Journal of the colleges of medicine of South Africa最新文献

{"title":"Factors influencing delayed presentation of periorbital carcinoma requiring orbital exenteration.","authors":"Nadine van Wyk, Akiel Asvat, Mokokomadi A Makgotloe, Mantoa Mokhachane","doi":"10.4102/jcmsa.v3i1.201","DOIUrl":"10.4102/jcmsa.v3i1.201","url":null,"abstract":"<p><strong>Background: </strong>Ocular surface squamous neoplasia is the most widespread indication for orbital exenteration and the presenting feature of human immunodeficiency virus (HIV) in 50% to 86% of patients in endemic areas. Overall survival at 1 year post-exenteration ranged from 69.1% to 97.0%, according to a review article, with the lower rate attributed to delayed referral.</p><p><strong>Methods: </strong>A qualitative, descriptive phenomenological study was conducted to identify factors responsible for delayed presentation in advanced periorbital carcinoma requiring orbital exenteration. A total of 25 participants were enrolled using convenience sampling. Data were collected by means of a structured questionnaire and open-ended questions. The questionnaire was conducted as a semi-structured interview and recorded with a voice recorder, and the interviews were coded and themes were identified. Data were analysed using Colaizzi's seven steps for thematic analysis.</p><p><strong>Results: </strong>Six major themes were identified: a disregard for the seriousness of the condition; financial constraints; delays caused by the clinic; alternative treatment sought; stigma and fear; and relief and hope.</p><p><strong>Conclusion: </strong>Participants acknowledged that the mass was ignored. However, once healthcare was sought, many felt treatment was delayed as they had to wait for results or because of delayed appointment dates. A lack of financial freedom and a fear of loss of income further delayed participants. Traditional healers were sought as an adjunct to allopathic medicine to appease family. Stigma surrounding the loss of an eye burdened and alienated participants, but many were able to look to the future and forge a new hope and identity.</p><p><strong>Contribution: </strong>This study contributes to our understanding of the patient-related and systemic factors leading to delay. It highlights key barriers and and promotes earlier diagnosis and intervention.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"201"},"PeriodicalIF":0.0,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12424028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hybrid Clinician-Managers: Exploration of opportunities and challenges in a hospital setting.","authors":"Anita N Parbhoo, Vera Scott","doi":"10.4102/jcmsa.v3i1.182","DOIUrl":"10.4102/jcmsa.v3i1.182","url":null,"abstract":"<p><strong>Background: </strong>Effective leadership and management are required for quality health services in low- and middle-income countries (LMICs). As in higher income countries (HICs), clinicians in LMICs often transition from a purely clinical to a hybrid role with managerial responsibilities, without management training. These clinicians with dual responsibilities are referred to as hybrid managers (HMs). This study explored opportunities and challenges experienced by HMs in a tertiary academic hospital in South Africa.</p><p><strong>Methods: </strong>A qualitative study was conducted using purposive sampling. In-depth interviews were conducted with 12 clinicians who were in a managerial role for over 12 months with no formal management training.</p><p><strong>Results: </strong>Hybrid managers experienced minimal support when first stepping into the job and articulated the large administrative burden. In an academic hospital, there is the double burden of bureaucracy from the hospital and the university, with the expectation to conduct research, teaching and training. However, direct patient interactions and clinical service also brought opportunities. This included knowledge of the business needs from a clinician's perspective, as well as meaning-making, de-stressing and job satisfaction.</p><p><strong>Conclusion: </strong>Hybrid managers in this LMIC setting share challenges experienced by HMs in HICs with respect to identity, competing work priorities and the complexity of research and teaching responsibilities.</p><p><strong>Contribution: </strong>Hybrid managers in tertiary hospitals require support with adequate orientation towards the administrative processes, budgeting, human resources management and workflows in the hospital and university. Mentorship is key, as is training towards a mind shift change for HMs to truly embrace the role.