Case of the Month
An Unusually Severe Ear Infection
A 76-year old woman presents has severe otalgia in her left ear that has been gradually worsening over the past few weeks. She describes the pain as being ‘unrelenting’ and she has been unable to sleep for several nights. Her family have noticed that the left side of...
A Strange Rash After Swimming the English Channel
A 58-year-old woman presents to a walk-in clinic with a severe rash on her arms, legs and torso. The previous day she had swum the English Channel in 12 hours. When you examine her, you can see well-demarcated welts all over the affected areas with surrounding...
Spontaneous Ankle Pain After a Course of Antibiotics
A 62-year-old man presents with pain in the back of his right ankle. He was walking to the shops when he suddenly heard a loud ‘snap’. He states it felt like he had been ‘kicked in the back of the ankle’. On examination there is swelling, tenderness and bruising...
The Man Who Forgot Who He Was
A 24-year-old man is brought into an A&E department by the Police. He has been found wandering the streets locally. He is unable to remember anything from his past and is unsure where he is. He is also unable to answer questions about his own personal identity....
‘Ripping’ Chest Pain in a 38-Year-Old Man
A 38-year-old man with Marfan syndrome presents with sudden severe chest pain that radiates through to his back. He describes the pain as being sharp and ‘ripping’ in nature. He smokes 25 cigarettes per day. He is sweaty, nauseated and appears pallid. On examination...
An HIV Positive Patient with Blurred Vision
A 34-year-old man with a known history of HIV presents with blurring of his vision and ‘floaters’ in his right eye that have gradually worsened over the past 10 days. He is experiencing no eye pain and there is no redness or injection of the eye. He states that he had...
A 60-Year-Old with Abdominal Pain
A 60-year-old woman presents with a one-week history of abdominal pain, nausea and reduced frequency of bowel motions. Her observations are as follows: HR 97, BP 113/76, RR 19, SaO2 98% on air. On examination she has right upper quadrant tenderness. Her chest X-ray is...
The Strange Case of the ‘Octopus Pot’ Heart
A 53-year-old woman presents with severe central crushing chest pain that radiates to her left arm. She has been under a significant amount of stress recently following the unexpected death of her husband. Her ECG is shown below: She is taken to the cath lab for a...
An 18-Month-Old with Stridor
A mother brings in her 18-month-old to the Emergency Department with breathing difficulties. The boy was seen earlier that week with a possible mild allergic reaction following eating a cake, but at that time his symptoms settled rapidly following administration of...
A 61-Year-Old Man with Widespread Hyperpigmentation
A 61-year-old man presents with generalised weakness and skin hyperpigmentation. His only past medical history of note is a bilateral adrenalectomy for Cushing’s syndrome 18 years earlier. On examination of his visual fields you discover a bitemporal hemianopia. 1....
