Cerebral toxoplasmosis in an HIV positive patient: a case report and review of pathogenesis and laboratory diagnosis

Toxoplasmosis is a worldwide infection. It may have acute or latent clinical presentations. Because of defective cell mediated immunity, patients are at a higher risk of developing toxoplasma encephalitis. We report the first biopsy diagnosed case of cerebral toxoplasmosis in an HIV positive patient from the Kingdom of Bahrain and review the pathogenesis, pathology and laboratory diagnosis

Extra-gonadal endometriosis: unusual presentation

Extra-gonadal Endometriosis is a rare entity. It is rarely reported from this region. To present six cases of unusual extra-gonadal endometriosis. Retrospective review. Surgical Department, Salmaniya Medical Complex, Kingdom of Bahrain. Six patients with extra-gonadal endometriosis who presented to the surgical department during a period of three years [between 2002 -2005] were reviewed. The patients were females with age ranging between 29 and 48 years. Three patients presented with painful umbilical mass and bleeding during menses. One patient had a painful nodule in her lower segment caesarian section scar; another had endometrioma of the appendix and one presented with acute small bowel obstruction. All had regular menstrual cycle. The majority had associated menorrhagia and dysmenorrhea but did not have any significant past gynecological history. CT scan in three patients confirmed the presence of umbilical nodule or mass but was not helpful in reaching the diagnosis pre-operatively. In the other three cases, pre-operative investigations were not helpful in reaching the definitive diagnosis. The management in all the cases was complete resection. Histopathology confirmed the diagnosis. Six cases of extra-gonadal endometriosis with unusual presentation had been reviewed and presented in this study. Extra-gonadal endometriosis is a rare condition presenting to the general surgeon. Clinical awareness is more important in diagnosis than radiological findings. Complete surgical resection is the rule in all cases