HM2018 Abstract Number: 645

Pituitary Apoplexy with Binasal Visual Defect

Case Presentation: A 67-year-old Japanese man was brought to our hospital because of a headache. He had noticed his headache and retroorbital pain four days before and they had been getting worse gradually. Subsequently, he [...]

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HM2018 Abstract Number: 911

NON-TRAUMATIC COMPARTMENT SYNDROME DUE TO STREPTOCOCCUS AGALACTIAE IN AN IMMUNOCOMPROMISED HOST

Case Presentation: A 34-year-old male with recently diagnosed Philadelphia chromosome-positive acute lymphoblastic leukemia developed neutropenic fever with right arm pain on day thirteen of induction chemotherapy. He was placed on empiric piperacillin-tazobactam. Blood cultures grew [...]

By | 2018-03-19T15:43:53+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on NON-TRAUMATIC COMPARTMENT SYNDROME DUE TO STREPTOCOCCUS AGALACTIAE IN AN IMMUNOCOMPROMISED HOST

HM2018 Abstract Number: 423

ATRAUMATIC SPLENIC RUPTURE SECONDARY TO BABESIOSIS: A STEALTHY DEADLY DISEASE

Case Presentation: A 66 year-old Caucasian male presented to the emergency department with intermittent fevers, chills, fatigue and dyspnea of 1 week duration. He denied any nausea, vomiting, abdominal pain, changes in bowel habit or [...]

By | 2018-03-19T15:43:53+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on ATRAUMATIC SPLENIC RUPTURE SECONDARY TO BABESIOSIS: A STEALTHY DEADLY DISEASE

HM2018 Abstract Number: 595

DIFFUSE ALVEOLAR HEMORRHAGE FROM ATYPICAL HEMOLYTIC UREMIC SYNDROME SECONDARY TO LUPUS NEPHRITIS.

Case Presentation: A 20 year old man with history of Systemic Lupus erythematous (SLE) with Lupus nephritis presented to the hospital with cough and hemoptysis for the past few days. He was found to have [...]

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HM2018 Abstract Number: 604

My sinuses problems made me swollen all over!!

Case Presentation: A 40-year-old male of Hispanic/Asian origin with a history of diabetes mellitus type II, hypertension, dyslipidemia, recurrent sinusitis and bilateral otitis media presented to the emergency department complaining of acute hand joints pain, [...]

By | 2018-03-19T15:43:54+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on My sinuses problems made me swollen all over!!

HM2018 Abstract Number: 497

An Unnecessary Procedure in a Sickle Cell Patient with Acute Chest Syndrome

Case Presentation: A 28-year-old woman with sickle cell disease and chronic pain who required inpatient care several times yearly presented with worsening nausea, emesis and uncontrolled pain to the emergency department (ED). Symptoms were typical [...]

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HM2018 Abstract Number: 813

WHILE TISSUE IS THE ISSUE, INFECTIONS ALWAYS COME DOWN TO LOCATION, LOCATION, LOCATION!

Case Presentation: A 25 year-old white man with no significant past medical history presented with gradually progressive dyspnea on exertion and dry cough for approximately two months. He was treated for community-acquired pneumonia with various [...]

By | 2018-03-19T15:43:54+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on WHILE TISSUE IS THE ISSUE, INFECTIONS ALWAYS COME DOWN TO LOCATION, LOCATION, LOCATION!

HM2018 Abstract Number: 661

OF ULCERS AND ESCHAR

Case Presentation: A 62-year-old man presented with 5 weeks of progressive right lower extremity ulceration associated with pain, swelling, erythema, fevers, and diaphoresis. Initially, outpatient providers diagnosed patient with cellulitis following minor trauma and complicated [...]

By | 2018-03-19T15:43:54+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on OF ULCERS AND ESCHAR

HM2018 Abstract Number: 425

MISS UNDERSTOOD: A CASE OF HASHIMOTO’S ENCEPHALOPATHY

Case Presentation: A 75-year-old African-American female with a past medical history of hypothyroidism, hypertension, and Alzheimer’s dementia presented to the emergency room with altered mental status and concern for possible stroke; family also reported new [...]

By | 2018-03-19T15:43:54+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on MISS UNDERSTOOD: A CASE OF HASHIMOTO’S ENCEPHALOPATHY

HM2018 Abstract Number: 503

ACNE? NOT SO MUCH: A RARE CLINICAL MANIFESTATION OF PROPIONIBACTERIUM ACNES

Case Presentation: A 69-year-old immune-competent male presented with one-month history of fatigue and weakness. Patient endorsed decreased oral intake. He also noted dyspnea on exertion, non-productive cough and peripheral edema. Past medical history was significant [...]

By | 2018-03-19T15:43:54+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on ACNE? NOT SO MUCH: A RARE CLINICAL MANIFESTATION OF PROPIONIBACTERIUM ACNES

HM2018 Abstract Number: 765

LEVOFLOXACIN-INDUCED MYOCLONUS

Case Presentation: A 61-year-old man with stage 5 chronic kidney disease was admitted to the hospital with four days of new, uncontrollable muscle twitching. One week prior, he had undergone incision and drainage of a [...]

By | 2018-03-19T15:43:57+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on LEVOFLOXACIN-INDUCED MYOCLONUS

HM2018 Abstract Number: 533

CATATONIA WITH WAXY FLEXIBILTY IN A HOSPITALIZED WOMAN WITH LUPUS

Case Presentation: A 32 year-old female with history of systemic lupus erythematosus, depression and anxiety was admitted to the medical ward with cytomegalovirus pneumonitis and viremia. On hospitalization day 21, patient had an acute change [...]

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HM2018 Abstract Number: 524

OPSOCLONUS MYOCLONUS SYNDROME IN A PATIENT WITH VIRAL ENCEPHALITIS

Case Presentation: A 39 year-old woman presented to our hospital in late August with non-neutropenic fever and a diffuse maculopapular rash involving her palms and soles. Past medical history was significant for HER2 positive, locally [...]

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HM2018 Abstract Number: 606

A RARE CASE OF SELECTIVE IGM DEFICIENCY IN AN OTHERWISE HEALTHY ADULT

Case Presentation: 59 yo Caucasian male presented from an outside hospital (OSH) with primary complaint of “leg abscesses” of 1 wk duration. Patient was afebrile, vital signs stable and in no acute distress complaining of [...]

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HM2018 Abstract Number: 525

Worsening headache after first-time dialysis

Case Presentation: A 53 year old man presented with a global headache and difficulty concentrating for one week. The patient’s past medical history included systemic amyloidosis status post autologous stem cell transplant, hypertension, and end [...]

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HM2018 Abstract Number: 549

RADIATION INDUCED CONDUCTIVE HEART DISEASE: A NEED FOR REGISTRIES

Case Presentation: 72-year-old male with history of hypertension, Stage IIIB squamous cell cancer of the right lung status post chemo-radiation presented to the clinic for a routine annual physical. He was found to be bradycardic [...]

By | 2018-03-19T15:44:01+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on RADIATION INDUCED CONDUCTIVE HEART DISEASE: A NEED FOR REGISTRIES

HM2018 Abstract Number: 439

Rethinking the Diagnosis: A Case of Vertigo

Case Presentation: 80 year-old-male with past medical history of hypertension, coronary artery disease, chronic systolic heart failure, diabetes mellitus type 2, chronic kidney disease stage 2 presented with acute onset of constant vertigo for 1 [...]

By | 2018-03-19T15:44:01+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on Rethinking the Diagnosis: A Case of Vertigo

HM2018 Abstract Number: 452

All JAK’d up on Budd

Case Presentation: A 66 year-old woman with a prior history of alcohol abuse presented from an outside hospital for further evaluation of a one week history of increasing abdominal distension, lower extremity edema and a [...]

By | 2018-03-19T15:44:01+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on All JAK’d up on Budd

HM2018 Abstract Number: 884

Provoked DVT- Is It May Thurner Syndrome?

Case Presentation: 28F PMH of cholelithiasis s/p recent lap cholecystectomy presented with chest pain and lower extremity edema for 2 days. Chest pain was not associated with shortness of breath or diaphoresis. It was relieved [...]

By | 2018-03-19T15:44:01+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on Provoked DVT- Is It May Thurner Syndrome?

HM2018 Abstract Number: 535

TISSUE IS THE ISSUE: A RARE PRESENTATION OF DIFFUSE DERMAL ANGIOMATOSIS IN A BODY BUILDER

Case Presentation: A 49-year-old actively competing male powerlifter presented to our institution for a second opinion of swelling, painful purpura, and necrotic skin ulcerations of the arms and legs. One month prior to presentation, he [...]

By | 2018-03-19T15:44:01+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on TISSUE IS THE ISSUE: A RARE PRESENTATION OF DIFFUSE DERMAL ANGIOMATOSIS IN A BODY BUILDER

HM2018 Abstract Number: 880

A CASE OF BILATERAL FACIAL PALSY

Case Presentation: A healthy 33-year-old woman presented with bilateral facial palsy for one week. Three weeks prior to presentation, she developed fevers, headache, diffuse myalgias, and distal limb paresthesias. One week prior to admission, she [...]

By | 2018-03-19T15:44:04+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on A CASE OF BILATERAL FACIAL PALSY

HM2018 Abstract Number: 672

A RARE CASE OF MACROPHAGE ACTIVATION SYNDROME IN A PATIENT WITH JUVENILE RHEUMATOID ARTHRITIS

Case Presentation: A 21M with a PMHx of juvenile rheumatoid arthritis on chronic prednisone and Ilaris presented with fevers and diarrhea. He was seen by his rheumatologist on morning of presentation for his monthly Ilaris [...]

By | 2018-03-19T15:44:07+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on A RARE CASE OF MACROPHAGE ACTIVATION SYNDROME IN A PATIENT WITH JUVENILE RHEUMATOID ARTHRITIS

HM2018 Abstract Number: 570

A CASE OF CONCURRENT BACTERIAL AND VIRAL MENINGITIS IN AN IMMUNOCOMPETENT ADULT PATIENT

Case Presentation: A 35 year-old undomiciled male with a history of epilepsy and recurrent aseptic meningitis was brought in to the emergency department after being found unresponsive. Initial vital signs were notable for temperature of [...]

By | 2018-03-19T15:44:07+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on A CASE OF CONCURRENT BACTERIAL AND VIRAL MENINGITIS IN AN IMMUNOCOMPETENT ADULT PATIENT

HM2018 Abstract Number: 567

A CASE OF RECURRENT HEPATIC ENCEPHALOPATHY: LACTULOSE IS NOT THE ANSWER

Case Presentation: A 51-year-old woman presented with recurrent confusion and altered mental status over the past 6 months. She reported associated hallucinations, altered sleep cycle and hyper-arousal symptoms. She was treated with lactulose and rifaximin [...]

By | 2018-03-19T15:44:08+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on A CASE OF RECURRENT HEPATIC ENCEPHALOPATHY: LACTULOSE IS NOT THE ANSWER

HM2018 Abstract Number: 536

ACUTE KIDNEY INJURY: A COLD CASE

Case Presentation: A 56 year-old woman with a history of untreated Hepatitis C, anal cancer status post chemotherapy and radiation, current IV heroin use, and MRSA tricuspid valve endocarditis presented with lethargy, jaundice, abdominal pain, [...]

By | 2018-03-19T15:44:08+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on ACUTE KIDNEY INJURY: A COLD CASE

HM2018 Abstract Number: 582

THE CASE OF THE VANISHING POTASSIUM: REFRACTORY HYPOKALEMIA WITH ACUTE OGILVIE’S SYNDROME

Case Presentation: A 59 year-old male with intellectual disability presented with abdominal pain and distension following a fecal impaction. Imaging revealed diffuse gaseous colonic distension with colonic wall thickening suggestive of inflammatory colitis and colonic [...]

By | 2018-03-19T15:44:08+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on THE CASE OF THE VANISHING POTASSIUM: REFRACTORY HYPOKALEMIA WITH ACUTE OGILVIE’S SYNDROME

HM2018 Abstract Number: 725

BLACK ESOPHAGUS: A CASE OF ACUTE ESOPHAGEAL NECROSIS

Case Presentation: Acute esophageal necrosis (AEN) is a rare condition which presents as acute-onset gastrointestinal bleeding. AEN is associated with vasculitis, coronary artery disease, malignancy, and other conditions which impair maintenance of the esophageal protective [...]

By | 2018-03-19T15:44:11+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on BLACK ESOPHAGUS: A CASE OF ACUTE ESOPHAGEAL NECROSIS

HM2018 Abstract Number: 726

HUMAN HERPES VIRUS 6 MENINGOENCEPHALITIS PRESENTING AS REFRACTORY SEIZURES IN AN IMMUNOCOMPETENT ADULT

Case Presentation: Human Herpes Virus 6 (HHV-6) is a member of the herpesviridae family. HHV-6 is the causative agent in roseola infantum, a usually mild and self-limiting childhood exanthem. HHV-6 is also associated with a [...]

By | 2018-03-19T15:44:13+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on HUMAN HERPES VIRUS 6 MENINGOENCEPHALITIS PRESENTING AS REFRACTORY SEIZURES IN AN IMMUNOCOMPETENT ADULT

HM2018 Abstract Number: 509

A CASE OF URTICARIAL VASCULITIS DUE TO PRIMARY EPSTEIN-BARR VIRUS INFECTION IN A PREGNANT PATIENT

Case Presentation: A 36-year-old Dominican female, G3P2002, at six weeks gestation and no significant medical history presented with complaints of fever, headache, myalgias, nausea, vomiting, diarrhea, and diffuse abdominal pain for two days. She denied [...]

By | 2018-03-19T15:44:14+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on A CASE OF URTICARIAL VASCULITIS DUE TO PRIMARY EPSTEIN-BARR VIRUS INFECTION IN A PREGNANT PATIENT

HM2018 Abstract Number: 815

This Friendship Isn’t Working For Me: Septic Shock Secondary to Lactobacillus acidophilus Bacteremia

Case Presentation: A 37 year old woman with past medical history of septic shock secondary to urinary tract infection (UTI), systemic lupus erythematosus treated with oral prednisone 10 mg/day, functional quadriplegia due to transverse myelitis, [...]

By | 2018-03-19T15:44:14+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on This Friendship Isn’t Working For Me: Septic Shock Secondary to Lactobacillus acidophilus Bacteremia

HM2018 Abstract Number: 601

AN UNUSUAL CASE OF MYCOBACTERIUM AVIUM COMPLEX-ASSOCIATED TENOSYNOVITIS

Case Presentation: 64-year-old female with non-insulin-dependent type 2 diabetes mellitus presented to the emergency room with a 2-week history of progressive pain and swelling of her left index finger. Prior outpatient evaluation with X-rays and [...]

By | 2018-03-19T15:44:14+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on AN UNUSUAL CASE OF MYCOBACTERIUM AVIUM COMPLEX-ASSOCIATED TENOSYNOVITIS

HM2018 Abstract Number: 600

A RARE CASE OF RAPID GROWING NON-TUBERCULOUS MYCOBACTERIAL INFECTION AFTER A COSMETIC PROCEDURE

Case Presentation: A 43-year-old female patient with no medical history presented with multiple abdominal wall abscesses. She attended a cosmetic spa four months prior where she received weight loss injections known as “carboxy therapy” to [...]

By | 2018-03-19T15:44:14+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on A RARE CASE OF RAPID GROWING NON-TUBERCULOUS MYCOBACTERIAL INFECTION AFTER A COSMETIC PROCEDURE

HM2018 Abstract Number: 795

The “SSA”fest Way To Approach A Case Of Acute Transverse Myelitis

Case Presentation: A 61 year old female presented to the ED with rapidly progressing lower extremity weakness, gait abnormalities, and urinary incontinence. Her neurologic exam was pertinent for bilateral lower extremity motor deficits, diminished reflexes, [...]

By | 2018-03-19T15:44:14+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on The “SSA”fest Way To Approach A Case Of Acute Transverse Myelitis

HM2018 Abstract Number: 695

CLOZAPINE-INDUCED MYOCARDITIS: A RARE ADVERSE DRUG EFFECT THAT MUST BE RECOGNIZED

Case Presentation: We present a case of a 24-year-old male with a history of schizophrenia who presented from a psychiatric facility for fever and tachycardia. The patient had been admitted to the facility for failure [...]

