Gestational Pemphigoid Presenting in the Second Trimester of Pregnancy: A Rare Finding.

Gestational pemphigoid (GP) is a rare autoimmune blistering disorder, occurring in 1 in 60,000 pregnancies. It occurs in the second or third trimester of pregnancy and is characterized by autoantibodies against hemidesmosomal proteins. A variety of dermatological conditions are associated with pregnancy; among these skin diseases, gestational pemphigoid is very rare. The purpose of this report is to highlight the specific findings of this rare disease to enable clinicians to take prompt intervention in treating this condition. A 23-year-old multigravida, with no known comorbidities, presented to us at 18 weeks of gestation with complaints of intensely pruritic tense blisters all over the body, sparing the scalp, palms, and soles. The diagnosis was confirmed by skin biopsy for histopathology, after which the patient was started on prednisolone, which was then gradually tapered to an appropriate maintenance dose and then discontinued as the patient did not report any new lesions after delivery. Gestational pemphigoid can recur in subsequent pregnancies with more severe lesions. However, this was the first time the patient presented with this condition in her third pregnancy. Proper management of this disease requires close monitoring and appropriate drug therapy to reduce maternal and neonatal morbidity.

A Rare Case of Third Generation Cephalosporin-Resistant Klebsiella Meningitis.

Acute bacterial meningitis is one of the very common and severe forms of central nervous system (CNS) infection worldwide in almost all age groups. It remains a common cause of mortality, especially in underdeveloped countries, if not treated timely. Detecting an organism from the CSF culture is crucial in the management of acute bacterial meningitis. Selection of antibiotics according to the culture are a very important part of the management. Most commonly involved organisms include Streptococcus pneumoniae, Neisseria meningitides, and Listeria monocytogenes, while other organisms are very uncommon. Here, we report a rare case of Klebsiella pneumoniae meningitis in a young female, which was found resistant to multiple antibiotics including third generation of cephalosporin.