Imatinib, a tyrosine kinase-C protein inhibitor remains the first choice for the management of chronic myeloid leukaemia (CML) since its introduction over a decade ago. Intracranial and gastrointestinal haemorrhages have been previously reported in association with Imatinib therapy. We report the case of a 47-yr-old man who was recently diagnosed with chronic phase of CML, that was complicated by a spontaneous intramuscular haematoma in the left gluteal region after 10 days of treatment with Imatinib. To the best of our knowledge, an intramuscular haemorrhage has not been described so far in association with Imatinib therapy. Clinicians should be alert to the possibility of spontaneous haemor- rhage at unusual sites in patients being treated with Imatinib.

Churg-Strauss Syndrome (CSS) is an uncommon systemic vasculitis affecting the medium and small sized arteries. CSS was earlier considered fatal, but prognosis has significantly improved with the use of steroids and other immunosuppressive therapy. CSS has been reported in patients as young as seven years old to as old as 74 but generally occurs in the third to fifth decade of life. Here we describe an 86-year-old Indian man who was affected by this disease with clinical presentations as described in younger individuals and excellent response to therapy. To our best knowledge, presentation at so late an age has not been documented in the literature.

Oesophageal ulcerations are generally rare occurrences that are most commonly associated with gastro-oesophageal reflux disorder. Other causes include medications and infections in immunocompromised patients. Among the medications used in daily practice, doxycycline is most commonly implicated. Multiple aetiologies are generally uncommon. We report a case of mid-oesophageal ulcerations secondary to doxycycline and herpes simplex virus infection in an immunocompetent patient.
Anti-Bacterial Agents ; adverse effects ; Doxycycline ; adverse effects ; Endoscopy, Gastrointestinal ; Esophageal Diseases ; etiology ; pathology ; Esophagus ; pathology ; virology ; Female ; Herpes Simplex ; complications ; Humans ; Middle Aged ; Ulcer ; etiology ; pathology

Kikuchi-Fujimoto’s disease (KFD), histologically described as necrotising histiocytic lymphadenitis, is a benign self-limiting disease though a few fatalities have been reported. It is uncommon outside Japan and other Asiatic countries and thus lack of awareness among physicians may have led to its under- diagnosis or misdiagnosis as lymphoma or tuberculosis. It has recently gained importance due to its possible association with autoimmune disorders and viral infections especially Infectious Mononucleo- sis. Here we report a young South Indian man with fever, upper respiratory tract infection and tender cervical lymphadenopathy confirmed by biopsy to be KFD. He also had coexistent scrub typhus infec- tion evident by positive markers during the course of illness, which became negative six weeks later. Supportive management with non-steroidal anti-inflammatory agents has led to complete remission of symptoms. Association between KFD and scrub typhus has not been previously reported.