Clinical Case Studies – NEW Immunopaedia

case study

Sudden onset of fever, fatigue, myalgia, and headache

A previously healthy 35-year-old male presents with sudden onset of fever, fatigue, myalgia, and headache. He reports recent travel to an Ebola-endemic region in West Africa. This case study was…

Bonamy HoltakMarch 19, 2025

case study

Weakness, myalgia, night sweats and sore throat

A 36-year-old man developed two eschars (localized skin lesions) after visiting a rural field in Manzini, Swaziland. He has general weakness, myalgia, night sweats and sore throat. He reports having…

Bonamy HoltakMarch 19, 2025

case study

Management of Rabies in Côte d’Ivoire

The annual incidence of rabies is around twenty human cases and ten animal cases in Côte d’Ivoire. FAO provides financial and technical support to the country’s National Integrated Rabies Control…

Bonamy HoltakMarch 19, 2025

case study

Agricultural worker with discomfort, cough and bleeding sputum

A 32-year-old male agricultural worker presented with general discomfort and cough with bleeding sputum. He was coughing sporadically in the last 6 months. This case study was created by Immunopaedia…

Bonamy HoltakMarch 19, 2025

case study

As I age, the Fc neonatal receptor may still contribute to controlling my disease

Hubert, a 67 year-old retired male, diagnosed with generalized myasthenia gravis positive for anti-acetylcholine receptor autoantibodies, was treated with efgartigimod for disease exacerbation. Acknowledgement This case study was provided by…

Bonamy HoltakMarch 17, 2025

case study

My hands swell and are painful

Eva is a 50-year-old Caucasian woman who presents to the clinic with complaints of hand and feet swelling to the point of visible deformities. Her joint pain wakes her up…

Bonamy HoltakMarch 17, 2025

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I’ve been coughing for so long

Jade, 20 years-old, has had episodes of paroxysmal dyspnea since the age of 12, especially at night, associated with coughing and chest tightness, sometimes with wheezing. For 1 year now,…

Bonamy HoltakFebruary 25, 2021

case study

Keep up while the storm is raging

Norberto, a 23-year old white male in his third relapse of a B cell acute lymphoblastic leukemia (B-ALL) has been treated with an infusion of autologous CD19 Chimeric Antigen Receptor…

Bonamy HoltakNovember 6, 2020

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Fireworks of autoimmunity from birth

A five-month-old male infant was brought into the emergency department by parents with hypotonicity (reduced muscular tone) and drowsiness that began the evening before. The infant presented with refractory atopic…

Bonamy HoltakFebruary 1, 2018

case study

I have spots and my skin burns

Peter, a 60 year-old Caucasian policeman, complains of a painful burning sensation in his lower extremities lasting for several months. Lower limbs petechiae (small purple/red hemorrhagic spots) appeared one week…

Bonamy HoltakDecember 12, 2017

case study

My eyes cross at twilight

A 25 years-old, teacher, complains of double vision. She finds it difficult to talk after prolonged speaking. She is pregnant.Episodes of double vision began 6 weeks ago. Elsa's husband reported…

Bonamy HoltakAugust 11, 2017

case study

Case of giant wart

A 28 year old HIV-infected man presented to a Sexually Transmitted Infections (STIs) clinic with a large cauliflower like wart on the shaft of his penis. The wart had appeared...

Bonamy HoltakDecember 17, 2014

case study

Case of recurrent meningitis

A 7 year old girl was brought in by her mother with a three day history of headache, pain in the left ear, fever and vomiting. Her mother was concerned…

Bonamy HoltakDecember 17, 2014

case study

Doctor, my sister is confused

A 34 year old female patient was brought into the outpatient clinic by her family who were concerned about her progressive forgetfulness and inability to take care of herself. She…

Bonamy HoltakDecember 17, 2014

case study

Enlarged Testicles

A 53 year old male, originally from India, presented to the clinic for a renewal of his hypertension medication. On routine weighing it was noted that he had lost 8…

Bonamy HoltakDecember 17, 2014

case study

Case of repeated apnoea and infections in a premature infant

A three and a half month old boy presents to the emergency room with a 1 day history of apnoea. Earlier in the day he had received his routine immunizations.…

Bonamy HoltakDecember 15, 2014

case study

Case of a right axillary swelling

Four weeks after starting ARVs an 11 month old baby presented with a one-week history of a right axillary swelling which was found to be 2.5cm in diameter, hard, tender…

Bonamy HoltakDecember 15, 2014

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A case of a 10 year old boy with a 3 week history of diarrhoea, vomiting and cough

A 10 year old boy presents with a 3 week history of weight loss, diarrhoea, vomiting and a cough. No toxin ingestion has been noted and the family denies any…

Bonamy HoltakDecember 15, 2014

case study

A 10 year old girl with a hard palate defect

A 10 year old girl recently diagnosed with HIV (WHO stage 4), presents with a 12 day history of diarrhoea, vomiting, difficulty swallowing and abdominal cramps. She has remained afebrile…