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"182"},"PeriodicalIF":0.0,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12424035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The predictive value of risk assessment models for venous thromboembolism on gynaecological cancer patients.","authors":"Phuti Khomotso Ratshabedi, Admire Chikandiwa, Langanani Mbodi","doi":"10.4102/jcmsa.v3i1.164","DOIUrl":"10.4102/jcmsa.v3i1.164","url":null,"abstract":"<p><strong>Background: </strong>Venous thromboembolism (VTE) is a multifactorial disease. There are two main clinical entities that are associated with morbidity and mortality, deep vein thrombosis and pulmonary embolism. Our study aimed to compare the three risk assessment models (RAMs), Khorana, Caprini and Padua in terms of predicting VTE in gynaecologic oncology patients.</p><p><strong>Methods: </strong>Patients were retrospectively scored according to Caprini, Padua and Khorana scoring models to assess the risk for VTE. Accuracy analysis of risk assessment models was performed using sensitivity, specificity, positive and negative predictive values as well as the area under the curve of each model per patient.</p><p><strong>Results: </strong>The Caprini score has good sensitivity (80.0), a poor specificity (24.3), low positive predictive value (7.2) and good negative predictive value (94.3) (95% CI). The Khorana score has a poor sensitivity (30.0), a fair specificity (62.5), low positive predictive value (5.6) and good negative predictive value (92.4) (95% CI). The Padua score has an average sensitivity (60.0), a poor specificity (42.6), low positive predictive value (7.1) and good negative predictive value (93.5) (95% CI). The Caprini score had the overall best performance.</p><p><strong>Conclusion: </strong>Caprini score performed better and proved to be the best score. It has the potential to reduce mortality associated with VTE in gynaecological cancer patients. However, the Caprini score needs to be tested in the same population in a prospective study in a multicentre.</p><p><strong>Contribution: </strong>The results of this study prove to us that Caprini score is the best to be used in a South African setting.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"164"},"PeriodicalIF":0.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12424007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A low-cost simulation model for priapism detumescence training.","authors":"Sachin Garach, Hanlie Dreyer, Ahmed Adam, Abdullah Laher","doi":"10.4102/jcmsa.v3i1.223","DOIUrl":"10.4102/jcmsa.v3i1.223","url":null,"abstract":"<p><p>Ischaemic priapism is a urological emergency requiring prompt intervention to prevent complications such as erectile dysfunction. Because of its low incidence, opportunities for hands-on training are limited, particularly in resource-constrained settings. To address this gap, we developed a low-cost, anatomically realistic simulation model to train emergency medicine and urology trainees in needle aspiration techniques. Constructed from readily available materials, the model replicates the anatomical and hepatic characteristics of priapism and was successfully integrated into a structured training programme for emergency medicine registrars. Although not formally evaluated, trainee feedback indicated improved procedural skill and confidence. The constructed reusable trainer offers an accessible and effective educational tool to enhance clinical preparedness, especially in low-resource environments. Further studies are needed to evaluate its impact on training outcomes.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"223"},"PeriodicalIF":0.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12423990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping the gap: Misalignment between emergency care research and consensus priorities in the Western Cape.","authors":"Robert Holliman, Colleen J Saunders","doi":"10.4102/jcmsa.v3i1.226","DOIUrl":"10.4102/jcmsa.v3i1.226","url":null,"abstract":"<p><strong>Background: </strong>The Western Cape (WC) province of South Africa is one of the highest emergency care (EC) research-producing regions in Africa. In 2021, a consensus exercise with key stakeholders established 26 EC research priorities. This study aimed to confirm evidence gaps in relation to the priorities and assess the alignment between frontline knowledge needs and research output within the WC EC community.</p><p><strong>Methods: </strong>We developed an evidence map of all EC research published from the WC between January 2017 and December 2021 to describe the alignment of each publication with any previously established priority. Additional data were extracted from all studies that addressed one or more of these priorities.