Tuberculosis (TB) is a multiorgan disease that can affect any part of the body. Though it is thought to be affecting mainly the pulmonary system, genitourinary TB is a rare but important manifestation of TB. It has been reported in <0.5% of extra pulmonary tuberculosis. Amongst instances of genitourinary TB, glandular TB is even scarcer. Maximum patients seek medical intervention later in the progression of ailment due to the attached stigma linked with tuberculosis and in view of affected site and part of the body and the reluctance on the patient’s side. In this case report, a 58-year-old male presented to Medicine Department with the complaint of a non healing wound on the scrotal region with excoriation since one month and irritability with altered sensorium since a week. Ultimately, it turned out to be a case of tubercular meningitis resulting from a neglected scrofula with neck rigidity, Kernig's and Brudzinski's sign positive. Though many case reports involving tubercular meningitis have been reported, a neglected scrofula remains a rare manifestation of tubercular meningitis.
Polyglobulia is secondary polycythaemia commonly due to underlying non haematological diseases like Chronic Obstructive Pulmonary Disease (COPD), obstructive sleep apnoea and also sometimes in people living in hilly or forest areas. It can occur in any venous or atrial thrombosis of the vessels, but cardiac, cerebral, and mesenteric vessels are usually involved. One of the rare causes of abrupt severe abdominal discomfort is portal vein thrombosis, usually associated with liver cirrhosis and thrombophilia. In this case report, the authors have highlighted a case of a 36-year-old male residing in the hilly area of Maharashtra, India, who reported to hospital with severe abdominal pain due to superior mesenteric vein thrombosis. On investigation, he had increased haemoglobin with raised haematocrit diagnosed as polyglobulia and became part of polycythaemia with positive JAK2 V617F mutation.
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