Unusual cause of seizures in Singapore: neurocysticercosis.

Neurocysticercosis is the commonest cause for adult onset of seizures in developing countries, and is relatively uncommon in Singapore. However, with the influx of foreign workers from developing countries, we need to consider it as a differential diagnosis in our approach to adult-onset seizures in this group of patients. We describe a neurocysticercosis occurring in a 22-year-old Indian man who presented with a single episode of generalised tonic-clonic seizures. Magnetic resonance imaging of the brain showed a well-defined, hypointense lesion in the cortical and subcortical regions of the left frontal lobe with adjacent vasogenic oedema. Following contrast administration, a well-defined ring enhancement was noted, with suggestion of some internal enhancement. Imaging findings were suggestive of neurocysticercosis. Follow-up magnetic resonance imaging of the brain two weeks after treatment showed lesion resolution.

The hunt for an elusive source of pyrexia in a foreign worker.

We report a 23-year-old Bangladeshi man who presented with fever and hepatosplenomegaly. The initial laboratory findings were bicytopenia with elevated serum globulins. The diagnosis of visceral leishmaniasis (Kala Azar) was suspected. The parasite Leishmania donovani was found on bone marrow aspiration. He was treated with liposomal amphotericin B and had a good response to treatment. The case highlights the need to be aware of this disease occurring in a foreign national from an endemic region when he presents with fever and hepatosplenomegaly.