Malawi medicine

Cases from inpatient and outpatient medicine in Malawi.

Cases are listed below.  Via Advanced Search in the right hand menu bar you can narrow the list down by Tags, including Level of Difficulty (You can use the tags to choose by topic and subtopic or difficulty (A=Learner; B=Practioner; C=Expert), e.g. search on Malawi Medicine and Level A or B).

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Malawi Medicine cases

  • A breathless 20 year old with cough and fever A 20 year old man complains of 3 weeks of cough and fever, and 4 days of oedema of his feet. On examination he is breathless.  There is marked engorgement of his neck veins, JVP higher than ears, ascites, 2+ oedema of his feet. P130/min irregularly irregular, of waxing and waning volume, apex rate 160. ...
  • A girl with facial swelling A 14 yearl old schoolgirl is referred from Thyolo District Hospital, Malawi, complaining of facial swelling for 3 weeks, worse in the morning.  3 days later she developed bilateral leg swelling and increasing abdominal distension with some suprapubic colicky pains.  She reported concentrated urine but no haematuria.  There was no significant past ...
  • A swollen leg A 39 year old subsistence farmer is referred to the dermatology clinic with massive left leg swelling, present for several years.  His main complaint is of “leaking” and malodour, and he is reluctant to remove the tubifast dressing that he has applied himself. What is the likely diagnosis? What advice and treatment would you give?
  • A 56 year old farmer with lip ulceration A 56 year old farmer who lives in a village near Blantyre, Malawi, presents with painful oral ulceration which is making eating difficult.  On further questioning he also admits that he has pain on micturition as he has painful penile ulceration. You also see that he has inflamed conjunctivae. He started antiretroviral drugs for newly diagnosed ...
  • A 19 year old albino with a skin lesion A 19 year old lady from Blantyre, Malawi, attends with a scaly lesion which has been present on her right cheek for 3 months. Can you describe what you see? What is the diagnosis? What is your management?
  • A man with a foot ulcer A 42 year old man attends the dermatology clinic in Queen Elizabeth Central Hospital, Blantyre in 2012 with an ulcer on the sole of his right foot.  He says that it has been present since 2004 but that he underwent surgery 1 and a half years ago.  He was told it was a squamous cell ...
  • An unwell lady with a history of breast cancer A 53 year old female presents to the Queen Elizabeth Hospital, Blantyre with a 2 day history of drowsiness, diarrhoea and vomiting. Her past medical history includes hypertension, diabetes and recently diagnosed breast cancer. On examination she is dehydrated, BP 95/60, pulse 120/min, temp 380C, O2 sats 90% on air and Glasgow Coma Score of 14/15 (E4V4M6). What other ...
  • A 4 year old boy with patchy hair loss A healthy 4 year old boy is brought to the Dermatology clinic at Queen Elizabeth Central Hospital, Blantyre by his parents.  He has been scratching his head, and they have recently noticed that he has developed several small scaly areas with associated hair loss. What is your diagnosis and how would you treat him? This case contributed ...
  • A 22 year old man with a painful rash A 22 year old plumber attends the drop-in clinic in the dermatology department at Queen Elizabeth Central Hospital, Blantyre.  He has a 1 day history of a painful vesicular rash on his right buttock and posterior thigh. He feels unwell with fever. What is your diagnosis? What is your management? This case contributed by Levie Mwale and Ann ...
  • A 34 year-old man with a fit A 34 year old man presents to Queen Elizabeth Central Hospital, Blantyre with a 2 day history of frontal headaches and generalized tonic clonic seizures. His guardians report that he has had multiple nodules all over his body since childhood but has previously been well. He has another prolonged seizure after admission. He is post-ictal on ...