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Medical education

Allergy Medical education 6 August 2026 Free

A Rare Case of Storage Mite Anaphylaxis in Infancy

This is one of the first reported cases of storage mite anaphylaxis in Australia, occurring in an infant who had two episodes of severe anaphylaxis, triggered by previously tolerated foods. Both episodes occurred following extended periods of food storage, and in both instances, the child required two doses of intramuscular adrenaline. Skin prick testing was negative to implicated foods, but demonstrated sensitisation to house dust mite, and serum-specific IgE confirmed storage mite sensitisation. Clinician recognition of this condition is essential for timely diagnosis and implementation of preventive measures to reduce further episodes of life-threatening anaphylaxis in at-risk patients.

Eliza Kluckow, Katie Frith

Mja2 70262
COVID-19 Medical education 14 July 2026 Open Access

Rhabdomyolysis After COVID-19

We report a case of a kidney transplant recipient who presented with generalised muscle pain, weakness and brown urine discoloration in the setting of acute severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Investigations demonstrated rhabdomyolysis with elevated creatine kinase levels and severe acute kidney injury (AKI). A muscle biopsy was consistent with an immune-mediated necrotising myositis. The patient received intravenous fluids, remdesivir and haemodialysis, with subsequent resolution of muscle injury and recovery of kidney function. This case indicates the potential for severe myositis to develop in patients with SARS-CoV-2 infection with the potential for rhabdomyolysis and AKI to occur.

Navya Kataria, Abel Devadass, Lana Sundac, Laura De Souza, Nabeel Sheikh, Samantha Ng, Scott Campbell, Yishen Wang, Ross S. Francis

Mja2 70247
Medical practices Medical education 11 June 2026 Open Access

When ‘Liver Enzymes’ Are Not Hepatic: Late-Onset Pompe Disease

Elevated liver function tests are commonly attributed to hepatic disease but may reflect extrahepatic pathology. We describe the case of an 18-year-old athletic woman with a 2-year history of elevated aspartate aminotransferase (AST), alanine aminotransferase (ALT) and creatine kinase (CK) levels, initially investigated extensively for hepatic causes. Despite normal liver imaging and biopsy, ongoing abnormalities prompted metabolic evaluation, leading to the diagnosis of late-onset Pompe disease. This case highlights the diagnostic challenges of rare metabolic myopathies, the importance of recognising muscle-derived aminotransferase elevation and the need for broad diagnostic consideration when standard investigations are unrevealing.

Shauna Madigan, Georgina England, Wayne Rankin

COVID-19 Medical education 26 April 2026 Open Access

Lesson From Practice: Not Gone, Should Not Be Forgotten: Recognising PIMS-TS Cases in a Post-Pandemic World

We describe the clinical presentation, laboratory findings and complications of severe paediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus 2 (PIMS-TS), also known as multisystem inflammatory syndrome in children in a 16-year-old female diagnosed in June 2025. This case highlights the importance of prompt diagnosis of PIMS-TS in the post-coronavirus disease 2019 pandemic era to ensure timely and appropriate management.

Rana Sawires, Anneke Engwerda, Mehyar Khair Baik, Philip N. Britton, David P. Burgner

Ophthalmology Medical education 2 March 2026 Free

A Diagnostic Headache

Giant cell arteritis (GCA) is the most prevalent systemic vasculitis of the elderly and can lead to irreversible vision loss and stroke. We report the case of an 84-year-old woman who presented with a persistent headache, prompting investigation for GCA, initially with a temporal artery ultrasound (TAUS) scan. The results were suggestive of GCA and the diagnosis was confirmed on a subsequent temporal artery biopsy (TAB). TAUS is now part of the classification criteria of GCA, and a diagnosis can be made without biopsy. TAB should be reserved for high-risk patients with a negative TAUS result.

Thomas Glynn, Michelle T. Leech, Stacy K. Goergen, Emily Lin, Nadeem Toodayan, Ralph Junckerstorff

Parasitology Medical education 18 January 2026 Open Access

Treatment Failure and Post-Artesunate Delayed Haemolysis in a Returned Traveller From Uganda With Partially Drug-Resistant Severe Plasmodium falciparum Malaria

A man aged in his 40s, recently returned from Uganda, was hospitalised with Plasmodium falciparum malaria, with hyperparasitaemia of ~1.5×106 parasites/μL (26%). He received intravenous artesunate followed by artemether–lumefantrine. However, parasite clearance was delayed, and despite a negative blood film following treatment, the patient was readmitted 3weeks later with recurrent parasitaemia. Further testing for drug-resistant phenotypes and genotypes demonstrated reduced susceptibility to lumefantrine, an A675V mutation in the pfk13 gene and increased ring-stage survival, consistent with partial artemisinin resistance. The case highlights the high risk of P. falciparum treatment failure in patients with hyperparasitaemia and partial drug resistance.

Jye Travis, Kate McCarthy, Paul Chapman, Lawrence Huang, Angelica Tan, Qin Cheng, Bridget E. Barber

Infectious diseases Medical education 5 January 2026 Free

Localised Herpes Simplex Following Midline Laparotomy

An older man with Crohn's disease underwent emergency laparotomy for small bowel perforation. A peri-incisional vesiculobullous eruption developed 5days later. Histopathology demonstrated viral cytopathic changes, immunohistochemistry was positive for herpes simplex virus and HSV-1 DNA confirmed by polymerase chain reaction test, representing the first reported case of localised herpes simplex following abdominal surgery.

Jessica S. Bulluss, Paul Chee, Matthew J. Verheyden

Dermatology Medical education 5 January 2026 Free

Diagnosing Acute Kava Dermopathy: A Case Report of a Characteristic Cutaneous Eruption

A 41-year-old woman presented to the emergency department with a widespread pruritic, erythematous eruption following 6weeks of kava consumption for anxiety and insomnia. The eruption began on the abdomen and progressively involved the chest, upper back and face. Laboratory investigations revealed mild derangement of liver function test results. Skin biopsy results demonstrated folliculocentric inflammation and necrosis of sebaceous glands, consistent with acute kava dermopathy. Kava, a traditional anxiolytic herbal preparation, has been implicated in both chronic and acute cutaneous reactions, including ichthyosiform and sebotropic eruptions. Its active compounds, kavalactones, are hypothesised to provoke a cytotoxic T-cell–mediated response targeting sebaceous glands. This case is notable as it occurred in an Australian woman with no travel history to the Pacific Islands—a region where kava use is prevalent. Moreover, the distinct histopathological findings, rarely documented in the literature, provide valuable diagnostic insight and serve as a visual reference for clinicians encountering this condition.

Ali Abid, Nicholas Allen, Abeer Hagelamin, Christopher Henderson, Artiene Tatian

Emergency medicine Medical education 5 May 2025 Free

Platypus envenomation

A 62-year-old woman presented to an emergency department with severe pain two hours after rescuing a wild platypus, with two penetrating injuries to her right hand

Irene M Moyer de Miguel · Jennifer C Jamieson · Lori Coulson · Ingrid Berling

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