By | 2018-03-19T15:44:15+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on CLOZAPINE-INDUCED MYOCARDITIS: A RARE ADVERSE DRUG EFFECT THAT MUST BE RECOGNIZED

HM2018 Abstract Number: 696

PIPERACILLIN-TAZOBACTAM CAUSING NEPHROGENIC DIABETES INSIPIDUS: AN OLD DRUG, BUT A NEW ADVERSE DRUG EFFECT

Case Presentation: We present a case of a 50-year-old male with a history of developmental disability and hypothyroidism who presented from a nursing home with fatigue and cough for three days. The patient was found [...]

By | 2018-03-19T15:44:15+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on PIPERACILLIN-TAZOBACTAM CAUSING NEPHROGENIC DIABETES INSIPIDUS: AN OLD DRUG, BUT A NEW ADVERSE DRUG EFFECT

HM2018 Abstract Number: 683

ATYPICAL HEMOLYTIC-UREMIC SYNDROME – WHEN DIARRHEA BECOMES LIFE THREATENING

Case Presentation: Atypical (complement-mediated) Hemolytic-Uremic Syndrome is a rare but life threatening thrombotic microangiopathy that affects patients of all ages. About 33-40% of patients sustain end-stage renal disease, stroke, myocardial infarction or have mortality during [...]

By | 2018-03-19T15:44:15+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on ATYPICAL HEMOLYTIC-UREMIC SYNDROME – WHEN DIARRHEA BECOMES LIFE THREATENING

HM2018 Abstract Number: 918

Who done it: Is lupus really to blame?

Case Presentation: A 60-year-old woman presented with non-healing bilateral lower extremity ulcers. She had a history of systemic lupus erythematosus (SLE) treated with prednisone, azathioprine, methotrexate, and hydroxychloroquine. She previously took warfarin for treatment of [...]

By | 2018-03-19T15:44:15+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on Who done it: Is lupus really to blame?

HM2018 Abstract Number: 675

A RARE CASE OF VASCULITIS-ASSOCIATED CVA IN AN ADULT PATIENT WITH HENOCH-SCHONLEIN PURPURA

Case Presentation: A 64 year-old male with a past medical history significant for COPD presented with fever, abdominal pain and rash. Patient endorsed fever and chills for 2 weeks prior to inpatient hospitalization. Patient subsequently [...]

By | 2018-03-19T15:44:21+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on A RARE CASE OF VASCULITIS-ASSOCIATED CVA IN AN ADULT PATIENT WITH HENOCH-SCHONLEIN PURPURA

HM2018 Abstract Number: 676

INSANE IN THE MEMBRANE: A RARE CASE OF VIABLE NEUROCYSTICERCOSIS

Case Presentation: A 23 year-old Central American male with a past medical history significant for an isolated seizure one year prior to present admission presents with seizure and headache. Vital signs, examination and laboratory studies [...]

By | 2018-03-19T15:44:21+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on INSANE IN THE MEMBRANE: A RARE CASE OF VIABLE NEUROCYSTICERCOSIS

HM2018 Abstract Number: 647

VASCULITIS THROWS A CURVEBALL

Case Presentation: A 19 year-old man presented with two days of non-radiating left testicular pain. He denied associated symptoms or trauma. His past medical and surgical histories were unremarkable. He denied sexual activity and denied [...]

By | 2018-03-19T15:44:21+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on VASCULITIS THROWS A CURVEBALL

HM2018 Abstract Number: 704

BOOT CAMP INDUCED ATTACK OF ACUTE INTERMITTENT PORPHYRIA

Case Presentation: A 21-year-old otherwise healthy female army recruit undergoing basic training was admitted to an outside hospital with severe abdominal pain, nausea, and vomiting. An abdominal CT was unremarkable. Laboratory results revealed hyponatremia (Na [...]

By | 2018-03-19T15:44:21+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on BOOT CAMP INDUCED ATTACK OF ACUTE INTERMITTENT PORPHYRIA

HM2018 Abstract Number: 752

YOU’RE GETTING ON MY NERVES: A CASE OF EOSINOPHILIC GRANULOMATOSIS WITH POLYANGIITIS

Case Presentation: A 27-year-old white male with adult-onset asthma and recurrent pneumonia presented to a rural hospital with a one month history of ascending lower extremity numbness. He also reported fever, fatigue, night sweats, and [...]

By | 2018-03-19T15:44:22+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on YOU’RE GETTING ON MY NERVES: A CASE OF EOSINOPHILIC GRANULOMATOSIS WITH POLYANGIITIS

HM2018 Abstract Number: 565

Malignant Epistaxis: A case of wandering metastasis

Case Presentation: A 79-year-old male with metastatic prostate cancer status post multiple systemic agents presented with recurrent episodes of epistaxis with associated anemia and fatigue. The patient had a pertinent history of multifactorial CKD stage [...]

By | 2018-03-19T15:44:22+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on Malignant Epistaxis: A case of wandering metastasis

HM2018 Abstract Number: 750

Hemobilia due to Mycotic Hepatic Artery Aneurysm

Case Presentation: A 58 year old man with history of Enterococcus faecalis endocarditis and mechanical aortic valve replacement on oral anticoagulation presented to the emergency department with epigastric and right upper quadrant abdominal pain, melena, [...]

By | 2018-03-19T15:44:22+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on Hemobilia due to Mycotic Hepatic Artery Aneurysm

HM2018 Abstract Number: 783

EYE’M MELTING

Case Presentation: A 50 year-old gentleman with seronegative rheumatoid arthritis on leflunamide presented with foreign body sensation, irritation, pain and photophobia in bilateral eyes which acutely worsened to bilateral vision loss. Funduscopic and slit-lamp examination [...]

By | 2018-03-19T15:44:22+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on EYE’M MELTING

HM2018 Abstract Number: 864

REVENGE OF THE RABBIT

Case Presentation: A 60-year-old female presented to the emergency department with a chief complaint of dyspnea, fevers, and malaise that had worsened over two days. She was found to be in acute hypoxic respiratory failure, [...]

By | 2018-03-19T15:44:22+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on REVENGE OF THE RABBIT

HM2018 Abstract Number: 784

‘HAIRY’ KIDNEYS AND PERICARDIAL EFFUSION: A DIAGNOSTIC DILEMMA

Case Presentation: A 61 year-old-female presented to an outside institution with worsening exertional dyspnea, chest pressure, and fatigue. Echocardiogram revealed a large pericardial effusion bordering on tamponade which was drained with great improvement of symptoms. [...]

By | 2018-03-19T15:44:22+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on ‘HAIRY’ KIDNEYS AND PERICARDIAL EFFUSION: A DIAGNOSTIC DILEMMA

HM2018 Abstract Number: 386

CARDIAC AMYLOIDOSIS MISTAKEN FOR ANGIOEDEMA: A DELAY TO DIAGNOSIS

Case Presentation: A 57 year old man with a history of heart failure with preserved ejection fraction (HFpEF), chronic kidney disease (CKD) and hypertension presented with two weeks of exertional dyspnea and lower extremity edema, [...]

By | 2018-03-22T15:50:13+00:00 March 19th, 2018|Adult, Clinical Vignettes, Finalist Posters, Uncategorized|Comments Off on CARDIAC AMYLOIDOSIS MISTAKEN FOR ANGIOEDEMA: A DELAY TO DIAGNOSIS

HM2018 Abstract Number: 596

The Good Patient: A case of B12 deficiency anemia caused by metformin use

Case Presentation: 44 year old male with insulin dependent type 2 Diabetes mellitus and hypothyroidism presented with fatigue, weakness, dyspnea on exertion and light headedness for several weeks. He denied bloody stools or melena. Medications [...]

By | 2018-03-19T15:44:28+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on The Good Patient: A case of B12 deficiency anemia caused by metformin use

HM2018 Abstract Number: 620

LYMPHOCYTIC COLITIS MIMICKING HYPERPLASTIC POLYPOSIS SYNDROME

Case Presentation: 25 year-old female with past medical history of irritable bowel syndrome and asthma was evaluated for one year of watery diarrhea. She reported 3-4 watery bowel movement daily associated with abdominal cramping. No [...]

By | 2018-03-19T15:44:28+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on LYMPHOCYTIC COLITIS MIMICKING HYPERPLASTIC POLYPOSIS SYNDROME

HM2018 Abstract Number: 774

FEVER INDUCED TYPE I BRUGADA PATTERN IN AN ASYMPTOMATIC MAN – A CLINICAL CONUNDRUM

Case Presentation: 59 year old man with past medical history of renal cell carcinoma, with right nephrectomy 20 years ago, presented to the Emergency Department with fever and dysuria. Upon presentation, he was found to [...]

By | 2018-03-19T15:44:28+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on FEVER INDUCED TYPE I BRUGADA PATTERN IN AN ASYMPTOMATIC MAN – A CLINICAL CONUNDRUM

HM2018 Abstract Number: 455

NARROWING THE DIAGNOSIS: A CASE OF AN 18 YEAR OLD WITH SEVERE CARDIOMYOPATHY

Case Presentation: An 18 year old Spanish speaking male from Honduras presented following a motor vehicle accident. Initial assessment in the ED included a CXR and bedside Echocardiogram which noted cardiomegaly and a reduced EF [...]

By | 2018-03-19T15:44:28+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on NARROWING THE DIAGNOSIS: A CASE OF AN 18 YEAR OLD WITH SEVERE CARDIOMYOPATHY

HM2018 Abstract Number: 659

FROM A BURN SCAR TO MALIGNANCY! MARJOLIN’S ULCER, A DISEASE OF WOUND NEGLECT

Case Presentation: A 63-year-old gentleman with a past medical history of hypertension and remote history of left middle finger burn injury. He was admitted to the hospital with a 2-month history of painless left third [...]

By | 2018-03-19T15:44:29+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on FROM A BURN SCAR TO MALIGNANCY! MARJOLIN’S ULCER, A DISEASE OF WOUND NEGLECT

HM2018 Abstract Number: 906

AN ANATOMICAL EXPLANATION FOR A CHRONIC GASTROINTESTINAL COMPLAINT

Case Presentation: 75 yo female with a 20 year history of chronic dyspepsia, H. pylori, and C. difficile presented to the Emergency Department complaining of worsening nausea and two days of hematochezia. The patient stated [...]

By | 2018-03-19T15:44:29+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on AN ANATOMICAL EXPLANATION FOR A CHRONIC GASTROINTESTINAL COMPLAINT

HM2018 Abstract Number: 870

CLONUS AND CONFUSION: A CASE OF SEROTONIN SYNDROME AND SYNDROME OF INAPPROPRIATE ANTIDIURETIC HORMONE

Case Presentation: A 23-year-old woman with generalized anxiety disorder presents with 1 day of altered mental status. She had been taking duloxetine and fluoxetine chronically; however, fluoxetine was abruptly stopped for several weeks and then [...]

By | 2018-03-19T15:44:29+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on CLONUS AND CONFUSION: A CASE OF SEROTONIN SYNDROME AND SYNDROME OF INAPPROPRIATE ANTIDIURETIC HORMONE

HM2018 Abstract Number: 729

REINFORCING THE ATTACK AGAINST THE BODY: THE ASSOCIATION OF TWO AUTOIMMUNE DISORDERS

Case Presentation: We present a case of acquired hemophilia A (AHA) in an elderly patient with longstanding rheumatoid arthritis (RA). An 85-year-old woman was transferred from an outside hospital for further evaluation of spontaneous soft [...]

By | 2018-03-19T15:44:29+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on REINFORCING THE ATTACK AGAINST THE BODY: THE ASSOCIATION OF TWO AUTOIMMUNE DISORDERS

HM2018 Abstract Number: 869

A CASE OF PEMBROLIZUMAB-INDUCED COMPLETE HEART BLOCK AND MYASTHENIA GRAVIS

Case Presentation: A 60-year-old man with coronary artery disease and metastatic renal cell carcinoma presents with worsening dyspnea on exertion 3 weeks after his first infusion of pembrolizumab. On presentation, he was tachycardic and in [...]

By | 2018-03-19T15:44:29+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on A CASE OF PEMBROLIZUMAB-INDUCED COMPLETE HEART BLOCK AND MYASTHENIA GRAVIS

HM2018 Abstract Number: 928

Unrecognized Staphylococcal Vertebral Osteomyelitis and Epidural Abscess Leading to Meningitis, Infective Endocarditis, Cerebrovascular Accident, Sepsis and Death in a Previously Healthy Patient

Case Presentation: A 71-year-old Caucasian female with no known past medical history complained of insidious onset low back pain that became constant and severe, associated with generalized weakness and diffuse pain over the course of [...]

By | 2018-03-19T15:44:29+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on Unrecognized Staphylococcal Vertebral Osteomyelitis and Epidural Abscess Leading to Meningitis, Infective Endocarditis, Cerebrovascular Accident, Sepsis and Death in a Previously Healthy Patient

HM2018 Abstract Number: 853

COMMON DRUG REACTION LEADS TO ALMOST FATAL CONCLUSION

Case Presentation: A 46-year-old Hispanic male with acquired immunodeficiency syndrome (AIDS), history of lymphoma in remission and hypertension presented with fever, generalized weakness and 20 pounds of weight loss over a month. On arrival, he [...]

By | 2018-03-19T15:44:32+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on COMMON DRUG REACTION LEADS TO ALMOST FATAL CONCLUSION

HM2018 Abstract Number: 440

BREAKTHROUGH INVASIVE PULMONARY SCOPULARIOPSIS IN AN IMMUNOCOMPROMISED HOST

Case Presentation: A 59-year old man presented with high grade fever (102 F), non-productive cough, and malaise for two months duration. His medical history was significant for of relapsing Chronic lymphocytic leukemia; on chemotherapy, Chronic [...]

By | 2018-03-19T15:44:34+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on BREAKTHROUGH INVASIVE PULMONARY SCOPULARIOPSIS IN AN IMMUNOCOMPROMISED HOST

HM2018 Abstract Number: 826

A CASE OF LOPERAMIDE-INDUCED VENTRICULAR TACHYCARDIA

Case Presentation: Loperamide is an over-the counter anti-motility opioid agonist considered to be specific to the intestinal µ receptor, safe for non-prescription use, and to have low abuse potential. However, several cases of fatal cardiac [...]

By | 2018-03-19T15:44:35+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on A CASE OF LOPERAMIDE-INDUCED VENTRICULAR TACHYCARDIA

HM2018 Abstract Number: 456

IS DABIGITRAN EFFECTIVE IN THE MORBIDLY OBESE?

Case Presentation: A 50 year-old African American female with medical history of morbid obesity (BMI 40.8), hypertension, hyperlipidemia, diabetes mellitus, obstructive sleep apnea, atrial fibrillation, right MCA infarct one year prior to admission, and right [...]

By | 2018-03-19T15:44:35+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on IS DABIGITRAN EFFECTIVE IN THE MORBIDLY OBESE?

HM2018 Abstract Number: 875

WHIPPIT ABUSE: NOT A LAUGHING MATTER

Case Presentation: 46 year old woman presented with 1 week of bilateral lower extremity tingling, numbness, abnormal gait, leg spasms and impaired concentration. Exam revealed a disheveled, confused appearing Caucasian woman with a spastic, unsteady [...]

By | 2018-03-19T15:44:35+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on WHIPPIT ABUSE: NOT A LAUGHING MATTER

HM2018 Abstract Number: 812

NOT YOUR AVERAGE GASTROINTESTINAL BLEED: WHEN AORTIC DISSECTION REPAIR GOES AWRY

Case Presentation: A 59-year old male with a history of hypertension, chronic kidney disease, and Stanford Type A aortic dissection (treated six years prior by open followed by endovascular repair) presented with a four-day history [...]

By | 2018-03-19T15:44:35+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on NOT YOUR AVERAGE GASTROINTESTINAL BLEED: WHEN AORTIC DISSECTION REPAIR GOES AWRY

HM2018 Abstract Number: 924

NOT ALL LACTATES ARE CREATED EQUAL: THE CASE OF A TYPE B LACTIC ACIDOSIS CAUSED BY INHALED ALBUTEROL

Case Presentation: A 90-year-old female presented with 3 weeks of cough and dyspnea despite a course of antibiotics prescribed by her primary care provider. She was admitted for management of pneumonia. On hospital day 2 [...]