</p><p><strong>Results: </strong>A total of 246 EC publications were identified, with 24% (<i>n</i> = 60) addressing one or more of the 26 established priorities, while five priorities remained unaddressed. Priority-aligned papers appeared in 36 journals, of which 16% (<i>n</i> = 41), including seven priority-aligned papers, were behind a pay wall. Most priority-aligned studies were observational (48%) or qualitative (23%), with only two systematic reviews and no experimental studies.</p><p><strong>Conclusion: </strong>Less than a quarter of recent EC research publications from the WC addressed established consensus priorities, confirming the existence of consensus evidence gaps and suggesting potential misalignment between research output and community-identified needs.</p><p><strong>Contribution: </strong>This study provides an evidence-based assessment of how well EC research in the WC reflects community-established priorities. The findings highlight the need for stronger alignment between research production and frontline knowledge needs to maximise impact and reduce research waste.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"226"},"PeriodicalIF":0.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12424033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A 60% crisis: Mortality and hypertension-driven intracranial haemorrhage at a South African tertiary hospital.","authors":"Umar Jacobs, Thaakir-Ahmed Jacobs, Janneke Pienaar, Sideeqa Jakoet, Aaqilah Fataar, Neshaad Schrueder, Sa'ad Lahri","doi":"10.4102/jcmsa.v3i1.202","DOIUrl":"10.4102/jcmsa.v3i1.202","url":null,"abstract":"<p><strong>Background: </strong>Spontaneous intracranial haemorrhage (ICH) is a significant cause of morbidity and mortality worldwide, with a disproportionate burden in low- and middle-income countries. Data on ICH in South Africa are limited, hindering targeted intervention efforts.</p><p><strong>Methods: </strong>A retrospective, descriptive study was conducted at Tygerberg Hospital, Cape Town, reviewing records of patients with confirmed spontaneous ICH based on computed tomography imaging from 01 January 2021 to 31 December 2022. Demographics, risk factors, clinical presentation, imaging findings and outcomes were analysed.</p><p><strong>Results: </strong>Of the 162 eligible cases, 53.09% were male, with a mean age of 51.81 years (standard deviation: 11.88). Hypertension was the most prevalent risk factor (87.04%), with 84.57% presenting with grade 2 hypertension on admission. Basal ganglia involvement was the most common ICH location (55.56%). Complications were frequent, with 79.82% showing intraventricular extension. The 3-month and 1-year mortality rates were 59.88% and 60.49%, respectively. Only 57.41% of hypertensive patients were on antihypertensive medication prior to ICH.</p><p><strong>Conclusion: </strong>This study highlights the significant burden of spontaneous ICH in a South African tertiary hospital setting, characterised by a younger age of onset and high prevalence of modifiable risk factors, particularly uncontrolled hypertension. These findings underscore the urgent need for enhanced hypertension management and targeted primary prevention strategies to reduce the ICH burden, providing valuable data to inform public health interventions in resource-limited settings.</p><p><strong>Contribution: </strong>This study provides data on spontaneous intracranial hemorrhage (ICH) in a South African tertiary hospital, identifying a high mortality rate and the prevalence of uncontrolled hypertension in a younger population. The findings address a key data scarcity in low- and middle-income countries and promote the development of tailored prevention and management initiatives, which are consistent with the journal's emphasis on regionally appropriate, evidence-based healthcare interventions.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"202"},"PeriodicalIF":0.0,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12424030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of shock index to predict mortality risk in decompensated heart failure.","authors":"Amanda Naidoo-Pillay, Suma Rajan, Andreas Engelbrecht","doi":"10.4102/jcmsa.v3i1.193","DOIUrl":"10.4102/jcmsa.v3i1.193","url":null,"abstract":"<p><strong>Background: </strong>Decompensated heart failure (HF) is a serious condition that requires rapid evaluation and treatment. Shock index (SI) is a bedside predictor tool used to identify risk of mortality and morbidity.