Adnexa masses occur in one out of two hundred pregnancies
(1). Many are benign ovarian cysts diagnosed in women
during antenatal care and managed conservatively with success.
Occasionally, ovarian accidents occur that necessitate
emergency surgeries. However, in women, unbooked during
pregnancy, presentation to hospital may occur for the first
time in the puerperium and it may pose a diagnostic challenge.
We present the case of a 33-year old multipara who
presented with acute abdomen in the puerperium. The initial

Transverse myelitis is a very rare neurological condition associated with immunologic and infectious
conditions causing interruption of the neuroanatomical pathways in a transverse plane in the spinal
cord. Herein is described the fatal case of a patient that developed transverse myelitis after a
Caesarean delivery, probably related to the epidural analgesia.

Fulminant myocarditis, especially those caused by the
Ebstein-Barr virus (EBV) is a rare disease (1). For the first
time, we describe a case of fulminant myocarditis caused by
EBV in a young, immunocompetent adult, co-infected with
parvovirus B19.

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INTRODUCTION

ABSTRACT
Aorto-cavitary fistulae are rare complications of infective endocarditis. The diagnosis, in the absence of concomitant aortic valve disease, replacement of aortic valve with homograft or prosthetic valve, periannular abscess and negative blood culture, requires a high index of suspicion and has important prognostic and management significance. The sensitivity of the Modified Duke Criteria is challenged in this case report with a documented right sinus of valsalva fistula to the right ventricle seen on transthoracic echocardiography.

Patients with sickle cell disease are more susceptible to acute anaerobic osteomyelitis due to focal gut mucosal ischaemia, translocation of bacteria, and seeding in infarcted bone marrow. Modulation of the immune system is also present. The isolation of anaerobic organisms requires a high index of suspicion, correct specimen collection procedures and meticulous specimen handling. Bacteroides is the predominant organism isolated. Intra-osseous gas in the bone may be seen within four days and radiographs are therefore useful earlier than with aerobic osteomyelitis.