Sting to the heart – Acute pulmonary edema following hymenoptera sting

Hymenoptera stings have been reported earlier to cause mild local reactions to severe systemic reactions such as anaphylactic shock. Myocardial infarction following insect stings has been widely described. In this case, we describe a 64-year-old male patient who presented with pulmonary edema 4 h after the initial insult followed by a new onset myocardial infarction which was considered to be a variant of Kounis syndrome. The patient was managed in intensive care with diuretics, positive pressure ventilation, and glucocorticoids and made a complete recovery

Aplastic anemia in a patient with chronic liver disease

The association of aplastic anemia with chronic liver disease is rare. We report the case of a 47-year-old male patient who presented with bleeding gums and melena. He was found to have pancytopenia and on evaluation, had an aplastic bone marrow. He also had cirrhosis with portal hypertension (cryptogenic cirrhosis) for which no cause could be ascertained. This case illustrates that in a patient with cirrhosis and pancytopenia, we must look for causes other than hypersplenism

Creutzfeldt-Jakob disease: A great masquerade in neurology, a rare case report from South India

Creutzfeldt-Jakob disease (CJD) is a rare, fatal neurodegenerative disease caused by an infectious protein called prion and is characterized by spongiform changes, neuronal loss, reactive astrocytic proliferation, and accumulation of pathologic cellular protein. Clinical presentation of CJD is characterized by rapidly progressive dementia, neurologic symptoms and visual impairment, and the development of akinetic mutism, which can mimic many neurological conditions. The diagnosis is based on clinical presentation, electroencephalogram, and typical cerebrospinal fluid and magnetic resonance imaging (MRI) findings. Literature on the incidence and prevalence of CJD is lacking in South India. We report the case of a 57-year-old woman with progressive dementia and typical neurologic symptoms, myoclonic jerks, and MRI findings of CJD. This case highlights the need for a high index of suspicion to diagnose CJD