By | 2018-03-19T15:44:35+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on NOT ALL LACTATES ARE CREATED EQUAL: THE CASE OF A TYPE B LACTIC ACIDOSIS CAUSED BY INHALED ALBUTEROL

HM2018 Abstract Number: 737

A KIDNEY’S CRISIS

Case Presentation: A 46-year-old female presented for evaluation of two days of nausea and vomiting. She also described swelling in her legs and decreased urination over that time. Exam revealed blood pressure of 150/100 (baseline [...]

By | 2018-03-19T15:44:35+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on A KIDNEY’S CRISIS

HM2018 Abstract Number: 599

Blocking a Rash Diagnosis: An Unusual Case of Infective Endocarditis

Case Presentation: An 82-year-old man with a history of hypertension and known aortic insufficiency presented with bilateral lower extremity rash, ankle edema, and bradycardia. The ankle edema began two weeks prior to presentation followed by [...]

By | 2018-03-19T15:44:35+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on Blocking a Rash Diagnosis: An Unusual Case of Infective Endocarditis

HM2018 Abstract Number: 896

BILATERAL GIANT CELL ARTERITIS WITH RENAL ANCA-ASSOCIATED VASCULITIS

Case Presentation: 72-year-old Caucasian woman with PMH of cervical spinal stenosis presented with one-month history of worsening generalized weakness and soreness in all her extremities. Three months prior she had complained of persistent headaches for [...]

By | 2018-03-19T15:44:36+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on BILATERAL GIANT CELL ARTERITIS WITH RENAL ANCA-ASSOCIATED VASCULITIS

HM2018 Abstract Number: 390

SYPHILITIC HEPATITIS: AN UNCOMMON AND OVERLOOKED MENIFESTATION OF SECONDARY SYPHILIS

Case Presentation: An otherwise healthy 31 years old Brazilian male presented to the hospital with two months history of constitutional symptoms, diffuse pruritic rash on torso and extremities, and diffuse lymphadenopathy. He lived with his [...]

By | 2018-03-22T15:50:13+00:00 March 19th, 2018|Adult, Clinical Vignettes, Finalist Posters, Uncategorized|Comments Off on SYPHILITIC HEPATITIS: AN UNCOMMON AND OVERLOOKED MENIFESTATION OF SECONDARY SYPHILIS

HM2018 Abstract Number: 654

HICC-UP THE ANTE: A CATASTROPHIC CASE OF BABESIOSIS

Case Presentation: An 82 year-old male with atrial fibrillation, hypertension, and Type 2 Diabetes Mellitus presented with hiccups for five days. He also endorsed non-productive cough for weeks, chills, dysuria, and dark urine, for which [...]

By | 2018-03-19T15:44:36+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on HICC-UP THE ANTE: A CATASTROPHIC CASE OF BABESIOSIS

HM2018 Abstract Number: 558

VASODILATOR TESTING FOR IDIOPATHIC PULMONARY HYPERTENSION: IS IT REALLY NECESSARY?

Case Presentation: A 72 year old male presented with worsening shortness of breath and increasing oxygen requirement for six weeks. The patient had been on supplemental oxygen for the past 2 years for hypoxia. As [...]

By | 2018-03-19T15:44:36+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on VASODILATOR TESTING FOR IDIOPATHIC PULMONARY HYPERTENSION: IS IT REALLY NECESSARY?

HM2018 Abstract Number: 587

LISTEN TO YOUR GUT

Case Presentation: 60-year-old woman with a twelve-year history of presumed gastroparesis of unclear etiology, was admitted for worsening chronic abdominal pain, nausea and vomiting with unintentional weight loss of over 80 pounds over a year. [...]

By | 2018-03-19T15:44:39+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on LISTEN TO YOUR GUT

HM2018 Abstract Number: 578

A 50-YEAR-OLD MAN WITH MULTIPLE AND VARIED SYMPTOMS: HICKHAM VERSUS OCCAM – THE END-GAME

Case Presentation: A 50-year-old man visited our hospital with complaints of malaise, appetite loss, diarrhea, and arthralgia, all of which he had experienced for 5 days before the visit. Although he had been previously healthy [...]

By | 2018-03-19T15:44:41+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on A 50-YEAR-OLD MAN WITH MULTIPLE AND VARIED SYMPTOMS: HICKHAM VERSUS OCCAM – THE END-GAME

HM2018 Abstract Number: 591

EBV Double Whammy

Case Presentation: A 19 year old African American male with no significant history presented to the emergency room with complaints of scleral icterus and epigastric abdominal pain after a week of headaches, fatigue and fevers. [...]

By | 2018-03-19T15:44:42+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on EBV Double Whammy

HM2018 Abstract Number: 429

MOYAMOYA WITH DVT AND TRANSIENT ANTIPHOSPHOLIPID ANTIBODIES

Case Presentation: A 60 -year old Caucasian female presented to the emergency department with right-sided hemiparesis and dysarthria. The patient had been admitted to an outside facility one week prior to presentation for left foot [...]

By | 2018-03-19T15:44:42+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on MOYAMOYA WITH DVT AND TRANSIENT ANTIPHOSPHOLIPID ANTIBODIES

HM2018 Abstract Number: 377

ATYPICAL PRESENTATION OF ANTI-SYNTHETASE SYNDROME IN A YOUNG WOMAN WITH REFRACTORY HYPOXIC RESPIRATORY FAILURE

Case Presentation: A 36-year-old female with a history of morbid obesity and hypertension presented with three weeks of progressive dyspnea and productive cough. She was previously diagnosed with community-acquired pneumonia and completed two five-day courses [...]

By | 2018-03-22T15:52:22+00:00 March 19th, 2018|Adult, Clinical Vignettes, Finalist Posters, Hospital Medicine 2018, Uncategorized|Comments Off on ATYPICAL PRESENTATION OF ANTI-SYNTHETASE SYNDROME IN A YOUNG WOMAN WITH REFRACTORY HYPOXIC RESPIRATORY FAILURE

HM2018 Abstract Number: 658

CMV-INDUCED ACUTE PANCREATITIS IN IMMUNOCOMPETENT PATIENT

Case Presentation: A 29-year-old otherwise healthy male presented to the emergency department with a 1-day history of abdominal pain radiating to his back and associated with nausea and nonbilious vomiting. He denied any fever, chills, [...]

By | 2018-03-19T15:44:42+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on CMV-INDUCED ACUTE PANCREATITIS IN IMMUNOCOMPETENT PATIENT

HM2018 Abstract Number: 897

HIGH IGG4 ANTIBODY LEVELS IN TISSUES WITH NORMAL CIRCULATING LEVELS IN SERUM: A PARADOX OF IGG4-RELATED DISEASE

Case Presentation: 41-year-old Hispanic man presented for reevaluation of the swellings on his forearms newly associated with Raynaud’s phenomenon on his fingers. He initially presented 5 years prior with swellings on his forearms and groin, [...]

By | 2018-03-19T15:44:42+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on HIGH IGG4 ANTIBODY LEVELS IN TISSUES WITH NORMAL CIRCULATING LEVELS IN SERUM: A PARADOX OF IGG4-RELATED DISEASE

HM2018 Abstract Number: 907

A RECURRENT PAIN IN THE REAR

Case Presentation: 23 year-old woman presenting with left thigh pain and erythema. Reported rapid onset of pain in left upper thigh and buttock one day prior to admission with no associated fever or chills and [...]

By | 2018-03-19T15:44:43+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on A RECURRENT PAIN IN THE REAR

HM2018 Abstract Number: 921

RECURRENT CARDIAC ARREST – AN UNEXPECTED CAUSE

Case Presentation: A 52-year-old African-American male was admitted to the hospital with sepsis secondary to urinary tract infection and pneumonia. His past medical history is significant for gunshot wound to C6-C7 region of the spine [...]

By | 2018-03-19T15:44:43+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on RECURRENT CARDIAC ARREST – AN UNEXPECTED CAUSE

HM2018 Abstract Number: 514

COMMON VARIABLE IMMUNODEFICIENCY WITH GRANULOMATOUS-LYMPHOCYTIC INTERSTITIAL LUNG DISEASE

Case Presentation: A 34 year old male with a history of CVID subclass 2 and 4, with low IgG level, absent IgA, liver nodular regenerative hyperplasia with portal hypertension, and immune thrombocytopenic purpura status post [...]

By | 2018-03-19T15:44:43+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on COMMON VARIABLE IMMUNODEFICIENCY WITH GRANULOMATOUS-LYMPHOCYTIC INTERSTITIAL LUNG DISEASE

HM2018 Abstract Number: 922

SALICYLATE TOXICITY- WHEN INTUBATION BECOMES NECESSARY

Case Presentation: A 54-year-old female with past medical history significant for major depression with prior suicide attempt was brought to the hospital after a repeat attempted suicide. She reportedly consumed several aspirin pills, but the [...]

By | 2018-03-19T15:44:43+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on SALICYLATE TOXICITY- WHEN INTUBATION BECOMES NECESSARY

HM2018 Abstract Number: 754

Don’t Leave Me Hanging Out to Dry

Case Presentation: A 49-year old man with no significant medical history presented with dyspnea and presyncope. He presented similarly six weeks prior and was diagnosed with constrictive pericarditis thought to be of a viral etiology. [...]

By | 2018-03-19T15:44:43+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on Don’t Leave Me Hanging Out to Dry

HM2018 Abstract Number: 891

DYSPHAGIA AORTICA WITH LEFT ATRIAL COMPRESSION: A RARE CAUSE OF DYSPHAGIA IN AN ELDERLY MAN

Case Presentation: An 80 years old male with pertinent history of coronary artery disease, descending fusiform thoracic aortic aneurysm and systolic heart failure presented with shortness of breath and chest pain. Exam revealed bibasilar lung [...]

By | 2018-03-19T15:44:43+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on DYSPHAGIA AORTICA WITH LEFT ATRIAL COMPRESSION: A RARE CAUSE OF DYSPHAGIA IN AN ELDERLY MAN

HM2018 Abstract Number: 734

A STROKE MISDIAGNOSED: A CASE OF FAMILIAL CREUTZFELDT-JAKOB DISESASE REVEALED

Case Presentation: A 68 year-old male with hypertension and bipolar disorder presented with a 3-week history of memory deficits, weight loss, and increasing irritability. Exam revealed disorientation, dysarthria, and left sided weakness. MRI was suggestive [...]

By | 2018-03-19T13:24:48+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A STROKE MISDIAGNOSED: A CASE OF FAMILIAL CREUTZFELDT-JAKOB DISESASE REVEALED

HM2018 Abstract Number: 434

A GIANT BLOB OF FAT – A RARE CASE OF GASTRIC OUTLET OBSTRUCTION.

Case Presentation: A 70 year old man presented with four days of epigastric pain, nausea, vomiting and abdominal distension. He reported 50lbs of weight loss due to decrease in appetite over two months. He denied [...]

By | 2018-03-19T13:24:41+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A GIANT BLOB OF FAT – A RARE CASE OF GASTRIC OUTLET OBSTRUCTION.

HM2018 Abstract Number: 433

‘DIARRHEA, THE TIP OF THE ICEBERG’ A FATAL CASE OF ENTEROPATHY ASSOCIATED T-CELL LYMPHOMA

Case Presentation: A 67 year old woman presented with right upper quadrant abdominal pain and was diagnosed with acute cholecystitis. She underwent elective cholecystectomy, complicated by Clostridium difficile colitis. Despite treatment with oral Vancomycin, she [...]

By | 2019-03-11T16:27:38+00:00 March 19th, 2018|Adult, Clinical Vignettes|Comments Off on ‘DIARRHEA, THE TIP OF THE ICEBERG’ A FATAL CASE OF ENTEROPATHY ASSOCIATED T-CELL LYMPHOMA

HM2018 Abstract Number: 883

RARE CASE OF HYPOKALEMIC PERIODIC PARALYSIS ASSOCIATED WITH MARIJUANA BINGE EPISODE

Case Presentation: A 30-year-old male presented to the ED with sudden onset flaccid paralysis involving the entire body except the head and neck. He reported heavy marijuana use 2 days prior during which he consumed [...]

By | 2018-03-19T13:24:35+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on RARE CASE OF HYPOKALEMIC PERIODIC PARALYSIS ASSOCIATED WITH MARIJUANA BINGE EPISODE

HM2018 Abstract Number: 539

SARCOID WITH SUBACUTE CONFUSION

Case Presentation: A 64 year old male suffered from gradual onset fatigue and change in mentation over the course of a month. His symptoms then progressively worsened as he became confused and developed intermittent headaches. [...]

By | 2018-03-19T13:24:32+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on SARCOID WITH SUBACUTE CONFUSION

HM2018 Abstract Number: 678

AN ATYPICAL PRESENTATION OF MYXEDEMA COMA

Case Presentation: A 49-year-old male presented with altered mental status and diffuse body pain. He denied any alcohol or drug intoxication, chest pain, shortness of breath, or infectious symptoms. His past history included chronic hypothyroidism [...]

By | 2018-03-19T13:24:30+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on AN ATYPICAL PRESENTATION OF MYXEDEMA COMA

HM2018 Abstract Number: 893

SPONTANEOUS ONSET OF COMPLEX REGIONAL PAIN SYNDROME (TYPE 1)

Case Presentation: A 44-year-old Hispanic male presented with a two-month history of sudden onset, severe left lower extremity burning pain associated with edema, erythema, and intermittent paresthesia, limiting his daily activities. His symptoms were initially [...]

By | 2018-03-19T13:24:25+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on SPONTANEOUS ONSET OF COMPLEX REGIONAL PAIN SYNDROME (TYPE 1)

HM2018 Abstract Number: 931

Fulminant gram-negative septic shock due to Capnocytophaga infection.

Case Presentation: 68-year-old female presented to the Emergency Department with dark liquid stool, nausea, and dry heaves for 4 days. She denied eating anything unusual, sick contacts, or recent tick exposure. Medical history was only [...]

By | 2018-03-19T13:24:24+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Fulminant gram-negative septic shock due to Capnocytophaga infection.

HM2018 Abstract Number: 618

EVERY RED IS NOT CELLULITIS: DEPENDENT RUBOR RARE BUT CLASSICAL FINDING OF SEVERE ARTERIAL INSUFFICIENCY

Case Presentation: A sixty-eight-year-old man was admitted for severe depression with suicidal ideation. He had a history of insulin dependent Diabetes Mellitus, non-obstructive coronary artery disease with a ninety-pack year history of smoking. Physical examination [...]

By | 2018-03-19T13:24:22+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on EVERY RED IS NOT CELLULITIS: DEPENDENT RUBOR RARE BUT CLASSICAL FINDING OF SEVERE ARTERIAL INSUFFICIENCY

HM2018 Abstract Number: 630

LARGE LEFT LIVER LOBE LESION: A LURKING LANGUISHMENT

Case Presentation: A healthy 50-year-old woman with no past medical history was transferred from an outside hospital for intermittent, progressively worsening abdominal pain of six weeks duration. Her pain was sharp, stabbing, and located in [...]

By | 2018-03-19T13:24:21+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on LARGE LEFT LIVER LOBE LESION: A LURKING LANGUISHMENT

HM2018 Abstract Number: 631

PERIPHERAL SMEAR: A HIGH VALUE CARE ADDITION TO THE WORKUP OF A FEVER OF UNKNOWN ORIGIN

Case Presentation: A 68 year old man with past medical history of rheumatoid arthritis with recent travel to Mexico was admitted after clinically worsening at home roughly a week after a previous 10 day admission [...]

By | 2018-03-19T13:24:19+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on PERIPHERAL SMEAR: A HIGH VALUE CARE ADDITION TO THE WORKUP OF A FEVER OF UNKNOWN ORIGIN

HM2018 Abstract Number: 731

A RARE CASE OF BCG-OSIS

Case Presentation: A 78-year-man with a high-grade-T1-urothelial carcinoma status post transurethral resection of the prostate (TURBT), on weekly intravesical-BCG for past 2-months, presented a day following his last instillation with fever, chills and altered mental [...]

