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1.  An unusual cause for recurrent jaundice in an otherwise healthy male 
The Australasian Medical Journal  2012;5(10):541-543.
A 41-year-old Asian-Indian male presented with recurrent episodes of jaundice over the past six months. Physical examination was normal, barring mild icterus. Laboratory parameters revealed indirect hyperbilirubinemia. Further evaluation yielded a diagnosis of severe nutritional vitamin B12 deficiency. Indirect hyperbilirubinemia was ascribed to ineffective erythropoiesis. Underlying Gilbert's syndrome was ruled out by provocative testing with lipid-restricted diet. Presentation of severe vitamin B12 deficiency with isolated hyperbilirubinemia without concomitant major haematologic or neurologic dysfunction is unusual and potentially underdiagnosed. Awareness of this possibility can permit early diagnosis of vitamin B12 deficiency and forestall development of severe haematologic and neurologic sequelae.
doi:10.4066/AMJ.2012.1404
PMCID: PMC3494826  PMID: 23173018
Recurrent jaundice; indirect hyperbilirubinemia; vitamin B12 deficiency; ineffective erythropoiesis
2.  Cranial melioidosis with extradural extension after a fall in the bathroom 
The Australasian Medical Journal  2012;5(8):455-458.
A 32-year-old diabetic male, with a past history of head injury and seizures, presented with a painful swelling over his forehead present for the past three months. Cranial MRI demonstrated the presence of a scalp collection with extradural extension through a bony defect. Biopsy from the area showed caseating necrosis suggestive of tuberculosis. Although the patient failed to return for initiation of anti-tubercular therapy for the next 11 months, the swelling did not progress, and there were no constitutional symptoms. The indolent nature of the swelling prompted re-evaluation and delayed cultures of pus from the collection grew Burkholderia pseudomallei.
doi:10.4066/AMJ.2012.1374
PMCID: PMC3442190  PMID: 23024720
Cranial epidural abscess; melioidosis; Burkholderia pseudomallei
3.  A rare case of seronegative culture-­proven infection with Brucella suis 
The Australasian Medical Journal  2012;5(7):340-343.
Brucellosis is a chronic infection produced by members of the Brucella family. Diagnosis of this condition requires either isolation of the organism in culture or positive serological tests.
We describe a 27-year-old male admitted as a case of pyrexia of unknown origin (PUO), who tested negative for Brucella IgM ELISA test on preliminary evaluation but was subsequently diagnosed on the strength of positive blood and bone marrow cultures to be a case of brucellosis secondary to Brucella suis infection. In addition to highlighting the pathogenic potential of an unusual organism, this case demonstrates the unreliability of standard serological tests based on the Brucella melitensis antigen for infection with other species of Brucella.
doi:10.4066/AMJ.2012.1177
PMCID: PMC3412998  PMID: 22905059
Brucella suis; pyrexia of unknown origin; serological tests

Results 1-3 (3)