</p><p><strong>Methods: </strong>This multicentre retrospective descriptive study evaluated SI, modified shock index (MSI) and reverse shock index (RSI) as predictors of mortality in decompensated HF. Emergency department records for a 6-month period were analysed. The primary outcome was to identify if SI > 0.9 could predict mortality during hospital admission. Secondary outcomes included SI > 0.9, MSI > 0.93 and RSI < 1 for prediction of 72-h mortality, use of non-invasive positive pressure ventilation, inotropic, vasopressor or nitroglycerine infusions and need for endotracheal intubation.</p><p><strong>Results: </strong>Overall mortality during hospital admission was 4.3%, impacting internal validity. For inotrope use, SI > 0.9 at 12 h produced an odds ratio (OR) of 12.33 (confidence interval [CI] 2.03-74.89; <i>P</i> = 0.006). Modified shock index > 0.93 suggested potential for mortality and critical intervention prediction but lacked statistical significance. Reverse shock index < 1.0 at 0 h indicated ORs of 8.89 (CI 1.11-70.98) for in-hospital mortality and 9.88 (CI 1.70-57.27) for inotrope use.</p><p><strong>Conclusion: </strong>SI > 0.9 at 12 h predicted an increased need for inotropes. Reverse shock index demonstrates significant predictive value for mortality and critical interventions in decompensated HF. Reverse shock index appears to be the most effective index in predicting both mortality and need for critical interventions, outperforming SI and MSI. Further prospective studies are needed to validate these findings.</p><p><strong>Contribution: </strong>This research will assist with early triage of decompensated HF patients to appropriate dispositions and guide inexperienced clinicians to identify high-risk patients.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"193"},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12424009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cultural competence of paediatric doctors: A qualitative study in a rural setting.","authors":"Ntandoyenkosi L Msomi, Suvishka Barath","doi":"10.4102/jcmsa.v3i1.204","DOIUrl":"10.4102/jcmsa.v3i1.204","url":null,"abstract":"<p><strong>Background: </strong>Cultural competence is an important aspect of patient-centred care, particularly in paediatric settings, where doctors from diverse backgrounds interact with families from different cultural contexts. South Africa is a multi-cultural country, with doctors working with people whose concepts of health and healing include traditional beliefs and practices. While the importance of cultural competence is widely acknowledged, limited data exist on how doctors exercise cultural competence in a neonatal intensive care unit (NICU). This study addresses this gap by exploring doctors' perspectives on providing culturally responsive care in a rural NICU.</p><p><strong>Methods: </strong>We conducted an exploratory qualitative study, situated within a constructivist paradigm, to explore how doctors understand and practise cultural competence. The constructivist lens guided the exploration of participants' socially constructed perspectives within their clinical contexts. Nine doctors working in the NICU of a public-sector regional hospital in KwaZulu-Natal Province, South Africa, were purposively sampled. Semi-structured interviews were conducted, and data were analysed thematically.</p><p><strong>Results: </strong>Five themes were generated: (1) understanding cultural competence, (2) learning cultural competence, (3) importance of clinical settings, (4) professional challenges in displaying cultural competence and (5) evaluating cultural competence. Collectively, these themes highlight the disconnect between the perceived value of cultural competence and the realities of insufficient training, inconsistent application and limited institutional support in high-pressure clinical settings.</p><p><strong>Conclusion: </strong>While the doctors recognised cultural competence as integral to effective paediatric care, gaps remain in training, implementation and evaluation. Addressing these challenges through structured education may enhance culturally responsive health care delivery.</p><p><strong>Contribution: </strong>This study contributes to the growing discourse on cultural competence in health care by providing perspectives into its practical application and challenges in a South African paediatric setting.