In Bangladesh and in most parts common causes of acute hepatitis include hepatitis viruses, alcohol and drugs. However less common aetiologies like Wilson’s disease must be kept in mind and looked for, whenever there is strong suspicion. Here we present a young male who presented to us with classic features of acute hepatitis including prodrome and on evaluation was diagnosed as a case of acute...

An accurate clinical diagnosis requires differentiation between epilepsy and other causes of transient neurological disturbance and collapse, but the manifestations of epileptic seizures are diverse and there are many imitators, ranging from convulsive syncope to parasomnias. Nevertheless, the diagnosis of epilepsy is frequently straightforward, particularly when precise and detailed personal a...

The listeria rhombencephalitis is an uncommon and severe infection of the brainstem, usually occurring in healthy adults with a typical biphasic picture. A prodrome of fever, headache, nausea and vomiting followed by abrupt neurological symptoms. A stiff neck is present in half of the cases and positive culture in cerebrospinal fluid (CSF) in about 40% of the cases. Mortality is high and seriou...

An MR arteriogram obtained in a patient with migraine headaches during prodrome showed features of carotid dissection. A repeated study conducted within minutes demonstrated complete patency. Vascular spasm was proposed to be the cause. Migraine occurs in more than 10% of the population. The possibility of misdiagnosing a vascular spasm as carotid dissection is real and should be guarded agains...

We present a series of 19 cases of invasive Group A streptococcal (iGAS) infection reported to the Thames Valley Health Protection Unit from 1 December 2010 to 15 January 2011. Ten patients died and a prodrome of influenza-like illness was reported in 14 cases.Influenza B co-infection was confirmed in four cases,three of which were fatal. Our report provides further evidence that influenza B co...