Extra Pulmonary Tuberculosis Manifesting as Liver Abscess

Liver abscess is a rare presentation of extrapulmonary tuberculosis. It may present with nonspecific symptoms such as fever, weight loss and abdominal pain and requires a high degree of suspicion. We present a case of a 57-year-old male previously treated for a liver abscess and presented with abdominal pain, vomiting and fever and a contrast-enhanced computed tomography (CECT) showed a loculated liver abscess. Ultrasound-guided aspiration of the pus was sent for GeneXpert MTB (Cepheid, Sunnyvale, CA, USA) and mycobacterial culture which confirmed the diagnosis. The patient was started on anti-tubercular therapy and clinically improved.

Through the Haze of Hemorrhage: Unraveling Leptospirosis With Diffuse Alveolar Hemorrhage

Leptospirosis is a zoonotic infection caused by Leptospira species, presenting with a wide spectrum of clinical manifestations ranging from mild febrile illness to severe multi-organ dysfunction, also known as Weil's disease. This case describes a patient with severe leptospirosis complicated by diffuse alveolar hemorrhage, acute kidney injury, hepatic dysfunction, and thrombocytopenia. The diagnosis was initially challenging due to negative serology in the early phase of the illness, but strong clinical suspicion led to a repeat Leptospira IgM positivity. Later, the diagnosis was confirmed with the microscopic agglutination test. The patient responded well to antibiotic therapy and supportive care, emphasizing the importance of clinical suspicion and repeat testing in severe cases of leptospirosis.