By | 2018-03-19T13:24:17+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A RARE CASE OF BCG-OSIS

HM2018 Abstract Number: 773

A CASE OF CANAGLIFLOZIN INDUCED EUGLYCEMIC DIABETIC KETOACIDOSIS: RARE BUT SIGNIFICANT

Case Presentation: A 54 year-old woman with a past medical history of hypertension and Type 2 diabetes mellitus treated with metformin and canagliflozin presented to the hospital with lethargy and malaise. She reported that her [...]

By | 2018-03-19T13:24:13+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A CASE OF CANAGLIFLOZIN INDUCED EUGLYCEMIC DIABETIC KETOACIDOSIS: RARE BUT SIGNIFICANT

HM2018 Abstract Number: 859

Atypical Acute Encephalitis Due to Immune Checkpoint Inhibitor

Case Presentation: An 84-year-old man with stage II non-small cell lung adenocarcinoma had tumor recurrence in the lungs after lobectomy. For first line systemic therapy he was started on pembrolizumab, a monoclonal antibody immune checkpoint [...]

By | 2018-03-19T13:24:11+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Atypical Acute Encephalitis Due to Immune Checkpoint Inhibitor

HM2018 Abstract Number: 892

STERNOCLAVICULAR SEPTIC ARTHRITIS: A RARE PRESENTATION OF SHOULDER PAIN

Case Presentation: A 69 years old farmer presented to the hospital with right shoulder pain, fever and chills. Past medical history was significant for coronary artery disease, a remote history of neck tumor status post [...]

By | 2018-03-19T13:24:06+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on STERNOCLAVICULAR SEPTIC ARTHRITIS: A RARE PRESENTATION OF SHOULDER PAIN

HM2018 Abstract Number: 538

NONUREMIC CALCIPHYLAXIS – AN INFREQUENT DIAGNOSIS WITHOUT STANDARD OF CARE

Case Presentation: 59 year old African American male with a history of sarcoidosis on prednisone, pulmonary HTN, CKD 3, NIDDM, and NICM presented to the ED with a 2 week history of leg swelling/pain. He [...]

By | 2018-03-19T13:24:05+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on NONUREMIC CALCIPHYLAXIS – AN INFREQUENT DIAGNOSIS WITHOUT STANDARD OF CARE

HM2018 Abstract Number: 890

CONGENITAL INFERIOR VENA CAVA ATRESIA: A RARE CULPRIT ASSOCIATED WITH RECURRENT DEEP VEIN THROMBOSIS

Case Presentation: A 45 years old Vietnamese male was diagnosed with left leg deep vein thrombosis about 2 years ago in Vietnam for which he was taking herbal supplements without improvement. Soon after immigrating to [...]

By | 2018-03-19T13:24:03+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on CONGENITAL INFERIOR VENA CAVA ATRESIA: A RARE CULPRIT ASSOCIATED WITH RECURRENT DEEP VEIN THROMBOSIS

HM2018 Abstract Number: 914

BRONCHIECTASIS IN A YOUNG ADULT: A CASE OF SYMPTOMATIC CYSTIC FIBROSIS IN A HETEROZYGOTE

Case Presentation: A 38-year-old Guyanese man with a history of pulmonary tuberculosis 16 years ago, treated with a standard four-drug regimen, presented with an acute exacerbation of chronic cough which he had suffered for 12 [...]

By | 2018-03-19T13:23:59+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on BRONCHIECTASIS IN A YOUNG ADULT: A CASE OF SYMPTOMATIC CYSTIC FIBROSIS IN A HETEROZYGOTE

HM2018 Abstract Number: 622

HOW PILLS CAN BREAK YOUR HEART

Case Presentation: A sixty-eight year-old woman presented with two days of confusion and lethargy following two weeks of worsening abdominal pain, nausea and emesis. Medical history was significant for chronic pain, depression, hypertension, and a [...]

By | 2018-03-19T13:23:57+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on HOW PILLS CAN BREAK YOUR HEART

HM2018 Abstract Number: 808

A CASE OF ACUTE HEMOLYTIC ANEMIA FOLLOWING HIGH DOSE INTRAVENOUS IMMUNOGLOBULIN (IVIG)

Case Presentation: A 32-year-old African American male past medical history significant for recently diagnosed Guillain-Barre syndrome (GBS) was admitted for recurrent mechanical falls at home. One week prior to his admission, he was treated for [...]

By | 2018-03-19T13:23:56+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A CASE OF ACUTE HEMOLYTIC ANEMIA FOLLOWING HIGH DOSE INTRAVENOUS IMMUNOGLOBULIN (IVIG)

HM2018 Abstract Number: 840

INTRACTABLE HICCUPS: AN UNSUAL PRESENTATION OF NEUROSARCOIDOSIS

Case Presentation: 65-year-old female with no significant past medical history presented with intractable hiccups for past few months. Hiccups were progressively getting worse with development of intermittent nausea. Her vital signs and physical exam were [...]

By | 2018-03-19T13:23:53+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on INTRACTABLE HICCUPS: AN UNSUAL PRESENTATION OF NEUROSARCOIDOSIS

HM2018 Abstract Number: 881

Hypertrophic Cardiomyopathy with Atrial Fibrillation Masquerading as Left Main Acute Coronary Syndrome

Case Presentation: ST-elevation in lead aVR, with ST-depression in precordial leads, has been reported to arise from left main coronary disease, often required emergent cardiac catheterization. We present a case of unstable SVT in a [...]

By | 2018-03-19T13:23:51+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Hypertrophic Cardiomyopathy with Atrial Fibrillation Masquerading as Left Main Acute Coronary Syndrome

HM2018 Abstract Number: 632

ARTIFICIAL HYPOGLYCEMIA: WHEN NOT TO PANIC ABOUT HYPOGLYCEMIA.

Case Presentation: 87 year old woman with a medical history of coronary artery disease, congestive heart failure, raynaud’s syndrome, sicca syndrome and hyperlipidemia was brought in after choking on food. Her hospital course was complicated [...]

By | 2018-03-19T13:23:48+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on ARTIFICIAL HYPOGLYCEMIA: WHEN NOT TO PANIC ABOUT HYPOGLYCEMIA.

HM2018 Abstract Number: 545

ENDOCARDITIS AFTER TRANSCATHETER AORTIC VALVE REPLACEMENT

Case Presentation: 85 year old female was admitted on account of lethargy and decreased oral intake for the previous week, and evidence of anemia. She had undergone a transcatheter aortic valve replacement(TAVR) 5 months prior [...]

By | 2018-03-19T13:23:45+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on ENDOCARDITIS AFTER TRANSCATHETER AORTIC VALVE REPLACEMENT

HM2018 Abstract Number: 572

Know What You’re Missing: Benzodiazepine Withdrawal-induced Catatonia.

Case Presentation: A 65 yo male with insulin-dependent diabetes, chronic kidney disease, and bipolar disorder was referred to hospital due to a rising creatinine level and decreased urine output. Home medications included furosemide, insulin, amlodipine, [...]

By | 2018-03-19T13:23:43+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Know What You’re Missing: Benzodiazepine Withdrawal-induced Catatonia.

HM2018 Abstract Number: 516

MIC FOR FLUOROQUINOLONES IN NON-TYPHOIDAL SALMONELLA- WHEN IS IT SUSCEPTIBLE?

Case Presentation: 34 year old lady with AML presented with diarrhea of 2 days duration and was found to be positive for Salmonella on GI PCR, which was subsequently confirmed on stool culture.She was started [...]

By | 2018-03-19T13:23:38+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on MIC FOR FLUOROQUINOLONES IN NON-TYPHOIDAL SALMONELLA- WHEN IS IT SUSCEPTIBLE?

HM2018 Abstract Number: 693

SPINAL EPIDURAL LIPOMATOSIS COINCIDING WITH MULTIPLE SCLEROSIS

Case Presentation: A 26-year-old male without prior medical history was referred by a spine surgeon to the emergency department (ED) with weakness, numbness, and discoordination of the right leg, worsening over a four month period [...]

By | 2018-03-19T13:23:37+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on SPINAL EPIDURAL LIPOMATOSIS COINCIDING WITH MULTIPLE SCLEROSIS

HM2018 Abstract Number: 378

LOW CARBS, HIGH ACUITY: SEVERE KETOACIDOSIS IN A PALEOLITHIC DIET

Case Presentation: A 40-year-old previously healthy female presented nine weeks postpartum with numerous episodes of nonbilious, nonbloody emesis that began 24 hours prior to admission. She took no medications and denied fevers, chills, dysuria, cough, [...]

By | 2018-03-22T15:49:31+00:00 March 19th, 2018|Adult, Clinical Vignettes, Finalist Posters, Hospital Medicine 2018|Comments Off on LOW CARBS, HIGH ACUITY: SEVERE KETOACIDOSIS IN A PALEOLITHIC DIET

HM2018 Abstract Number: 836

NOVEL ORAL ANTICOAGULANTS – A CURSE IN DISGUISE ?

Case Presentation: A 90-year-old Caucasian female with non-valvular atrial fibrillation, on therapeutic anticoagulation with warfarin was admitted with community acquired pneumonia. She was treated with Levofloxacin. She underwent cardioversion for symptomatic atrial fibrillation with rapid [...]

By | 2018-03-19T13:23:29+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on NOVEL ORAL ANTICOAGULANTS – A CURSE IN DISGUISE ?

HM2018 Abstract Number: 835

COMPLICATIONS OF TREATING ATRIAL FIBRILLATION BY CATHETER ABLATION

Case Presentation: Introduction: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. In the past decade, catheter ablation of AF has evolved from an investigational procedure to a frequent therapeutic one. Phrenic nerve injury [...]

By | 2018-03-19T13:23:27+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on COMPLICATIONS OF TREATING ATRIAL FIBRILLATION BY CATHETER ABLATION

HM2018 Abstract Number: 712

A RARE CASE OF BILATERAL VOCAL CORD PALSY DUE TO DIFFUSE IDIOPATHIC SKELETAL HYPEROSTOSIS

Case Presentation: An 89-year-old woman presented to the emergency department with dyspnea and dysphagia. She gave a one-year history of progressive hoarseness of voice, intermittent dyspnea, and dysphagia. Physical exam was positive for stridor, but [...]

By | 2018-03-19T13:23:20+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A RARE CASE OF BILATERAL VOCAL CORD PALSY DUE TO DIFFUSE IDIOPATHIC SKELETAL HYPEROSTOSIS

HM2018 Abstract Number: 543

Cardiac Tamponade As A Late And Unusual Presentation Of Adenocarcinoma Of The Lung

Case Presentation: We describe a 57 year-old man with no significant medical history, who was in his usual state of health until one week prior to presentation when he developed flu-like symptoms, cough, exertional dyspnea [...]

By | 2018-03-19T13:23:17+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Cardiac Tamponade As A Late And Unusual Presentation Of Adenocarcinoma Of The Lung

HM2018 Abstract Number: 755

WHEN YOU CAN’T C THE DIAGNOSIS

Case Presentation: A 71-year-old woman presented with one month of progressive dyspnea, fatigue, weight loss, bilateral lower extremity edema, and new “purple and red spots” on her extremities. Her medical history included breast cancer more [...]

By | 2018-03-19T13:23:15+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on WHEN YOU CAN’T C THE DIAGNOSIS

HM2018 Abstract Number: 718

A Fatal Golfing Tragedy

Case Presentation: IntroductionMost cases of mushroom ingestion are benign with fatalities being rare. Symptoms range from acute gastro-enteritis to psychotropic manifestations that are usually self-limiting. Our case highlights a unique case of mushroom poisoning fatality [...]

By | 2018-03-19T13:23:10+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A Fatal Golfing Tragedy

HM2018 Abstract Number: 495

PAPILLARY MUSCLE RUPTURE AFTER MYOCARDIAL INFARCTION WITH NON-OBSTRUCTIVE CORONARY ARTERY DISEASE

Case Presentation: A 68-year-old woman with a history of hypertension and possible interstitial lung disease presented with one week of worsening midsternal chest pain, diaphoresis and nausea. Initial vitals were unremarkable. Exam revealed bibasilar crackles [...]

By | 2018-03-19T13:23:09+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on PAPILLARY MUSCLE RUPTURE AFTER MYOCARDIAL INFARCTION WITH NON-OBSTRUCTIVE CORONARY ARTERY DISEASE

HM2018 Abstract Number: 382

PERITONEAL COCCIDIOIDOMYCOSIS: A TRIAD OF PERITONITIS, OMENTAL NODULES, AND EOSINOPHILIA

Case Presentation: A 50-year-old Filipino man with poorly controlled type 2 diabetes mellitus presented with 4 days of fever, abdominal pain and distention. He endorsed unintentional weight loss of 30lbs over the last year as [...]

By | 2018-03-22T15:50:12+00:00 March 19th, 2018|Adult, Clinical Vignettes, Finalist Posters, Hospital Medicine 2018|Comments Off on PERITONEAL COCCIDIOIDOMYCOSIS: A TRIAD OF PERITONITIS, OMENTAL NODULES, AND EOSINOPHILIA

HM2018 Abstract Number: 770

A LIFESAVING FEVER – UNMASKING BRUGADA

Case Presentation: A 60-year-old man presented with several days of diarrhea, fevers, and syncope. Past medical history was significant for recurrent syncopal episodes, all of which occurred during febrile illnesses. Review of systems was negative [...]

By | 2018-03-19T13:23:05+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A LIFESAVING FEVER – UNMASKING BRUGADA

HM2018 Abstract Number: 733

ACUTE HANTAVIRUS INFECTION: THE IMPORTANCE OF EARLY CLINICAL DIAGNOSIS

Case Presentation: A healthy 35-year-old female from eastern Arizona presented in February with two weeks of fever, headache, epigastric pain, decreased appetite, two episodes of non-bloody emesis, dyspnea, and with orthopnea. She was cleaning out [...]

By | 2018-03-19T13:23:04+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on ACUTE HANTAVIRUS INFECTION: THE IMPORTANCE OF EARLY CLINICAL DIAGNOSIS

HM2018 Abstract Number: 490

WHEN A MEDICATION CAN BE CAUSE AND CURE. ALEMTUZUMAB AS THE CAUSE OF AUTOIMMUNE HEMOLYTIC ANEMIA

Case Presentation: A 32 year old Caucasian female with a fourteen year history of relapsing-remitting MS was admitted to the hospital for evaluation of severe headache, fatigue and dizziness. On physical exam she was tachycardic [...]

By | 2018-03-19T13:23:00+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on WHEN A MEDICATION CAN BE CAUSE AND CURE. ALEMTUZUMAB AS THE CAUSE OF AUTOIMMUNE HEMOLYTIC ANEMIA

HM2018 Abstract Number: 776

To Pick or Not to Pick: A Case of Mushroom Poisoning

Case Presentation: A 61 year-old female presented with nausea, vomiting, and upper abdominal pain 18 hours after ingesting local wild mushrooms. Initially, her physical exam was benign, including a normal abdominal exam. Her laboratory results [...]

By | 2018-03-19T13:22:59+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on To Pick or Not to Pick: A Case of Mushroom Poisoning

HM2018 Abstract Number: 637

Lidocaine-Induced Takotsubo Cardiomyopathy

Case Presentation: A 47-year-old African American female with a past medical history of complex regional pain syndrome (CRPS), chronic migraines, and history of transient ischemic attack was admitted for elective lidocaine infusion for generalized pain [...]

By | 2018-03-19T13:22:57+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Lidocaine-Induced Takotsubo Cardiomyopathy

HM2018 Abstract Number: 648

CHOREA IN CANCER: AN UNLIKELY CULPRIT

Case Presentation: 52-year-old female with history of Stage IIIA triple negative right sided breast cancer, seizure disorder, and s/p lumpectomy presents with ataxia, confusion, and dyskinesia over the past 2 weeks. The patient is chronically [...]

By | 2018-03-19T13:20:49+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on CHOREA IN CANCER: AN UNLIKELY CULPRIT

HM2018 Abstract Number: 379

A GREAT IMITATOR: A CASE OF CNS INTRAVASCULAR LARGE CELL LYMPHOMA

Case Presentation: A 65 year-old woman with a history of renal cell cancer status post nephrectomy and breast cancer treated with lumpectomy and radiation presented with three weeks of progressive lower extremity weakness and confusion. [...]