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"204"},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12423978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetic Ketoacidosis and COVID-19: Patient profiles from a regional emergency department in Johannesburg, South Africa.","authors":"Hanlie Dreyer, Pravani Moodley, Robert Kieser","doi":"10.4102/jcmsa.v3i1.142","DOIUrl":"10.4102/jcmsa.v3i1.142","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to describe the clinical features and severity of illness in patients diagnosed with both coronavirus disease 2019 (COVID-19) and diabetic ketoacidosis (DKA) at a South African regional hospital.</p><p><strong>Methods: </strong>This was a single centre, retrospective, observational study conducted at a regional hospital in Johannesburg, South Africa. Records of patients who presented to the emergency department (ED) between 01 April 2020 to 31 August 2021 and were diagnosed with DKA were reviewed. Both COVID-19 positive and negative patients were included.</p><p><strong>Results: </strong>Of the 104 patients with DKA, 35 (33.7%) tested positive for COVID-19. Among the COVID-19 positive group, two required ICU admission and two were admitted to the High Care Unit (HCU). Interventions included high-flow nasal cannula (1 patient), intubation (2 patients), and inotropic support (1 patient). Outcomes included one death (2.9%), one patient declining treatment, and one transfer. A statistically significant association was found between the COVID-19 positive group and increased age (<i>p</i> = 0.02), as well as a positive association with Type 2 Diabetes Mellitus (DMT2) (<i>p</i> = 0.03).</p><p><strong>Conclusion: </strong>This retrospective study demonstrated that patients with COVID-19 and DKA had a lower mortality rate than previously described. In patients with both COVID-19 and DKA, a significant association with advanced age and DMT2 was noted.</p><p><strong>Contribution: </strong>Data on the burden of co-existing DKA and COVID-19 in South Africa remain limited. This study contributes by highlighting a lower observed mortality rate and underscores the need for further local research on this patient population.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"142"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12423984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary central nervous system lymphomas at a tertiary academic hospital in Johannesburg.","authors":"Garrick E Laudin, Vinitha Philip, Sugeshnee Pather, Atul Lakha, Romana Jassat, Faadil Waja, Ahshish Govind, Lindokuhle Goqwana, Moosa Patel","doi":"10.4102/jcmsa.v3i1.135","DOIUrl":"10.4102/jcmsa.v3i1.135","url":null,"abstract":"<p><strong>Background: </strong>Primary central nervous system lymphomas (PCNSL) are diffuse large B-cell lymphomas (DLBCL), which affect multiple regions of the neuroaxis, including the brain parenchyma, the orbits, cranial nerves and leptomeninges, without systemic disease. The aim of this study was to review the clinical characteristics as well as the outcome of patients referred to a tertiary academic hospital in Johannesburg (South Africa) with a presumed PCNSL diagnosis based on histology, cerebrospinal fluid (CSF) analysis and neuroimaging.</p><p><strong>Methods: </strong>This retrospective record review at a tertiary academic hospital in Soweto (Johannesburg), included patients aged ≥ 17 years referred with a presumed diagnosis of PCNSL, based on biopsy-confirmed PCNSL, CSF analysis or neuroimaging, between January 2010 and December 2022. Patient characteristics (laboratory, clinical, treatment(s), outcome) were analysed in three groups based on diagnostic certainty for PCNSL (diagnostic, suspicious, consistent).</p><p><strong>Results: </strong>The cohort comprised 14 patients, with most cases occurring in People Living with Human Immunodeficiency Virus (PLWH) (<i>n</i> = 10; 71%), with equal representation of male and female patients. The median age of diagnosis was 43 years (17-64), with PLWH diagnosed at an earlier mean age of 40 compared to human immunodeficiency virus (HIV)-negative patients (mean age 52). Both surviving patients received between 6 and 8 cycles of high-dose methotrexate (HD-MTX), with one receiving an autologous stem cell transplant. Over half (57%) of the cohort died with a median overall survival of two months (95% CI 1.3-2.6).</p><p><strong>Conclusion: </strong>Establishing a PCNSL diagnosis without histology often relies on several ancillary investigations. The high mortality and poor median survival highlight the importance of timely diagnosis and treatment.</p><p><strong>Contribution: </strong>This case series highlights the the complexities of a PCNSL diagnosis in PLWH and will hopefully inspire future work in this area.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"135"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12424003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}