Hemophagocytic lymphohistiocytosis presenting with acute liver failure and central nervous system involvement in early infancy

Hemophagocytic lymphohistiocytosis (HLH) is a potentially fatal and likely underdiagnosed disease characterized by unregulated histiocyte proliferation, hypercytokinemia and hemophagocytosis, causing life-threatening tissue damage and organ failure. We report a case of a 56-day-old infant presenting with fever, acute liver failure, and neurological manifestations as presenting features that succumbed to rapidly progressive HLH. Our objective is to emphasize the importance of early diagnosis by high suspicion in varied initial presentation of HLH so that life-saving therapy may be instituted in time.

Occupational injury at Gangsaw machine A rare occurrence.

Since last few decades, occupational injuries have been a major cause of morbidity and mortality among people working in factories, especially those working with unprotected rotating machines. Women are specifically prone to such injuries because of their long unprotected hairs being trapped in moving parts of the machines. Long hairs can get entangled in moving machinery resulting in complete or partial avulsion of scalp. A large scalp avulsion injury may lead to severe bleeding and may cause trauma to forehead, eyebrows and per auricular tissue, which may further bring fatal results aesthetically and functionally. Severe deformities as a result of this trauma may lead to severe psychological trauma, disabling the patient to lead a normal social life. Here, we are presenting a case report of a patient who had an occupational injury causing scalp avulsion with cervical spine injury at gang saw machine.

Signet ring cell carcinoma of ampulla of Vater in a young adult.

Signet ring cell carcinoma of the ampulla of Vater is extremely rare. The 7 cases reported earlier have been in older patients. We report a 32-year-old lady with this condition, who also had metastases in the bone marrow, vertebrae, lungs and liver.