By | 2018-03-22T15:49:31+00:00 March 19th, 2018|Adult, Clinical Vignettes, Finalist Posters, Hospital Medicine 2018|Comments Off on A GREAT IMITATOR: A CASE OF CNS INTRAVASCULAR LARGE CELL LYMPHOMA

HM2018 Abstract Number: 521

NOT YOUR TYPICAL HUS: COMPLEMENT MEDIATED HEMOLYTIC UREMIC SYNDROME

Case Presentation: 23 years old female with history of lupus and Sjogren’s syndrome was sent to the hospital by her rheumatologist for worsening anemia, thrombocytopenia and kidney injury. Patient was recently admitted to the hospital [...]

By | 2018-03-19T13:20:46+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on NOT YOUR TYPICAL HUS: COMPLEMENT MEDIATED HEMOLYTIC UREMIC SYNDROME

HM2018 Abstract Number: 926

INJECTION SITE REACTION AND LEUKOCYTOCLASTIC VASCULITIS ASSOCIATED WITH ADALIMUMAB THERAPY FOR RHEUMATOID ARTHRITIS

Case Presentation: The patient is a 75-year-old woman with seropositive RA with polyarthropathy, who had recently started adalimumab presented with a diffuse skin eruption. She had been previously treated with tocilizumab (4mg/kg monthly), methotrexate (10 [...]

By | 2018-03-19T13:20:44+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on INJECTION SITE REACTION AND LEUKOCYTOCLASTIC VASCULITIS ASSOCIATED WITH ADALIMUMAB THERAPY FOR RHEUMATOID ARTHRITIS

HM2018 Abstract Number: 912

HEART FAILURE WITH A LARGE RETROPERITONEAL MASS: CONNECTED OR COINCIDENCE?

Case Presentation: A 40 year-old male with no significant past medical history presented with two months of increasing fatigue, anorexia, and progressive exertional dyspnea. Additionally, he reported a mild increase in abdominal girth during the [...]

By | 2018-03-19T13:18:34+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on HEART FAILURE WITH A LARGE RETROPERITONEAL MASS: CONNECTED OR COINCIDENCE?

HM2018 Abstract Number: 428

AN UNUSUAL BUG IN THE SPUTUM

Case Presentation: A 81 year Albanian male presented to the emergency with pain in right upper abdomen. Abnormal vitals during presentation were temperature of 101.8F, respiratory rate of 24/min and blood pressure of 85/66mmg Hg. [...]

By | 2018-03-19T13:18:31+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on AN UNUSUAL BUG IN THE SPUTUM

HM2018 Abstract Number: 763

Broadening The Differential For Acute Kidney Injury: A Case Of IgG4-Related Tubulointersitial Nephritis

Case Presentation: A 66-year-old man with history of hypertension, gastroesophageal reflux disease, and hyperlipidemia presented with jaundice and one week of diarrhea with occasional hematochezia. In addition, he noted dark urine, decreased PO intake and [...]

By | 2018-03-19T13:18:22+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Broadening The Differential For Acute Kidney Injury: A Case Of IgG4-Related Tubulointersitial Nephritis

HM2018 Abstract Number: 916

BACK (AND FLANK) TO THE BASICS

Case Presentation: A 68-year-old man presented with one week of weakness and fatigue. The patient had presented to the emergency department (ED) one week earlier with persistent bleeding from the left ear after a fall [...]

By | 2018-03-19T13:18:20+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on BACK (AND FLANK) TO THE BASICS

HM2018 Abstract Number: 649

STATIN-INDUCED NECROTIZING AUTOIMMUNE MYOPATHY: A CASE OF DELAYED ONSET FOLLOWING STATIN DISCONTINUATION

Case Presentation: Statin-induced necrotizing autoimmune myopathy (SINAM) is an immune mediated myopathy characterized by proximal muscle weakness and necrosis in the presence of autoantibodies to hydroxyl-methyl-glutaryl-coenzyme-A (HMG-CoA) reductase. It is a rare side effect of [...]

By | 2018-03-19T13:18:18+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on STATIN-INDUCED NECROTIZING AUTOIMMUNE MYOPATHY: A CASE OF DELAYED ONSET FOLLOWING STATIN DISCONTINUATION

HM2018 Abstract Number: 753

A Distinct Clinical Entity? Two Cases of TAFRO Syndrome with Different Features

Case Presentation: Case 1: A 25-year-old female was transferred to our hospital with fever and systemic inflammation refractory to prednisolone treatment. Two weeks prior to the transfer, she was admitted to another hospital on account [...]

By | 2018-03-19T13:18:17+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A Distinct Clinical Entity? Two Cases of TAFRO Syndrome with Different Features

HM2018 Abstract Number: 817

Tricuspid Valve Infective Endocarditis due to Klebsiella Pneumoniae in Intravenous Drug User

Case Presentation: A 55-year-old woman with intravenous polysubstance abuse presented with a 1-week history of back pain, fever, and cough with blood-tinged sputum. Vital sign on admission showed tachycardia and hypotension but she responded well [...]

By | 2018-03-19T13:18:13+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Tricuspid Valve Infective Endocarditis due to Klebsiella Pneumoniae in Intravenous Drug User

HM2018 Abstract Number: 626

Consider malignancy, but keep an open mind: An uncommon cause of pleural effusion, ascites and pelvic masses

Case Presentation: A 39-year-old African American nulliparous female with a history of endometriosis and recent outside hospitalization presents with 10 days of acute on chronic lower abdominal pain and dyspnea. On exam, she has a [...]

By | 2018-03-19T13:18:09+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Consider malignancy, but keep an open mind: An uncommon cause of pleural effusion, ascites and pelvic masses

HM2018 Abstract Number: 492

Cutaneous Leukocytoclastic Vasculitis associated with Methimazole

Case Presentation: Anti-thyroid Drugs (ATD) such as propilthiourcil (PTU) and methimazole (MTM) can cause a number of systemic changes such as fever, rash, and respiratory symptoms (from epistaxis to diffuse alveolar hemorrhage). Guidelines almost always [...]

By | 2018-03-19T13:18:04+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Cutaneous Leukocytoclastic Vasculitis associated with Methimazole

HM2018 Abstract Number: 830

My Heartburn is Better but I am confused: A Rare Case of Calcium Carbonate-Induced Severe Hypercalcemia

Case Presentation: A 54 year-old male with history of stroke, hypertension, chronic kidney disease stage III, gastroesophageal reflux, diabetes mellitus, peripheral vascular disease, and alcohol abuse (sober for 3 months), presented with acute change in [...]

By | 2018-03-19T13:18:02+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on My Heartburn is Better but I am confused: A Rare Case of Calcium Carbonate-Induced Severe Hypercalcemia

HM2018 Abstract Number: 874

MULTIFOCAL IN-SITU SIGNET RING CELL CARCINOMA OF THE COLON IN MIDDLE-AGED WOMAN

Case Presentation: A 47 year old woman with Lynch syndrome presented with only intermittent abdominal discomfort and mucus in her stools for several months. Colonoscopy showed patchy erythema in the cecum and the transverse colon. [...]

By | 2018-03-19T13:18:00+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on MULTIFOCAL IN-SITU SIGNET RING CELL CARCINOMA OF THE COLON IN MIDDLE-AGED WOMAN

HM2018 Abstract Number: 705

A CASE OF NON-OCCLUSIVE ACUTE GASTRIC ISCHEMIA FROM HYPOTENSION DURING DIALYSIS

Case Presentation: A 69-year-old man presented with acute onset abdominal pain during hemodialysis. He had a history of end stage renal disease and extensive vascular disease, including coronary artery disease, peripheral arterial disease, and an [...]

By | 2018-03-19T13:17:57+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A CASE OF NON-OCCLUSIVE ACUTE GASTRIC ISCHEMIA FROM HYPOTENSION DURING DIALYSIS

HM2018 Abstract Number: 816

Disseminated Herpes Zoster in a Young Immunocompetent Female

Case Presentation: A 37-year-old woman with no significant medical history initially presented to the Emergency Department (ED) with an itchy rash on her left thigh that developed over a week. The only preceding event was [...]

By | 2018-03-19T13:17:54+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Disseminated Herpes Zoster in a Young Immunocompetent Female

HM2018 Abstract Number: 473

OH, THE PLACES ENDOMETRIUM CAN GO

Case Presentation: A 33-year-old nulliparous female with no past medical history presented with 10 months of postmenstrual umbilical pain. She denied vomiting or bowel habit changes, but noted recent orthopnea and nocturnal wheezing. She had [...]

By | 2018-03-19T13:17:50+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on OH, THE PLACES ENDOMETRIUM CAN GO

HM2018 Abstract Number: 430

FACIAL DIPLEGIA: A CASE REPORT OF A STROKE MIMICKER

Case Presentation: A 46-year-old female with a past medical history of hypertension, diabetes mellitus, and asthma who initially presented 2 weeks prior to the emergency department for right-sided facial paralysis and was diagnosed with idiopathic [...]

By | 2018-03-19T13:17:46+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on FACIAL DIPLEGIA: A CASE REPORT OF A STROKE MIMICKER

HM2018 Abstract Number: 469

NEW ONSET HYPERTENSIVE URGENCY FOLLOWING RENAL ARTERY EMBOLIZATION

Case Presentation: A 64-year-old year old woman with no personal or family history of HTN was diagnosed with right renal angiomyolipoma incidentally on work up for latent TB and referred to interventional radiology for partial [...]

By | 2018-03-19T13:17:40+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on NEW ONSET HYPERTENSIVE URGENCY FOLLOWING RENAL ARTERY EMBOLIZATION

HM2018 Abstract Number: 544

BADAS: ‘BAD’ SKIN WITH DIARRHEA

Case Presentation: A 55-year-old woman, with benign past medical history presented with a two-week of low-grade fevers and erythematous papules that evolved into small discrete honey-colored crusted plaques and pustules on her face. She was [...]

By | 2018-03-19T13:17:38+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on BADAS: ‘BAD’ SKIN WITH DIARRHEA

HM2018 Abstract Number: 641

THE STORY OF A CATWOMAN: IS THERE A LINK BETWEEN CIRRHOSIS AND PASTEURELLA

Case Presentation: The patient is a 67 years old female with Hepatitis C and alcoholic liver cirrhosis, HCC, atrial fibrillation who presented to the ED with fever, chills and altered mental status. Per husband, the [...]

By | 2018-03-19T13:17:36+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on THE STORY OF A CATWOMAN: IS THERE A LINK BETWEEN CIRRHOSIS AND PASTEURELLA

HM2018 Abstract Number: 640

DO NOT FORGET IT YET

Case Presentation: The patient is a 23 years old Hispanic male with no significant past medical history presented to the ED with the chief complaints of sore throat, headache, nausea, vomiting for 5 days. He [...]

By | 2018-03-19T13:17:34+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on DO NOT FORGET IT YET

HM2018 Abstract Number: 609

Double Vision — More Than Meets the Eye: A Case of Sphenoid Sinusitis Causing Cavernous Sinus Thrombosis

Case Presentation: A 65-year-old female with a history of sphenoid sinusitis status post recent fiberoptic endoscopic sinus surgery presented with one week of neck stiffness and two days of fever, headache, photosensitivity, and diplopia. Vital [...]

By | 2018-03-19T13:17:24+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Double Vision — More Than Meets the Eye: A Case of Sphenoid Sinusitis Causing Cavernous Sinus Thrombosis

HM2018 Abstract Number: 575

A RARE CASE OF METASTATIC INSULINOMA IN A 28 YEAR OLD FEMALE

Case Presentation: Insulinoma is a rare tumor that originates in the beta cells of the pancreas with an incidence of 1-4 cases/million persons/year. Less than 10% of insulinomas are malignant and represent a treatment challenge [...]

By | 2018-03-19T13:17:22+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A RARE CASE OF METASTATIC INSULINOMA IN A 28 YEAR OLD FEMALE

HM2018 Abstract Number: 472

Not “Just the Flu”: A case of post-influenza S. aureus pneumonia

Case Presentation: A healthy 22-year-old woman presented to the ED with five days of fevers, dry cough, dyspnea and right-sided pleuritic chest pain. Lab work and a CXR were unremarkable. A nasal swab diagnosed Influenza [...]

By | 2018-03-19T13:17:18+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Not “Just the Flu”: A case of post-influenza S. aureus pneumonia

HM2018 Abstract Number: 542

IT’S ALL IN THE HEAD: A CASE REPORT ON METRONIDAZOLE-INDUCED ENCEPHALOPATHY (MEI) AND NEUROPATHY

Case Presentation: We report a case of a 44 year old female with a history of hepatitis C and alcoholic cirrhosis, abstinent from alcohol for about two years, who presented from a nursing facility with [...]

By | 2018-03-19T13:17:12+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on IT’S ALL IN THE HEAD: A CASE REPORT ON METRONIDAZOLE-INDUCED ENCEPHALOPATHY (MEI) AND NEUROPATHY

HM2018 Abstract Number: 380

Where’s the Fat? A Challenging Case of Recurrent Ascites of Unclear Etiology

Case Presentation: A 75 year-old man with recently diagnosed bladder cancer presented with fever and dyspnea, one month after a laparoscopic cystectomy, radical prostatectomy, lymph node dissection, and urinary diversion via ileal conduit. On arrival, [...]

By | 2018-03-22T15:49:31+00:00 March 19th, 2018|Adult, Clinical Vignettes, Finalist Posters, Hospital Medicine 2018|Comments Off on Where’s the Fat? A Challenging Case of Recurrent Ascites of Unclear Etiology

HM2018 Abstract Number: 568

SPOTS AND ANEMIA, LYME AND BABESIA!

Case Presentation: A 69-year-old female with no significant past medical history presented with three weeks of intermittent fevers followed by 24-hours of persistent fever associated with nausea, fatigue, and malaise. She lived in the metro-Boston [...]

By | 2018-03-19T13:17:06+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on SPOTS AND ANEMIA, LYME AND BABESIA!

HM2018 Abstract Number: 860

Sour without the Sweet: A Subtle Presentation of Euglycemic Diabetic Ketoacidosis

Case Presentation: A 48-year-old male nurse presented with one week of fever, nausea, abdominal pain, dysuria, urinary frequency, and suprapubic pain. His past medical history was significant for type 2 diabetes mellitus (recent hemoglobin a1c [...]

By | 2018-03-19T13:17:04+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Sour without the Sweet: A Subtle Presentation of Euglycemic Diabetic Ketoacidosis

HM2018 Abstract Number: 697

PARANEOPLASTIC CUSHING’S SYNDROME IN A HYPOTENSIVE, HYPOKALEMIC PATIENT

Case Presentation: A 61 year old woman presented to the hospital with dyspnea and chest pain. She had been gaining weight, and experiencing night sweats and lower extremity swelling for several months. She had a [...]

By | 2018-03-19T13:17:02+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on PARANEOPLASTIC CUSHING’S SYNDROME IN A HYPOTENSIVE, HYPOKALEMIC PATIENT

HM2018 Abstract Number: 594

Acute Severe Mitral Regurgitation With Cardiogenic Shock Due To Papillary Muscle Rupture In Acute Myocardial Infarction

Case Presentation: We describe an interesting case of a 59-year-old female patient who arrived unresponsive to ED, with symptoms concerning for acute coronary syndrome(ACS). There was no informant present along with the patient, so very [...]

By | 2018-03-19T13:17:00+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Acute Severe Mitral Regurgitation With Cardiogenic Shock Due To Papillary Muscle Rupture In Acute Myocardial Infarction

HM2018 Abstract Number: 867

EUGLYCEMIC DIABETIC KETOACIDOSIS: A CHALLENGING CONSEQUENCE OF SGLT2 INHIBITION

Case Presentation: A 53-year-old woman with Type 2 Diabetes Mellitus (DM) on insulin complicated by prior DKA presented with headache, nausea, vomiting, and palpitations for several hours. Her DM regimen included insulin glargine, linagliptin, and [...]

By | 2018-03-19T13:16:54+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on EUGLYCEMIC DIABETIC KETOACIDOSIS: A CHALLENGING CONSEQUENCE OF SGLT2 INHIBITION

HM2018 Abstract Number: 476

SEVERE THROMBOCYTOPENIA INDUCED BY VANCOMYCIN-DEPENDENT ANTI-PLATELET ANTIBODIES

Case Presentation: A 69-year-old woman with metastatic breast cancer, atrial fibrillation (on coumadin) and CKD stage III was admitted after a fall. She was treated for pneumonia with ceftriaxone and azithromycin. On hospital day 2, [...]

