Atypical Onset of Eosinophilic Granulomatosis with Polyangitis in a Patient with Long-term Well-controlled Bronchial Asthma / General Medicine

Eosinophillic glanuromatosis with polyangitis (EGPA) usually occurs in patients with a recent history (usually less than 10 years) of uncontrolled bronchial asthma. Here we describe a case of EGPA that occurred in a 68-year-old female who had well-controlled bronchial asthma for 17 years. A leukotriene receptor antagonist that had been prescribed one week before onset might have triggered the disease. Our case shows that there is a wide spectrum of clinical characteristics of EGPA, making diagnosis difficult in a primary care setting.

Lower Limb Infection in an Infant with <i>Haemophilus influenzae</i> Serotype b / General Medicine

We describe a rare case of lower leg infection caused by <i>Haemophilus influenzae</i> serotype b (Hib) in a previously healthy 14-month-old boy. In primary care, <i>H. influenzae</i> is a common pathogen affecting children, and which causes respiratory and central nervous system infection alike. Conversely, skin and soft tissue infections caused by Hib are a somewhat rare occurrence. Beta-lactamase-negative ampicillin-resistant strains have been spreading throughout Japan, although the type of Hib in our case was cephalosporin-sensitive. As a result, we need to pay attention to Hib infection in various clinical settings.