We report a case of rhabdomyolysis associated with Mycoplasma pneumoniae pneumonia in a 37-year-old Sri Lankan man who presented to the emergency department with complaints of feverishness, shortness of breath, cough, and generalised muscle pain. He had a serum creatinine kinase of 14 220 U/L, serum myoglobin of 1822 ng/mL, and serum creatinine of 195 µmol/L. His chest X-ray revealed bibasilar interstitial infiltrates. The antimycoplasma antibody titre was high. The patient was successfully treated with aggressive intravenous fluid replacement and azithromycin. The outcome was rapidly favourable, allowing us to discharge the patient 12 days after admission. On discharge, the serum creatinine kinase was 924 U/L and the creatinine was 126 µmol/L; the chest examination was unremarkable.

The 'wandering spleen' is a rare condition due to extreme laxity or absence of ligaments that fix the organ in its normal anatomical position within the left upper quadrant. Without early surgical intervention, wandering spleen can lead to torsion and subsequent splenic infarction or rupture. Clinical suspicion plus urgent investigation and intervention are important, so as to salvage the spleen and prevent complications. We present a case of torsion of a wandering spleen in a 21-year-old young woman, who presented with a painful pelvic mass. We also reviewed the literature on this entity.

Benign metastasising leiomyomatosis is a rare condition affecting women in the reproductive age-group with a history of uterine fibroids, who have undergone treatment by myomectomy or hysterectomy. It is characterised by development of multiple, indolent, smooth muscle tumours outside the uterus, most commonly in the lungs, and manifests several years after the uterine surgery. We describe the case of a young woman, who had undergone total abdominal hysterectomy and bilateral salpingo-oophorectomy for multiple fibroids and a right ovarian cyst. After 5 years of being on oestrogen replacement therapy, she was detected to have benign metastasising leiomyoma, for which an additional laparotomy was performed. At laparotomy, removal of the pelvic mass was associated with several complications. The metastatic lesions in the lung responded well to progestogens (megestrol acetate) alone as evidenced by regression of the lesions detected at follow-up after 6 months and 1 year.

We report herein a patient with a urethral calculus associated with urethral diverticulum. A 39-year-old man presented with scrotal swelling and acute retention of urine. Computed tomography of the pelvis and cystoscopy demonstrated a giant calculus in the proximal penile urethra. Emergency in-situ lithotripsy was performed. Complete stone clearance was achieved and a large urethral diverticulum was encountered. The rare occurrence of urethral diverticulum and associated stone disease were discussed.

Vesicular rashes in neonates are challenging in terms of diagnosis and management. Herpes infection is an important diagnostic consideration. We report two illustrative neonatal cases of herpesvirus infections with vesicular rashes. Such babies may be remarkably asymptomatic. A high index of suspicion leading to a prompt diagnosis, timely quarantine measures, and institution of antiviral treatment are pivotal for desirable outcomes.