By | 2018-03-19T13:16:53+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on SEVERE THROMBOCYTOPENIA INDUCED BY VANCOMYCIN-DEPENDENT ANTI-PLATELET ANTIBODIES

HM2018 Abstract Number: 566

NUTRITIONAL DEFICIENCY AS A CAUSE OF ACUTE ASCENDING NEUROPATHY MIMICKING GUILLAIN-BARRÉ SYNDROME

Case Presentation: A 39-year old female with a history of alcohol abuse presented with an eight-day history of numbness involving her bilateral lower extremities and hands which had progressed proximally to involve her chest wall. [...]

By | 2018-03-19T13:16:47+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on NUTRITIONAL DEFICIENCY AS A CAUSE OF ACUTE ASCENDING NEUROPATHY MIMICKING GUILLAIN-BARRÉ SYNDROME

HM2018 Abstract Number: 445

BLASTOMYCOSIS PRESENTING WITH ISOLATED EPIDIDYMO-ORCHITIS

Case Presentation: A 68-year-old male with a past medical history of well controlled diabetes mellitus and chronic lymphocytic leukemia-in remission, presented with a painful right scrotal swelling and redness of four days. The patient denied [...]

By | 2018-03-19T13:16:45+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on BLASTOMYCOSIS PRESENTING WITH ISOLATED EPIDIDYMO-ORCHITIS

HM2018 Abstract Number: 449

A CASE OF VOGT-KAYANAGI-HARADA DISEASE AS SEQUELA OF DRESS

Case Presentation: A 32 yo male presented after 1 week of high spiking fevers and a pruritic rash. Sulfamethoxazole-trimethoprim had been started 5 weeks prior. Treatment was started with antihistamines, topical steroids, and prednisone 60mg [...]

By | 2018-03-19T13:16:43+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A CASE OF VOGT-KAYANAGI-HARADA DISEASE AS SEQUELA OF DRESS

HM2018 Abstract Number: 680

MARCHIAFAVA-BIGNAMI DISEASE, A RARE COMPLICATION OF ALCOHOLISM

Case Presentation: A 55 year old male with a history of hypertension, hyperlipidemia and significant history of alcohol abuse presented after presyncope with subsequent fall and head trauma. On presentation he was confused and dysarthric. [...]

By | 2018-03-19T13:16:29+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on MARCHIAFAVA-BIGNAMI DISEASE, A RARE COMPLICATION OF ALCOHOLISM

HM2018 Abstract Number: 692

AN UNUSUAL CASE OF FEVERS; HOW URBAN LEGEND FINDS ITS WAY INTO MODERN-DAY MEDICINE

Case Presentation: A 43-year-old previously healthy Nigerian male presented to the ED with fevers for three weeks. He denied any chronic medical conditions, prior surgeries, or travel in the past year. He had initially presented [...]

By | 2018-03-19T13:16:25+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on AN UNUSUAL CASE OF FEVERS; HOW URBAN LEGEND FINDS ITS WAY INTO MODERN-DAY MEDICINE

HM2018 Abstract Number: 741

IR-RASH-IONAL FEAR

Case Presentation: A 58 year old man, who has sex with men, presented with three weeks of blurred vision. During this period he also noted fevers, malaise, and headache. Physical exam revealed a patchy erythematous [...]

By | 2018-03-19T13:16:24+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on IR-RASH-IONAL FEAR

HM2018 Abstract Number: 454

Plants in the Lung: a Case of Excipient-Related Granulomatous Disease

Case Presentation: A 27 year-old Caucasian man presented with hypoxia, recurrent fevers, and joint pains. He had Crohn’s disease with partial bowel resection and was actively being treated with Infliximab. He had previously worked as [...]

By | 2018-03-19T13:16:19+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Plants in the Lung: a Case of Excipient-Related Granulomatous Disease

HM2018 Abstract Number: 690

A RARE CASE OF PULMONARY BLASTOMYCOSIS COMPLICATED BY ARDS IN AN IMMUNOCOMPETENT INDIVIDUAL

Case Presentation: A 71-year-old female presented to an emergency department with progressive weakness and dyspnea with dry cough for 2 weeks; she was afebrile but hypoxic, requiring 2 liters oxygen by nasal cannula. Physical examination was remarkable [...]

By | 2018-03-19T13:15:29+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A RARE CASE OF PULMONARY BLASTOMYCOSIS COMPLICATED BY ARDS IN AN IMMUNOCOMPETENT INDIVIDUAL

HM2018 Abstract Number: 809

ADIPOSE TISSUE INFUSION AS A CAUSE OF RECURRENT FEVER

Case Presentation: An 87-year-old female with a history of bilateral knee osteoarthritis presented to the emergency room with complaints of intermittent fever ongoing at home for two weeks. She recently had a Lipogems injection procedure [...]

By | 2018-03-19T13:15:26+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on ADIPOSE TISSUE INFUSION AS A CAUSE OF RECURRENT FEVER

HM2018 Abstract Number: 756

A Dizzying Experience: A Case of Vertebral Artery Dissection

Case Presentation: A previously healthy 37-year-old male presented to the Emergency Department (ED) with sudden onset nausea and dizziness that after he had turned and looked over his right shoulder. He experienced 3 episodes of [...]

By | 2018-03-19T13:15:24+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A Dizzying Experience: A Case of Vertebral Artery Dissection

HM2018 Abstract Number: 751

A Case of Red Herrings, Wide Nets and Atypical Features

Case Presentation: A 33 year-old Caucasian female with history of 1 spontaneous abortion presented with periorbital edema, dark urine, arthralgias and fevers (Tmax 102) for 2 weeks. The patient reported many environmental exposures as a [...]

By | 2018-03-19T13:15:19+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A Case of Red Herrings, Wide Nets and Atypical Features

HM2018 Abstract Number: 674

A RARE PRESENTATION OF GASTRIC SIGNET RING CELL ADENOCARCINOMA (SRCA)

Case Presentation: A 25 year old Hispanic woman, G4P3 pregnant at 18 weeks with underlying hypertension and gallstones, initially presented with low back pain for 10 days. The pain started suddenly, constant, sharp with no [...]

By | 2018-03-19T13:15:15+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A RARE PRESENTATION OF GASTRIC SIGNET RING CELL ADENOCARCINOMA (SRCA)

HM2018 Abstract Number: 639

BONE, DRUGS, AND DISHARMONY: ELEVATED ALKALINE PHOSPHATASE DUE TO VORICONAZOLE-INDUCED PERIOSTITIS

Case Presentation: A 19-year-old male presented with three days of fevers, cough, and pleuritic chest pain. He had a history of cystic fibrosis (CF) with lung and pancreatic involvement and allergic bronchiopulmonary aspergillosis (ABPA). Home [...]

By | 2018-03-19T13:14:57+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on BONE, DRUGS, AND DISHARMONY: ELEVATED ALKALINE PHOSPHATASE DUE TO VORICONAZOLE-INDUCED PERIOSTITIS

HM2018 Abstract Number: 662

SEIZURE-INDUCED TAKOTSUBO CARDIOMYOPATHY

Case Presentation: A 68-year old female with a history of uncomplicated alcohol dependence was brought in by ambulance after a witnessed seizure at home characterized by myoclonus for several minutes and prolonged post-ictal confusion. Upon [...]

By | 2018-03-19T13:14:54+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on SEIZURE-INDUCED TAKOTSUBO CARDIOMYOPATHY

HM2018 Abstract Number: 563

THYROTOXIC PERIODIC PARALYSIS PRESENTING AS PAROXYSMAL DIFFUSE HYPOKALEMIC WEAKNESS

Case Presentation: A 29-year-old Asian male with a one-year history of recurrent generalized muscle weakness presented to the emergency department with whole body paralysis. The patient’s symptoms began abruptly that morning, when he was unable [...]

By | 2018-03-19T13:14:51+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on THYROTOXIC PERIODIC PARALYSIS PRESENTING AS PAROXYSMAL DIFFUSE HYPOKALEMIC WEAKNESS

HM2018 Abstract Number: 740

Penicilliosis: A Contaminant Confirmed

Case Presentation: A 44 year old African American man presented to the hospital for evaluation and treatment following generalized tonic-clonic seizures. He denied recent and remote travel, fever, chills, sick contacts, constitutional symptoms, and felt [...]

By | 2018-03-19T13:14:48+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Penicilliosis: A Contaminant Confirmed

HM2018 Abstract Number: 803

A Rare Case of Acute Interstitial Pneumonia (Hamman-Rich Syndrome)

Case Presentation: A 45-year-old female with PMH of hypertension presented with 3-days of worsening shortness of breath, general malaise and increasing home oxygen (O2) requirements. She was recently discharged from an outside hospital with home [...]

By | 2018-03-19T13:14:45+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A Rare Case of Acute Interstitial Pneumonia (Hamman-Rich Syndrome)

HM2018 Abstract Number: 447

A DIAGNOSIS HIDING IN PLAIN SITE

Case Presentation: A morbidly obese, but otherwise healthy, 57 year old male, presented to his initial visit with his primary care provider with complaints of dysphagia, vomiting, and unintentional weight loss of 15 pounds over [...]

By | 2018-03-19T13:14:35+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A DIAGNOSIS HIDING IN PLAIN SITE

HM2018 Abstract Number: 899

HARDER TO BREATHE: AN UNSUAL CASE OF SEVERE HYPERPHOSPHATURIC HYPOPHOSPHATEMIA AND NORMAL FGF-23 LEVELS IN A YOUNG FEMALE PATIENT

Case Presentation: A 33-year-old Caucasian woman presented with increasing fatigue, palpitations and shortness of breath for the previous three weeks. She had a history of iron deficiency anemia, gluten sensitivity, and compensated anorexia. One month [...]

By | 2018-03-19T13:14:33+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on HARDER TO BREATHE: AN UNSUAL CASE OF SEVERE HYPERPHOSPHATURIC HYPOPHOSPHATEMIA AND NORMAL FGF-23 LEVELS IN A YOUNG FEMALE PATIENT

HM2018 Abstract Number: 767

When Thunder Strikes

Case Presentation: Ms. T.J. is a 47-year-old female with a past medical history consisting of migraines and tobacco use who presented with headache. 6 weeks prior to admission, the patient had a sudden onset of [...]

By | 2018-03-19T13:14:30+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on When Thunder Strikes

HM2018 Abstract Number: 845

POST-SURGICAL LEMIERRE’S SYNDROME

Case Presentation: 50-year-old male with past medical history of hypertension, was diagnosed with a Warthin’s tumor. Patient underwent superficial parotidectomy with right neck lymph node dissection level. On POD #10, he presented to the ED [...]

By | 2018-03-19T13:14:27+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on POST-SURGICAL LEMIERRE’S SYNDROME

HM2018 Abstract Number: 879

NOT ALL PNEUMONIA IS INFECTIOUS!

Case Presentation: An 89 year-old male developed coagulase negative Staphylococcus bacteremia and infective endocarditis of mitral valve after urinary procedure for which he was started on Daptomycin for 6 weeks. At week 4, he developed [...]

By | 2018-03-19T13:14:22+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on NOT ALL PNEUMONIA IS INFECTIOUS!

HM2018 Abstract Number: 833

Blind to the diagnosis: a case of undetected neurosyphilis presenting as unilateral central scotoma.

Case Presentation: A 37-year-old man who has sex with men (MSM) with extensive cerebrovascular history, including non-traumatic internal carotid artery dissection, cerebrovascular accident (CVA) with left-sided hemiparesis, Circle of Willis aneurysm, presented with acute painless [...]

By | 2018-03-19T13:14:21+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Blind to the diagnosis: a case of undetected neurosyphilis presenting as unilateral central scotoma.

HM2018 Abstract Number: 849

HAVE YOU SEEN MY THIAMINE?

Case Presentation: A 26-year-old woman with a past medical history of obesity presented with four weeks of intractable nausea and vomiting associated with poor oral intake and a 60-pound unintentional weight loss. She also complained [...]

By | 2018-03-19T13:14:19+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on HAVE YOU SEEN MY THIAMINE?

HM2018 Abstract Number: 657

POLYARTERITIS NODOSA WITH NEGATIVE INFLAMMATORY MARKERS AND LOCALIZED VASCULITIS OF THE GASTROINTESTINAL TRACT– A CASE REPORT

Case Presentation: Case presentation:A 56 year-old caucasian man with no significant past medical history presented to our center with acute left upper quadrant abdominal pain. CT angiography of the thorax was performed to rule-out pulmonary [...]

By | 2018-03-19T13:12:45+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on POLYARTERITIS NODOSA WITH NEGATIVE INFLAMMATORY MARKERS AND LOCALIZED VASCULITIS OF THE GASTROINTESTINAL TRACT– A CASE REPORT

HM2018 Abstract Number: 534

INVASIVE CYTOMEGALOVIRUS IN A HOST WITH IMMUNE DYSREGULATION

Case Presentation: A 32-year-old woman with history of lupus not on steroid or immunosuppressive therapy for more than 10 years presented with headache, generalized weakness, abdominal pain, nausea, vomiting, and malaise. On exam, the patient [...]

By | 2018-03-19T13:12:43+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on INVASIVE CYTOMEGALOVIRUS IN A HOST WITH IMMUNE DYSREGULATION

HM2018 Abstract Number: 579

POTENTIALLY FATAL CONJUNCTIVAL HYPEREMIA: THE DANGER TRIANGLE OF THE FACE

Case Presentation: A 54-year-old male was referred to our hospital with a headache and left ophthalmalgia since a few weeks. The patient had a 6-month-old history of odontalgia and gingivalgia, but lived an otherwise healthy [...]

By | 2018-03-19T13:12:37+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on POTENTIALLY FATAL CONJUNCTIVAL HYPEREMIA: THE DANGER TRIANGLE OF THE FACE

HM2018 Abstract Number: 748

CASE OF A MESSY RASH

Case Presentation: A 57 year old Caucasian man with history of  porphyria cutanea tarda- recently started on therapeutic phlebotomy, COPD, alcohol abuse, hypertension was admitted to the hospital with recurrent syncopal spells of one day [...]

By | 2018-03-19T13:12:34+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on CASE OF A MESSY RASH

HM2018 Abstract Number: 888

Neurological damage induced by heroin inhalation: Chasing the dragon syndrome

Case Presentation: A 37-year-old man with no previous psychiatric or significant medical history was brought in by his family to the emergency department for an abnormal behavior included inability to speak and ambulate, motor restlessness, [...]

By | 2018-03-19T13:12:30+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Neurological damage induced by heroin inhalation: Chasing the dragon syndrome

HM2018 Abstract Number: 608

CARDIAC TAMPONADE AS A CAUSE FOR HYPONATREMIA IN PATIENTS WITH ACTIVE MALIGNANCY

Case Presentation: This is the case of a 57-year-old lady with rapidly progressive stage IV pulmonary adenocarcinoma who presented two months after diagnosis with findings of significant hyponatremia. Upon admission, she was afebrile, hypotensive and [...]

By | 2018-03-19T13:12:28+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on CARDIAC TAMPONADE AS A CAUSE FOR HYPONATREMIA IN PATIENTS WITH ACTIVE MALIGNANCY

HM2018 Abstract Number: 915

WERNICKE ENCEPHALOPATHY AFTER SLEEVE GASTRECTOMY FOR MORBID OBESITY

Case Presentation: Wernicke’s encephalopathy (WE) has been considered a disease of alcoholics, but it is also found in other scenarios in which severe nutritional deficiencies can result, such as in cancer patients with cachexia, and [...]

By | 2018-03-19T13:12:25+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on WERNICKE ENCEPHALOPATHY AFTER SLEEVE GASTRECTOMY FOR MORBID OBESITY

HM2018 Abstract Number: 691

Knee Deep in Trouble: A Fungus Complicates Wound Healing

Case Presentation: A 57-year old man with a history of chronic lymphocytic leukemia, complicated by treatment-related myelodysplastic syndrome (MDS), presented with a large, painful, dry ulcer with black eschar on his right knee. He was [...]

