Spontaneous Intra-Cerebral Haemorrhage Presenting with Chest Pain in a Healthy Young Man.

Spontaneous, non-traumatic intra-cerebral haemorrhage is the second most common type of stroke and is associated with significant morbidity and mortality. It is defined as the presence of blood within the cerebral parenchyma without prior injury or surgery. The purpose of this work is to describe an atypical presentation of spontaneous intra-cerebral haemorrhage in a healthy young adult. A literature review was also carried out. LEARNING POINTS: Spontaneous intra-cerebral haemorrhage is a challenge in daily practice due to the wide range of clinical symptoms on presentation.Chest pain mimicking acute myocardial infarction is an atypical presentation of intra-cerebral haemorrhage.In the primary care setting, misdiagnosis of a patient with spontaneous cerebral haemorrhage with chest discomfort suggesting cardiac aetiology and prompting antiplatelet/aspirin therapy could result in disaster.Taking a detailed history and conducting a thorough neurological examination is important in every clinical encounter and may trigger diagnostic suspicion.

A fatal case of cytomegalovirus disease in an immunocompetent young woman: a case report.

Cytomegalovirus can cause severe disease with adverse outcome in immunocompromised patients. Severe cytomegalovirus infection in previously healthy individuals is rare. Here we present an unusual case of cytomegalovirus infection with neurological and pulmonary involvement in a previously healthy young woman with no history of immuno-suppression. Unfortunately, the disease followed a malignant course and despite the efforts of the medical staff the patient died. CMV infection should be considered in the diagnostic work-up of immunocompetent patients with fever and unexplained neurological or pulmonary manifestations. Although uncertainty exists regarding the optimal treatment of CMV in healthy individuals, early recognition and administration of ganciclovir may prevent a fatal outcome.

Colorectal cancer, screening and primary care: A mini literature review.

Colorectal cancer (CRC) is a common health problem, representing the third most commonly diagnosed cancer worldwide and causing a significant burden in terms of morbidity and mortality, with annual deaths estimated at 700000. The western way of life, that is being rapidly adopted in many regions of the world, is a well discussed risk factor for CRC and could be targeted in terms of primary prevention. Furthermore, the relatively slow development of this cancer permits drastic reduction of incidence and mortality through secondary prevention. These facts underlie primary care physicians (PCPs) being assigned a key role in health strategies that enhance prevention and prompt diagnosis. Herein, we review the main topics of CRC in the current literature, in order to better understand its pathogenesis, risk and protective factors, as well as screening techniques. Furthermore, we discuss preventive and screening policies to combat CRC and the crucial role served by PCPs in their successful implementation. Relevant articles were identified through electronic searches of MEDLINE and through manual searches of reference lists.

Drug resistant pulmonary tuberculosis mimicking a flu-like syndrome in an elderly man: an atypical case report.

Despite remarkable reductions in its incidence and mortality, tuberculosis (TB) continues to be a major health burden globally. Pulmonary TB occasionally challenges physicians, either due to TB's ability to mimic many different conditions or because of the increasing number of drug-resistant Mycobacterium tuberculosis isolates. Here we present a case of pulmonary TB with both characteristics and a brief review of the relevant literature.

Tuberculosis infection mimicking brain metastatic malignancy lesions in an elderly male.

An 83-year-old Caucasian Greek man was referred by his general practitioner to the emergency department of the general hospital in Crete because of seizures and agitation. His past medical history was negative for any neurological or medical condition. Electroencephalogram showed a bradyarrhythmic theta activity, without evidence of any focal or other specific abnormality. Magnetic resonance imaging of the brain demonstrated a number of diffuse nodular lesions and moderate perivascular edema. An axillary lymph node fine needle aspiration cytology suggested a granulomatous lymphadenitis along with signs of tuberculous infiltration. Tuberculin skin test was positive. We report a rare case of extrapulmonary tuberculosis mimicking brain metastatic lesions.