Cotard syndrome features nihilistic delusions about one’s body or existence and is typically related to severe depression though is rarely associated with medical or neurological insults. The patient was a 62-year-old male with no past psychiatric history and a past medical history of congestive heart failure and consequent renal failure who presented for scheduled heart and kidney transplantation. He was started on routine post-transplant ganciclovir and steroids. Due to postoperative hypotension, empiric cefepime was initiated to cover for septic shock. One week postoperatively, the patient stated “I am dead.”

Necrotising fasciitis is a rapidly progressing soft tissue infection associated with significant morbidity and mortality. We present a case of cervical necrotising fasciitis with mediastinal extension in a diabetic young male who was COVID-19 positive. He presented with a five-day history of left-sided neck swelling which was fluctuant, red and painful. Subsequent debridement and management of the wound were complicated by the comorbid SARS-CoV2 infection due to potential need for proning. This case highlights the complex interplay between the management of two significant conditions; the surgical approach to necrotising fasciitis and the concern of deterioration due to COVID-19.

This report highlights the management challenges in patients with severe inherited bleeding disorders who develop an indication for anticoagulation or anti-platelet treatment in the context of the relativity uncommon entity of carotid artery dissection.

Arnold and Cameron describe a squamous cell carcinoma of the oral cavity in a patient with lower limb arteriopathy. The impact of comorbidities on surgical management of diseases such as cancer is an exigent discussion due to ageing populations.

We report a paediatric case of a 6-year-old girl with neurofibromatosis type 1 (NF1) who presented with easy bruising and gum bleeding. Following diagnosis and treatment as pre-B cell acute lymphoblastic leukaemia (pre-B ALL) the patient developed an acute myeloid leukaemia (AML) which was refractory to all available curative therapies.

An 81-year-old Chinese lady complained about worsening shortness of breath, paroxysmal nocturnal dyspnoea and dyspnoea at rest since 3 days before admission from nursing home. The symptoms were relieved by sublingual glyceryl trinitrate and oxygen.

  

Dengue is the most important mosquito-borne viral disease affecting humans and can be caused by any 1 of 4 dengue viruses (DENV-1 to DENV-4), transmitted by Aedes mosquitoes [1]. Currently, about 100 million clinically apparent cases are estimated to occur each year resulting in approximately 20000 deaths [2].