By | 2018-03-19T13:12:22+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Knee Deep in Trouble: A Fungus Complicates Wound Healing

HM2018 Abstract Number: 475

METHEMOGLOBINEMIA AND HEMOLYTIC ANEMIA SECONDARY TO PROPHYLACTIC DAPSONE

Case Presentation: An 84 year old female with a past medical history significant for systemic lupus erythematous (SLE) presented to the emergency department with fatigue and dizziness. She had recently been admitted to the same [...]

By | 2018-03-19T13:12:19+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on METHEMOGLOBINEMIA AND HEMOLYTIC ANEMIA SECONDARY TO PROPHYLACTIC DAPSONE

HM2018 Abstract Number: 498

AN ESSENTIAL CLUE IS THE METHYLENE BLUE

Case Presentation: A 47 year old female with a history of depression and remote Roux-en-Y gastric bypass surgery, presented for an elective laparoscopic gastrectomy due to hypertrophic pyloric stenosis causing complete gastric remnant outlet obstruction. [...]

By | 2018-03-19T13:12:12+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on AN ESSENTIAL CLUE IS THE METHYLENE BLUE

HM2018 Abstract Number: 451

YOU MAKE MY HEART STOP: A CASE OF VARICELLA MYOCARDITIS PRESENTING AS STOKES-ADAMS ATTACKS

Case Presentation: A 30 year old well male presented with one day history of multiple episodes of loss of consciousness. Each episode lasted several minutes with no preceding warning. There was no limb jerking, tongue [...]

By | 2018-03-19T13:12:10+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on YOU MAKE MY HEART STOP: A CASE OF VARICELLA MYOCARDITIS PRESENTING AS STOKES-ADAMS ATTACKS

HM2018 Abstract Number: 738

EARLY RECOGNITION AND TREATMENT OF A PATIENT WITH AN ATYPICAL PRESENTATION OF HASHIMOTO ENCEPHALOPATHY

Case Presentation: Hashimoto encephalopathy is a poorly understood and rare complication of Hashimoto thyroiditis. Patients can present with seizures, movement disorders, or cognitive decline that improves with steroid therapy. The disease is a diagnosis of [...]

By | 2018-03-19T13:12:06+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on EARLY RECOGNITION AND TREATMENT OF A PATIENT WITH AN ATYPICAL PRESENTATION OF HASHIMOTO ENCEPHALOPATHY

HM2018 Abstract Number: 782

Please Don’t Eat Me: A case of Adult Hemophagocytic Lymphohistiocytosis

Case Presentation: A 58 year old previously healthy Nigerian female presented with a 6-week history of high-grade fevers, weakness, malaise, and a 10-pound weight loss. On physical exam she was found to have tachycardia, hypotension, [...]

By | 2018-03-19T13:11:54+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Please Don’t Eat Me: A case of Adult Hemophagocytic Lymphohistiocytosis

HM2018 Abstract Number: 837

UREMIC PERICARDITIS: DISTINGUISHING FEATURES IN A NOW-UNCOMMON SYNDROME

Case Presentation: A 47 year-old man presented with two weeks of dyspnea, pleuritic chest pain and acutely worsening renal function. His medical history included type 2 diabetes mellitus with resultant diabetic nephropathy. The patient had [...]

By | 2018-03-19T13:11:50+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on UREMIC PERICARDITIS: DISTINGUISHING FEATURES IN A NOW-UNCOMMON SYNDROME

HM2018 Abstract Number: 823

Diarrhea in my lung? A rare case of Clostridium difficile empyema

Case Presentation: 52 year old female with history of stage IV invasive colorectal adenocarcinoma of sigmoid colon with multifocal bilobar liver metastasis s/p sigmoid colon resection, diverting loop ileostomy and partial hepatectomy (two stage surgery [...]

By | 2018-03-19T13:11:48+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Diarrhea in my lung? A rare case of Clostridium difficile empyema

HM2018 Abstract Number: 919

TYPE B LACTIC ACIDOSIS IN AN ALCOHOLIC – PREDISPOSING FACTORS AND THE ROLE OF EMERGENT HEMODIALYSIS

Case Presentation: A 62 year old man with a history of alcohol dependence, chronic hepatitis B & C and Child C liver cirrhosis presented with a 3 day history of shortness of breath and pleuritic [...]

By | 2018-03-19T13:11:46+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on TYPE B LACTIC ACIDOSIS IN AN ALCOHOLIC – PREDISPOSING FACTORS AND THE ROLE OF EMERGENT HEMODIALYSIS

HM2018 Abstract Number: 489

COUGH, FEVER, AND HEADACHES: AN ATYPICAL PRESENTATION OF COCCIDIOIDOMYCOSIS

Case Presentation: Disseminated Coccidioidomycosis is a rare fungal infection that can have various presentations in a hospitalized patient. Given the high mortality rate associated with delayed diagnosis, it is essential to keep this rare infection on [...]

By | 2018-03-19T13:11:45+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on COUGH, FEVER, AND HEADACHES: AN ATYPICAL PRESENTATION OF COCCIDIOIDOMYCOSIS

HM2018 Abstract Number: 663

Difficult Diagnosis: Hospital Admission for Chronic Abdominal Pain

Case Presentation: 76-year-old male with a recent diagnosis of low-grade MDS presented to the hospital with complaints of severe fatigue, anorexia, abdominal pain and a 60 pound weight loss over six months. He also had [...]

By | 2018-03-19T13:11:40+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Difficult Diagnosis: Hospital Admission for Chronic Abdominal Pain

HM2018 Abstract Number: 764

Look Beyond The Lungs

Case Presentation: A 22-year-old Hispanic male presented with a 4 day history of rectal and abdominal pain. He denied any previous medical history. He also noted three months of productive cough, pyrexia, chills, night sweats, fatigue, and [...]

By | 2018-03-19T13:11:27+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Look Beyond The Lungs

HM2018 Abstract Number: 569

POST OPERATIVE STROKE REVEALS UNDERLYING GENETIC CONDITION

Case Presentation: A 46-year-old woman presented with left hemiparesis following elective hip replacement. Past medical history noted essential hypertension currently untreated and bilateral hip dysplasia corrected as a child. She took ibuprofen and hydrocodone-acetaminophen for [...]

By | 2018-03-19T13:11:26+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on POST OPERATIVE STROKE REVEALS UNDERLYING GENETIC CONDITION

HM2018 Abstract Number: 532

STEROIDS FOR TREATMENT OF CONFUSION IN AN OLDER FEMALE PATIENT

Case Presentation: The patient is a 70 y.o. female with a history of hypertension, bilateral lower extremity deep vein thrombosis (DVT), and peripheral neuropathy, who was brought to the emergency room (ER) by EMS due [...]

By | 2018-03-19T13:11:24+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on STEROIDS FOR TREATMENT OF CONFUSION IN AN OLDER FEMALE PATIENT

HM2018 Abstract Number: 768

A CASE OF PERNICIOUS ANEMIA WITH ASSOCIATED HEMOLYSIS AND GASTRIC CARCINOID

Case Presentation: A 43-year-old woman with controlled hypothyroidism presented to her primary care physician for evaluation of one-month of progressive fatigue, dizziness, and “disconnected” feeling. She noted decreased appetite leading to a twenty-pound weight loss. [...]

By | 2018-03-19T13:11:23+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A CASE OF PERNICIOUS ANEMIA WITH ASSOCIATED HEMOLYSIS AND GASTRIC CARCINOID

HM2018 Abstract Number: 850

A RARE CASE OF MULTIPLE MYELOMA PRESENTING WITH SPONTANEOUS TUMOR LYSIS SYNDROME

Case Presentation: Patient is a 62 year-old morbidly obese male (BMI 56), chronic obstructive pulmonary disease (COPD) on 4L of Nasal Cannula (NC) O2 at home, heart failure with preserved ejection fraction, who presented complaining [...]

By | 2018-03-19T13:11:21+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A RARE CASE OF MULTIPLE MYELOMA PRESENTING WITH SPONTANEOUS TUMOR LYSIS SYNDROME

HM2018 Abstract Number: 866

A RARE CASE OF EPSTEIN-BARR VIRUS ASSOCIATED POST-TRANSPLANT LYMPHOPROLIFERATIVE DISORDER APPEARING IN CERVIX

Case Presentation: A 48 YO female with ESRD due to IgA nephropathy underwent DDKT 13 years ago with thymo induction and subsequent maintenance immunosuppression with Tacrolimus & MMF and had excellent graft functions. Two years [...]

By | 2018-03-19T13:11:19+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A RARE CASE OF EPSTEIN-BARR VIRUS ASSOCIATED POST-TRANSPLANT LYMPHOPROLIFERATIVE DISORDER APPEARING IN CERVIX

HM2018 Abstract Number: 807

MIXED AUTOIMMUNE HEMOLYTIC ANEMIA AND THROMBOCYTOPENIA DUE TO ACUTE CYTOMEGALOVIRUS INFECTION.

Case Presentation: A 70-year-old male who presented to us with worsening dyspnea on exertion and non-productive cough. Review of systems was negative. Vitals were unremarkable; physical examination was significant for bilateral basilar rales which were [...]

By | 2018-03-19T13:11:18+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on MIXED AUTOIMMUNE HEMOLYTIC ANEMIA AND THROMBOCYTOPENIA DUE TO ACUTE CYTOMEGALOVIRUS INFECTION.

HM2018 Abstract Number: 761

UNSTEADY STATE: DIALYSIS DISEQUILIBRIUM SYNDROME IN THE ACUTE DIALYSIS PATIENT

Case Presentation: A 70yo female with bipolar disorder and type 2 DM on metformin presented to the hospital with altered mental status, nausea/vomiting and diarrhea for 3 days. Per report the patient had self-administered laxatives [...]

By | 2018-03-19T13:11:16+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on UNSTEADY STATE: DIALYSIS DISEQUILIBRIUM SYNDROME IN THE ACUTE DIALYSIS PATIENT

HM2018 Abstract Number: 621

CULTURE NEGATIVE INFECTIVE ENDOCARDITIS MASQUERADING AS RECURRENT SUPRAVENTRICULAR TACHYCARDIA

Case Presentation: A 93-year-old African-American male with history of CVA, HTN, and dementia presented with a right femoral neck fracture after a same level fall. Vital signs on admission were unremarkable. Physical examination revealed a [...]

By | 2018-03-19T13:11:10+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on CULTURE NEGATIVE INFECTIVE ENDOCARDITIS MASQUERADING AS RECURRENT SUPRAVENTRICULAR TACHYCARDIA

HM2018 Abstract Number: 603

Massive Pneumomediastinum and Subcutaneous Emphysema In the Setting of ARDS

Case Presentation: A 61-year-old male presented to the hospital with metastatic adenocarcinoma and peritoneal carcinomatosis causing small bowel obstruction. Following an aspiration event he was admitted to the ICU with multifocal pneumonia and findings consistent [...]

By | 2018-03-19T13:11:08+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Massive Pneumomediastinum and Subcutaneous Emphysema In the Setting of ARDS

HM2018 Abstract Number: 667

ACUTE KIDNEY INJURY RELATED TO A CHRONIC PROBLEM

Case Presentation: The prevalence of cocaine use is growing worldwide. Damaging effects of cocaine on the cardiovascular, neurologic, and pulmonary systems are well-established. In recent years, evidence has emerged for cocaine-induced damage to other organs, [...]

By | 2018-03-19T13:11:07+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on ACUTE KIDNEY INJURY RELATED TO A CHRONIC PROBLEM

HM2018 Abstract Number: 500

“ANGEL DUST BLUES’- A CASE OF PHENCYCLIDINE-INDUCED CATATONIA

Case Presentation: 41 year old male with a history of substance use (Phencyclidine/PCP) was brought to the hospital after being found nude and unconscious outside for an unknown period. At presentation he was awake but [...]

By | 2018-03-19T13:11:04+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on “ANGEL DUST BLUES’- A CASE OF PHENCYCLIDINE-INDUCED CATATONIA

HM2018 Abstract Number: 602

Fatal Macrophage Activation Syndrome in the Setting of Mixed Connective Tissue Disorder

Case Presentation: A 53 yo female presented with a subacute syndrome of intermittent fevers, fatigue, heliotrope rash, weight loss, fingertip necrosis, and nodular skin lesions. Skin biopsy was positive for septal and lobular granulomatous panniculitis. [...]

By | 2018-03-19T13:11:00+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Fatal Macrophage Activation Syndrome in the Setting of Mixed Connective Tissue Disorder

HM2018 Abstract Number: 668

AN OCCULT PRESENTATION OF A METASTATIC DISEASE

Case Presentation: Most complications of Hepatitis C virus (HCV) infection, such as progressive fibrosis and cirrhosis, hepatic decompensation, and hepatocellular carcinoma (HCC), are related to chronic infection. Upon adequate treatment of HCV with sustained virologic [...]

By | 2018-03-19T13:10:57+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on AN OCCULT PRESENTATION OF A METASTATIC DISEASE

HM2018 Abstract Number: 714

DISSEMINATED MYCOBACTERIUM AVIUM COMPLEX: A RARE CAUSE OF DIFFUSE ALVEOLAR HEMORRHAGE

Case Presentation: A 34 yo Hispanic male with recently diagnosed AIDS (CD4 <20) presented to our hospital with fevers, chills, shortness of breath, and hemoptysis. Patient initially presented one month ago with similar symptoms at [...]

By | 2018-03-19T13:10:56+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on DISSEMINATED MYCOBACTERIUM AVIUM COMPLEX: A RARE CAUSE OF DIFFUSE ALVEOLAR HEMORRHAGE

HM2018 Abstract Number: 746

RENAL ACTINOMYCOSIS

Case Presentation: A 56 year old female smoker with history of progressive weight loss in the past 6-9 months and changes in urinary frequency for about a month, presented with confusion, generalized weakness, lower extremity [...]

By | 2018-03-19T13:10:54+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on RENAL ACTINOMYCOSIS

HM2018 Abstract Number: 804

EXPANDING THE CLINICAL IMPLICATIONS OF COCAINE USE: A CASE OF LEVAMISOLE VASCULOPATHY WITH SEROSITIS

Case Presentation: A 49 year-old woman with levamisole-associated skin disease was admitted for worsening lower extremity ulcers and neutropenia in the setting of active cocaine use. Five years prior to admission, she presented in a [...]

By | 2018-03-19T13:10:53+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on EXPANDING THE CLINICAL IMPLICATIONS OF COCAINE USE: A CASE OF LEVAMISOLE VASCULOPATHY WITH SEROSITIS

HM2018 Abstract Number: 910

CORTICAL SPREADING DEPRESSION: A CASE OF DECEPTIVE NEUROLOGIC DEFICITS IN TRAUMATIC BRAIN INJURY

Case Presentation: An 86 year old man with atrial fibrillation on anticoagulation presented with altered mental status, right-sided weakness, and aphasia five days after a fall. CT head imaging demonstrated an acute left subdural hematoma [...]

By | 2018-03-19T13:10:51+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on CORTICAL SPREADING DEPRESSION: A CASE OF DECEPTIVE NEUROLOGIC DEFICITS IN TRAUMATIC BRAIN INJURY

HM2018 Abstract Number: 581

CHRONIC KIDNEY DISEASE AT AGE 23: A CASE OF COLLAPSING GLOMERULOPATHY SECONDARY TO PARVOVIRUS IN A YOUNG HEALTHY MAN

Case Presentation: The patient was a 23 year old African American male with obesity who presented to the hospital with bilateral lower leg swelling for 2 weeks. He initially noticed the swelling after a 3 [...]

By | 2018-03-19T13:10:49+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on CHRONIC KIDNEY DISEASE AT AGE 23: A CASE OF COLLAPSING GLOMERULOPATHY SECONDARY TO PARVOVIRUS IN A YOUNG HEALTHY MAN

HM2018 Abstract Number: 664

ACUTE URINARY RETENTION IN A YOUNG MALE: THINK OUTSIDE THE BOX!

Case Presentation: A previously healthy 20-year-old male presented with sudden onset urinary retention. He reported mild headaches, fevers, fatigue later followed by acute urinary retention associated with lower abdominal and back pain. Last void was [...]

