Granulomatous hepatitis: Analysis of twenty seven patients

Granulomatous hepatitis is a non-specific condition with different infective and non-infective aetiologies. This study was conducted on 27 patients of granulomatous hepatitis, to define aetiology, collected from different hospitals of Karachi and Peoples Medical College Hospital, Nawabshah. Tuberculosis was the common diagnosis, found in 24 [88.9%] patients, two [7.4%] had sarcoidosis while primary biliary cirrhosis was seen in one [3.7%] case only. Sex distribution showed female preponderance with 16 [59.23%] cases

Changing spectrum of typhoid

To determine the changing spectrum of typhoid fever, a study was conducted on 240 cases of typhoid fever, admitted over a period of 4 years. The classical [Stepladder fever] and relative bradycardia were less commonly seen. Presentation as hepatitis, psychosis, meningism, myocarditis, polyneuropathy and diarrhoea were encountered in a small number of patients. Reversible proximal myopathy occurred in four patients and all of them recovered completely over a period of 2-3 weeks. The total leukocyte counts were within normal range in most of the cases. Bone marrow cultures were positive in all untreated and partially treated patients. All strains of Salmonella typhi in this study were sensitive to ofloxacin ceftriaxone and ciprofloxacin

Faiciparum malaria or fulminant hepatic failure?

Six cases of severe jaundice and encephalopathy due to falciparum hepatitis initially diagnosed as fulminant hepatic failure are reported. This rare presentation of falciparum malaria should be suspected in patients with persistent fever, jaundice, encephalopathy and hepatomegaly. The diagnosis should be further suspected when the liver function tests show a predominantly conjugated hyperbilirubinemia with only modest elevation of liver enzymes and alkaline phosphatase. Liver biopsy is valuable in establishing the diagnosis at all stages of the disease

Isolated splenic tuberculosis, a report of five cases

Isolated splenic tuberculosis is a rare entity. In this study we describe five cases seen over a period of twenty years