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We report the case of a 28-year-old, HIV-positive woman presenting with painful vesicular and ulcerating lesions in the ano-genital region caused by varicella zoster virus that appeared similar to herpes simplex infection. The case highlights that herpes zoster needs to be considered in the differential diagnosis of genital lesions, particularly in HIV-positive individuals, and the importance of virological diagnosis by PCR to direct appropriate management.

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a serious reaction to drugs with a clinical presentation of rash, fever, lymph node enlargement and internal organ involvement. Reports have described the reactivation of human herpes virus 6 (HHV-6) and other HHVs in association with this syndrome. We report a 41-year-old woman who developed a rash, fever, liver dysfunction, eosinophilia and atypical monocytosis 21 days after initiation of the quadruple therapy for tuberculous cervical lymphadnitis. HHV-7 DNA was detected in blood by PCR suggesting infection with or more likely reactivation of HHV-7 as a contributing factor or consequence of this serious adverse drug reaction.

Acute colonic pseudo-obstruction syndrome, also known as Ogilvie's syndrome, is a rare condition associated with significant morbidity and mortality. We report a case that developed very rapidly after emergency caesarean section. A 20-year-old woman underwent an emergency caesarean section for failure to progress in the first stage of labour and a healthy male infant was delivered without incident. However, soon afterwards the patient developed significant abdominal distension and pain. Ogilvie's syndrome was diagnosed following an abdominal x-ray which revealed a gross large bowel obstruction without mechanical cause. To prevent caecal rupture, the patient underwent successful emergency colonic decompression.