a 4-month history of recurrent left hip pain, which worsened with initiation of movement and weightbearing on the affected side. The patient was overweight but normotensive with a full range of movement of the hips bilaterally. There were no abnormalities detected on initial X-ray images of the left hip. However, due to the persistent pain and sclerotic changes in a subsequent X-ray, a magnetic resonance image of the bilateral hips was obtained, leading to the diagnosis of osteonecrosis of the bilateral femoral heads. Due to the lack of improvement with physiotherapy and analgesia, the patient was subjected to conservative surgery of the symptomatic left hip with concurring evidence of avascular necrosis based on intraoperative anatomical biopsy. This case emphasizes the importance of identifying underlying issues during history taking and physical examination in adults without risk factors. The early diagnosis of osteonecrosis assists in preventing joint collapse and can delay the requirement of joint replacements. High levels of suspicion are necessary to instigate investigation in persistent cases without the presence of risk factors.