Bonamy HoltakDecember 15, 2014

case study

Case of sudden onset of fever, rash and neck pain

A previously healthy 6–year-old boy is brought to the emergency room with a 3-day history of fever, neck stiffness and a one day history of a generalised maculopapular rash.He has…

Bonamy HoltakDecember 15, 2014

case study

17 year old male with fever and decreased level of consciousness

A 17 year old adolescent presents to a refugee camp infirmary obtunded. He has been febrile for the last 4 days and has been complaining of back pain and stomach…

Bonamy HoltakDecember 15, 2014

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Eight month old boy with recurrent infections

An eight month old boy presented with failure to thrive and recurrent infections including dissemination of his BCG vaccination. HIV ELISA test was negative. 8 months old: child presented with…

Bonamy HoltakDecember 15, 2014

case study

A case of fever and general malaise

A 17 year old male presents to the hospital emergency room with a one week history of headache, fever, sore throat, painful swellings in the neck and muscle aches. He…

Bonamy HoltakDecember 15, 2014

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A case of decreased joint function, fever and rash

A 7 year old girl presented to her local hospital for the second time in 3 months with arthralgia, a migratory skin rash and fever for 5 days. She was…

Bonamy HoltakDecember 12, 2014

case study

3 TB Vignettes

A 20-year-old woman, in her first trimester of pregnancy, presents to the ante-natal clinic (ANC) for routine care. After counseling she volunteered for HIV testing and was found to be…

Bonamy HoltakDecember 12, 2014

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Failure to thrive despite appropriate treatment

A two year 1 month old boy who has been on TB treatment and antiretroviral therapy for the past 9 months presents with failure to thrive despite adherence and nutritional…

Bonamy HoltakDecember 12, 2014

case study

Right Axillary Swelling

On 18th July 2006, 6 weeks after introduction of ARVs, an 11 month old baby presented with a one-week history of a right axillary swelling, 2.5cm in diameter noted to…

Bonamy HoltakDecember 12, 2014

case study

Declining CD4 count, despite viral suppression?

A 22 year old female, who was diagnosed as HIV positive 18 months ago and has been on antiretroviral treatment since diagnosis. Although she had been doing well she recently…

Bonamy HoltakDecember 10, 2014

case study

25 year old female presents with persistent flu-like symptoms

A 25 year old female presents to her primary healthcare clinic complaining of flu-like symptoms which consist of a fever, headache, myalgia, abdominal pain, nausea and fatigue.

Bonamy HoltakDecember 10, 2014

case study

A sudden turn of events after successful therapy

HIV positive 7 year old female, classified as WHO Stage III. She has been on antiretrovirals for 9 months. She presents with a moderate pyrexia and severe weakness and ...

Bonamy HoltakDecember 10, 2014

case study

Defaulted treatment

This patient is a 15 year old girl, who is presumed to have been perinatally infected with HIV. She is classified as WHO stage III, and is aware of her…

Bonamy HoltakDecember 10, 2014

case study

A case of persistant hectic fever

Mr GH was a 59 year old factory worker from Cape Town. He presented to GSH with a 2 week history of fever, rigors, weakness and a fine maculopapular rash.…

Bonamy HoltakDecember 10, 2014

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A four year old with immunodeficiency

A severely undernourished 4-year-old girl is referred to the paediatric outpatient clinic for recurrent anaemia, an erythematous rash on her face and trunk and accompanying hepatosplenomegally. The child was born…

Bonamy HoltakDecember 10, 2014

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Young girl with recurrent history of mycobacterial disease

A 9 year old girl of mixed racial ethnicity with a recurrent history of mycobacterial disease presents to a tertiary hospital with a persistently painful, swollen left ankle responding slowly…

Bonamy HoltakDecember 10, 2014

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Severe anaemia in HIV positive child

A 5 ½ year old male child is referred from an HIV treatment clinic to the paediatric department at his local hospital because he was noted to be severely anaemic…

Bonamy HoltakDecember 10, 2014

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An 8 year old boy with recurrent respiratory infections

An 8 year old boy is referred to a regional hospital for a surgical consultation for a lobectomy following a diagnosis of bronchiectasis due to a chronic history...

Bonamy HoltakDecember 10, 2014

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4 year old boy with recurrent bacterial infections

A four and a half year old boy presents with pyrexia, neck stiffness and a purpuric rash. History: At age three years he had his first episode of meningococcal meningitis,…

Bonamy HoltakDecember 10, 2014

case study

Immunodeficiency and failure to thrive

A 5 and half year old female, having recently moved provinces, is seen by a new paediatrician and diagnosed with pneumonia. It is also noted that she is failing to…

Bonamy HoltakDecember 10, 2014

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Case of recurrent infections

A four year old boy presents with fever, abdominal pain with abdominal guarding and difficulty breathing. He also complains of headaches and frequent skin abscesses which take a long time…

Bonamy HoltakDecember 10, 2014

case study

A high risk pregnancy

A two month old baby boy is brought into the clinic for a check up. He appears to be healthy but his HIV positive mother is concerned about his HIV…

