Forgotten but not gone - Scrofuloderma in a migrant student from India

A 34-year-old Indian student who immigrated to Australia five years ago presented with a four-week history of neck pain. Physical examination revealed two firm fixed cervical lymph nodes in the anterior triangle and midline region which were tender on palpation and erythematous on inspection. Cording phenomenon was found on ZN staining of FNA sample and mycobacterium tuberculosis (M.tb) PCR confirmed the diagnosis with incomplete resistance to isoniazid. Patient was treated with other three first line antituberculosis medications for nine months with an excellent outcome. Prednisolone was also used as adjunctive therapy and tapered during the course of treatment

Iatrogenic meningitis caused by Neisseria sicca/subflava after intrathecal contrast injection, Australia

We report a case of invasive Neisseria sicca/subflava meningitis after a spinal injection procedure during which a face mask was not worn by the proceduralist. The report highlights the importance of awareness of, and adherence to, guidelines for protective face mask use during procedures that require sterile conditions

Forgotten but not gone - Scrofuloderma in a migrant student from India

A 34-year-old Indian student who immigrated to Australia five years ago presented with a four-week history of neck pain. Physical examination revealed two firm fixed cervical lymph nodes in the anterior triangle and midline region which were tender on palpation and erythematous on inspection. Cording phenomenon was found on ZN staining of FNA sample and mycobacterium tuberculosis (M.tb) PCR confirmed the diagnosis with incomplete resistance to isoniazid. Patient was treated with other three first line anti-tuberculosis medications for nine months with an excellent outcome. Prednisolone was also used as adjunctive therapy and tapered during the course of treatment

A case of Kingella kingae endocarditis complicated by native mitral valve rupture

We report a case of Kingella kingae endocarditis in a patient with a history of recent respiratory tract infection and dental extraction. This case is remarkable for embolic and vasculitic phenomena in association with a large valve vegetation and valve perforation. Kingella kingae is an organism known to cause endocarditis, however early major complications are uncommon. Our case of Kingella endocarditis behaved in a virulent fashion necessitating a combined approach of intravenous antibiotic therapy and a valve replacement. It highlights the importance of expedited investigation for endocarditis in patients with Kingella bacteraemia