An Unusual Clinical Presentation of Scrub Typhus.

Scrub typhus is still underdiagnosed despite a resurgence in incidence as the clinical presentation is often atypical leading to low index of suspicion among clinicians. We report a case of a young girl presenting as lobar pneumonia and diagnosed as scrub typhus. Despite such a classical picture of community-acquired pneumonia on clinical presentation and radiological findings the patient was found to have scrub typhus serologically thereby posing a diagnostic dilemma.

Refractory Hypoglycemia and Seizures as the Initial Presenting Manifestation of Empty Sella Syndrome.

An empty sella is reported to occur in 5.5%-23.5% of the population and is usually asymptomatic.

Inadvertent Skipping of Steroids in Septic Shock Leads to a Diagnosis of Adult Onset Still's Disease.

Adult onset Still's disease is uncommon in middle-aged and elderly individuals and can rarely present with shock; shock is usually associated with disseminated intravascular coagulation, multiorgan dysfunction syndrome or acute respiratory distress syndrome. We report a post-menopausal woman with arthritis, fever, pneumonitis and hypotension which was managed as septic shock. Steroids were inadvertently missed during the second day of hospitalization in the intensive care unit.