Bonamy HoltakDecember 9, 2014

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A case of persistent bloody diarrhoea

Patient is a 22 year old female who presented to the surgery department of a tertiary level hospital having been referred from a private clinic, with a two month history…

Bonamy HoltakDecember 9, 2014

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A case of sudden rapid neurological deterioration in an HIV positive 27 year old female

An HIV positive 27 year old female on antiretroviral therapy (ART) presented to her HIV clinic with a two week history of progressively worsening twitching and clumsiness in her right…

Bonamy HoltakDecember 9, 2014

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A case of scaly annular plaques

A 45 year old male is referred from outpatient clinic to a hospital dermatology department with well dermacated erythematous scaly annular plaques scattered on his...

Bonamy HoltakDecember 9, 2014

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Is this treatment failure or malnutrition

In March 2006 an 11 years and 9 months old patient presented to private GP after recurrent hospital admissions for pneumonia. n March 2006 an 11 years and 9 months…

Bonamy HoltakDecember 9, 2014

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TB or not TB: a confusing case

A previously well 17 month old boy presents with a three day history of fever and a skin rash. No accompanying cough or diarrhoea. The patient recently moved to South…

Bonamy HoltakDecember 9, 2014

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An unusual cause of fulminant hepatitis

A 22-year-old male presented to his physician complaining of a fever and sore throat with enlarged, tender lymph nodes in his neck for the last 24 hours. He was now…

Bonamy HoltakDecember 9, 2014

case study

Case of eye injury and decreased vision

A 12 year old boy is brought into the paediatric casualty by his parents approximately 18 hours after sustaining a penetrating knife injury to his left eye. The child was…

Bonamy HoltakDecember 9, 2014

case study

The case of a floppy infant

A 10-month-old boy presented to a private maternal and child health hospital with severe irritability and floppiness. He had been fully immunized and was breastfed until 9 months of age.…

Bonamy HoltakDecember 9, 2014

case study

My head hurts and I cannot speak?

A 33 year old female presents to the medical out patient department with a moderately severe headache, sudden onset of weakness in the right hand, numbness of the right side…

Bonamy HoltakDecember 8, 2014

case study

Why can I not walk today?

A 24 year old female, presented with a 6 day history of progressive weakness of her lower limbs and since this morning has been unable to walk due to complete…

Bonamy HoltakDecember 8, 2014

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A case of a 3 month old infant with bloody urine and stools

A three month old male infant presents to the emergency department with a one day history of haematochezia and haematuria, accompanied by a diffuse rash and shortness of breath. A…

Bonamy HoltakDecember 8, 2014

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A 9 year old girl presents with body swelling, shortness of breath and backache

A 9 year old girl presents with a one month history of generalised body swelling associated with shortness of breath and backache. Two and a half weeks previously the patient…

Bonamy HoltakDecember 8, 2014

case study

A 7 year old with severe muscle weakness and difficulty walking

A 7 year old female presents with a three week history of painful elbows, wrists and hands, generalised weakness and difficulty walking. History: Painful elbows, wrists and hands for 3/52;…

Bonamy HoltakDecember 8, 2014

case study

A case of swollen hands

A 25 year old female presented to her primary healthcare physician complaining of swollen hands for the last week. She had also noticed that over the last two days she…

Bonamy HoltakDecember 8, 2014

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14 year old with severe hip pain

A 14 and half year old boy presents with a recent history of tender temperomandibular joints and regular morning stiffness in both hips. He has a limited range of movement…

Bonamy HoltakDecember 8, 2014

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Adverse event following routine vaccination

A 19 month old infant presents with marked leg swelling, pain and inability to walk within 6 hours of receiving booster vaccinations. The child had been ambulatory for the prior…

Bonamy HoltakDecember 5, 2014

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A case of lymphadenopathy and night sweats

A 33 year old male presents with a one month history of a non-productive cough, fever, night sweats, malaise, abdominal pain and weight loss. History: Known HIV positive, Diagnosed 8…

Bonamy HoltakDecember 4, 2014

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A case of cough, wasting and lymphadenopathy

A 32 year old female presented to the emergency room with a two month history of worsening dyspnea, cough with production of sputum, haemoptysis and extensive weight loss. At the…

Bonamy HoltakDecember 4, 2014

case study

In the Red

A 55-year old HIV-infected male was referred to the Dermatology Outpatient Clinic with a four month history of a swollen face and multiple skin nodules. Three years prior to this…

Bonamy HoltakDecember 4, 2014

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Case of enlarged hard tongue

A 59 year old male presents to the medical out patient department with a one month history of progressively increasing fatigue and backache.For the last month the patient has been…

Bonamy HoltakDecember 3, 2014

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A case of acute fever, rash and vomiting

A 31 year old caucasian male presented to the HIV clinic complaining of recent onset of fever, vomiting, joint pain, muscle aches, sore throat and a fine red rash on…

Bonamy HoltakNovember 25, 2014

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