By | 2018-03-19T13:10:48+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on ACUTE URINARY RETENTION IN A YOUNG MALE: THINK OUTSIDE THE BOX!

HM2018 Abstract Number: 781

RARE CASE OF TRICUSPID MYCOBACTERIUM ENDOCARDITIS IN A YOUNG FEMALE: NON-SURGICAL MANAGEMENT

Case Presentation: A 24-year-old female with a history of IV drug abuse and MRSA tricuspid native valve endocarditis was treated for lobar pneumonia 4 months prior to readmission for non-bloody cough and pleuritic chest pain. [...]

By | 2018-03-19T13:10:44+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on RARE CASE OF TRICUSPID MYCOBACTERIUM ENDOCARDITIS IN A YOUNG FEMALE: NON-SURGICAL MANAGEMENT

HM2018 Abstract Number: 564

ACUTE LEFT BUNDLE BRANCH BLOCK: WHAT IS BEING CONCEALED?!

Case Presentation: 81 year old male with medical history of Abdominal Aortic aneurysm(AAA) ,COPD on home oxygen, diverticulitis post colon resection 10 years ago presented to the emergency department with painless hematochezia for 4 days. [...]

By | 2018-03-19T13:10:43+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on ACUTE LEFT BUNDLE BRANCH BLOCK: WHAT IS BEING CONCEALED?!

HM2018 Abstract Number: 573

Diagnosing Creutzfeldt-Jakob Disease: Leave No Stone Unturned

Case Presentation: A 57-year-old male patient with a previous history of alcohol use was brought in by his family for progressive myoclonus and confusion. At baseline, this patient performed activities of daily living with ease. [...]

By | 2018-03-19T13:10:40+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Diagnosing Creutzfeldt-Jakob Disease: Leave No Stone Unturned

HM2018 Abstract Number: 453

A RARE CAUSE OF PANNICULITIS

Case Presentation: 35-year-old Caucasian gentleman who was diagnosed with alpha-1 antitrypsin deficiency (PiZZ) 2 years ago. Two weeks prior to the hospitalization, he noticed skin nodules on both sides of the abdominal wall and in [...]

By | 2018-03-19T13:10:38+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A RARE CAUSE OF PANNICULITIS

HM2018 Abstract Number: 806

DELAYED VASCULITIS WITH PNEUMOCOCCAL MENINGITIS

Case Presentation: Objectives 1. Recognize delayed post infectious vasculitis as a rare complication of bacterial meningitis 2. Recognize the use of corticosteroids for treatment of post infectious vasculitis Case Description A 63-year-old man with a [...]

By | 2018-03-19T13:10:37+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on DELAYED VASCULITIS WITH PNEUMOCOCCAL MENINGITIS

HM2018 Abstract Number: 571

BE ADVISED BUT KEEP YOUR OWN COUNSEL: VITAMIN K ANAPHYLACTOID REACTION

Case Presentation: A 45 yo woman with alcohol use, liver cirrhosis, hepatic encephalopathy and recurrent abdominal ascites, presented to hospital with decreased urine output and abdominal swelling. She was found to have severe acute renal [...]

By | 2018-03-19T13:10:30+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on BE ADVISED BUT KEEP YOUR OWN COUNSEL: VITAMIN K ANAPHYLACTOID REACTION

HM2018 Abstract Number: 592

A Case of Mysterious Migraine

Case Presentation: : A 34-year-old female with history of migrainous headaches presented with complains of sudden onset, throbbing type of headache radiating to the back of the ear. This was associated with sudden loss of [...]

By | 2018-03-19T13:10:24+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A Case of Mysterious Migraine

HM2018 Abstract Number: 665

COLD FEET, WARM HEART – A RARE CASE OF SPONTANEOUS LEFT VENTRICULAR THROMBUS

Case Presentation: A 34-year-old Caucasian lady with metabolic syndrome and hypertension presented with a sudden onset 10/10 right lower extremity pain associated with numbness and inability to ambulate. Vital signs were stable. On examination, her [...]

By | 2018-03-19T13:10:21+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on COLD FEET, WARM HEART – A RARE CASE OF SPONTANEOUS LEFT VENTRICULAR THROMBUS

HM2018 Abstract Number: 810

NECROTIZING MYOPATHY SECONDARY TO STATIN USE VS POLYMYOSITIS ASSOCIATED WITH AUTOIMMUNE HEPATITIS – A DIAGNOSTIC DILEMMA

Case Presentation: A 75-year-old Caucasian female with a history of hyperlipidemia treated with statin presented to the emergency room for generalized weakness. She became completely bedbound over the course of 5 days. Examination showed symmetric [...]

By | 2018-03-19T13:10:20+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on NECROTIZING MYOPATHY SECONDARY TO STATIN USE VS POLYMYOSITIS ASSOCIATED WITH AUTOIMMUNE HEPATITIS – A DIAGNOSTIC DILEMMA

HM2018 Abstract Number: 512

WITHOUT A SECOND TO LOSE – IMPROVING OUTCOMES AND MORTALITY IN NECROTIZING FASCIITIS OF THE HEAD AND NECK

Case Presentation: A 41-year-old female with a history of hypertension, depression, and alcohol abuse presented to the emergency department with right facial swelling and pain after biting her cheek the previous night. The patient first [...]

By | 2018-03-19T13:10:15+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on WITHOUT A SECOND TO LOSE – IMPROVING OUTCOMES AND MORTALITY IN NECROTIZING FASCIITIS OF THE HEAD AND NECK

HM2018 Abstract Number: 510

A CASE OF OMINOUS HICCUPS

Case Presentation: A 50-year-old man with a history of hypertension presented to the emergency department with a three-day history of nonstop hiccups. His systolic blood pressure was more than 200 and chest x-ray imaging was [...]

By | 2018-03-19T13:10:09+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A CASE OF OMINOUS HICCUPS

HM2018 Abstract Number: 669

FUROSEMIDE-INDUCED DRUG REACTION WITH EOSINOPHILIA AND SYSTEMIC SYMPTOMS (DRESS) SYNDROME, A RARE DRUG REACTION COMPLICATED BY STEROID-REFRACTORY AUTOIMMUNE HEMOLYTIC ANEMIA.

Case Presentation: The patient is a 29-year-old female with the history of acute pancreatitis and gastric bypass surgery, who initially presented with lower extremity swelling in the setting of hypoalbuminemia and protein-calorie malnutrition. She was [...]

By | 2018-03-19T13:10:08+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on FUROSEMIDE-INDUCED DRUG REACTION WITH EOSINOPHILIA AND SYSTEMIC SYMPTOMS (DRESS) SYNDROME, A RARE DRUG REACTION COMPLICATED BY STEROID-REFRACTORY AUTOIMMUNE HEMOLYTIC ANEMIA.

HM2018 Abstract Number: 780

PAINFUL OCULOMOTOR NERVE PALSY DUE TO TOLOSA-HUNT SYNDROME: A CASE REPORT AND REVIEW OF THE LITERATURE

Case Presentation: A 47-year-old male with a past medical history of Bell’s palsy, hypertension, end-stage renal disease on hemodialysis, papillary thyroid cancer s/p thyroidectomy, and post-surgical hypothyroidism presented with new-onset left sided ptosis, mydriasis and [...]

By | 2018-03-19T13:10:06+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on PAINFUL OCULOMOTOR NERVE PALSY DUE TO TOLOSA-HUNT SYNDROME: A CASE REPORT AND REVIEW OF THE LITERATURE

HM2018 Abstract Number: 759

REVERSIBLE VISUAL LOSS IN POSTERIOR REVERSIBLE LEUKOENCEPHALOPATHY SYNDROME

Case Presentation: A 60-year-old female with history of hypertension, rheumatoid arthritis on Adalimumab, and end stage renal disease (ESRD) due to lupus nephritis for which she was recently started on mycophenolate and high dose steroids, [...]

By | 2018-03-19T13:10:03+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on REVERSIBLE VISUAL LOSS IN POSTERIOR REVERSIBLE LEUKOENCEPHALOPATHY SYNDROME

HM2018 Abstract Number: 593

Atraumatic Chylous Pleural Effusion in a Young Female

Case Presentation: A 41-year-old female presented with non-productive cough and worsening exertional shortness of breath for 3 weeks. She denied fever, night sweats, orthopnea, paroxysmal nocturnal dyspnea. There was no history of recent travel, smoking, [...]

By | 2018-03-19T13:09:58+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Atraumatic Chylous Pleural Effusion in a Young Female

HM2018 Abstract Number: 713

A NEW DIAGNOSIS OF MELANOMA DIFFERENTIATION-ASSOCIATED PROTEIN 5 DERMATOMYOSITIS

Case Presentation: A 50 yo Hispanic male with a history of Diabetes Mellitus Type 2 and hypertension presented to our hospital with seven months of joint pain and ulcers of his metacarpals, 50-pound weight loss, [...]

By | 2018-03-19T13:09:54+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A NEW DIAGNOSIS OF MELANOMA DIFFERENTIATION-ASSOCIATED PROTEIN 5 DERMATOMYOSITIS

HM2018 Abstract Number: 511

CATASTROPHE AVERTED – THE IMPORTANCE OF EARLY DIAGNOSIS OF CATASTROPHIC ANTIPHOSPHOLIPID SYNDROME

Case Presentation: A 56-year-old Caucasian female with history of mechanical aortic and mitral valves on chronic warfarin therapy, atrial fibrillation, and questionable history of SLE was admitted to the intensive care unit for emergent splenectomy [...]

By | 2018-03-19T13:09:51+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on CATASTROPHE AVERTED – THE IMPORTANCE OF EARLY DIAGNOSIS OF CATASTROPHIC ANTIPHOSPHOLIPID SYNDROME

HM2018 Abstract Number: 374

WHEN A RASH ISN’T JUST A RASH – MULTICENTRIC CASTLEMAN DISEASE

Case Presentation: A 48-year-old African American male with history of AIDS on antiretroviral therapy and Pneumocystis jirovecii pneumonia (PJP) was admitted for a two-week history of shortness of breath and 20 pound unintentional weight loss. [...]

By | 2018-03-22T15:49:30+00:00 March 19th, 2018|Adult, Clinical Vignettes, Finalist Posters, Hospital Medicine 2018|Comments Off on WHEN A RASH ISN’T JUST A RASH – MULTICENTRIC CASTLEMAN DISEASE

HM2018 Abstract Number: 523

STRANGER THINGS: THE CONNECTION BETWEEN MINIMAL CHANGE DISEASE AND CHILDHOOD ASBESTOS EXPOSURE

Case Presentation: A 78 year old male with diabetes mellitus, smoking, cirrhosis due to nonalcoholic steatohepatitis, and recurrent left-sided pleural effusions presented with volume overload and oliguria. His serum creatinine had been stable at a [...]

By | 2018-03-19T13:09:39+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on STRANGER THINGS: THE CONNECTION BETWEEN MINIMAL CHANGE DISEASE AND CHILDHOOD ASBESTOS EXPOSURE

HM2018 Abstract Number: 506

SEVERE HYPONATREMIA PRECIPITATING A BRUGADA-PATTERN ON ELECTROCARDIOGRAPHY

Case Presentation: A 51 year old Haitian male with a history of hypertension and what he described as “low sodium” presented to the emergency room with 4 days of dizziness, frontal headache, and nausea preceded [...]

By | 2018-03-19T13:09:37+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on SEVERE HYPONATREMIA PRECIPITATING A BRUGADA-PATTERN ON ELECTROCARDIOGRAPHY

HM2018 Abstract Number: 574

TO METASTASIZE OR TO EMBOLIZE: A CASE OF VANISHING LIVER LESIONS

Case Presentation: A 52 year-old man was hospitalized for hypoxia one month after surgery for ruptured appendicitis. He also reported abdominal pain and steatorrhea along with a 50 pound weight loss in five months. On [...]

By | 2018-03-19T13:09:31+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on TO METASTASIZE OR TO EMBOLIZE: A CASE OF VANISHING LIVER LESIONS

HM2018 Abstract Number: 722

DOUBLE AUDITORY TROUBLE: A CASE OF MALIGNANT OTITIS EXTERNA SUPERIMPOSED ON RAMSAY-HUNT SYNDROME

Case Presentation: A 84 year old Caucasian male with history of type 2 diabetes mellitus presented to the emergency room with left facial droop. He reported 1 week of left ear pain which progressed to [...]

By | 2018-03-19T13:09:29+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on DOUBLE AUDITORY TROUBLE: A CASE OF MALIGNANT OTITIS EXTERNA SUPERIMPOSED ON RAMSAY-HUNT SYNDROME

HM2018 Abstract Number: 501

PORTAL VEIN THROMBOSIS IN THE ABSENCE OF CIRRHOSIS: MAKING THE CASE FOR FACTOR VIII

Case Presentation: A 32 year old female with Systemic Lupus Erythematosus (malar rash, discoid lupus erythematosus, alopecia) presented with sepsis following a trans-jugular liver biopsy, which was obtained due to chronic transaminitis, thrombocytopenia, hypoalbuminemia, and [...]

By | 2018-03-19T13:09:27+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on PORTAL VEIN THROMBOSIS IN THE ABSENCE OF CIRRHOSIS: MAKING THE CASE FOR FACTOR VIII

HM2018 Abstract Number: 732

METHIMAZOLE INDUCED PANCREATITIS

Case Presentation: A 41-year-old female presented with symptoms of abdominal pain, nausea, and vomiting one week after starting Methimazole 10 mg daily for Graves’ disease. She had no prior history of alcohol use or cholelithiasis. [...]

By | 2018-03-19T13:09:25+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on METHIMAZOLE INDUCED PANCREATITIS

HM2018 Abstract Number: 799

PPI-INDUCED HYPOCALCEMIA IN A WOMAN WITH IATROGENIC HYPOTHYROIDISM

Case Presentation: A 58-year-old woman with a past medical history notable for thyroid cancer status-post thyroidectomy complicated by hypoparathyrodism presented with muscle spasms in her hands and feet for two days. Four days prior to [...]

By | 2018-03-19T13:09:23+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on PPI-INDUCED HYPOCALCEMIA IN A WOMAN WITH IATROGENIC HYPOTHYROIDISM

HM2018 Abstract Number: 461

WHEN THE BODY SHAKES, THE HEART BREAKS: A RARE CASE OF GENERALIZED TONIC CLONIC SEIZURE RESULTING IN TAKOTSUBO CARDIOMYOPATHY

Case Presentation: A 64-year-old Caucasian female patient with no significant medical history came to medical attention in December 2016 with an episode of generalized tonic clonic seizure. On admission, review of systems, vital signs and [...]

By | 2018-03-19T13:09:11+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on WHEN THE BODY SHAKES, THE HEART BREAKS: A RARE CASE OF GENERALIZED TONIC CLONIC SEIZURE RESULTING IN TAKOTSUBO CARDIOMYOPATHY

HM2018 Abstract Number: 898

NOT YOUR AVERAGE DVT: A CASE OF MAY-THURNER SYNDROME

Case Presentation: Fifty-six year old Caucasian male with a past medical history of coronary artery disease status post nineteen stents as well as coronary artery bypass graft, hypertension, hyperlipidemia, obstructive sleep apnea presented to the [...]

By | 2018-03-19T13:09:05+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on NOT YOUR AVERAGE DVT: A CASE OF MAY-THURNER SYNDROME

HM2018 Abstract Number: 389

DOC, I CANNOT HEAR! A RARE CAUSE OF SUDDEN HEARING LOSS IN A YOUNG WOMAN.

Case Presentation: 27-year-old African American woman with no medical history presented with one day of sudden onset bilateral hearing loss and tinnitus. Review of systems was positive for red eyes, blurred vision, photophobia and gait [...]

By | 2018-03-22T15:50:13+00:00 March 19th, 2018|Adult, Clinical Vignettes, Finalist Posters, Hospital Medicine 2018|Comments Off on DOC, I CANNOT HEAR! A RARE CAUSE OF SUDDEN HEARING LOSS IN A YOUNG WOMAN.

HM2018 Abstract Number: 499

STEMI IN A YOUNG MALE AFTER USE OF SYNEPHRINE CONTAINING DIETARY SUPPLEMENT

Case Presentation: A twenty-two-year-old male with no significant past medical history who presented with chest pain and found to have ST-segment elevation in leads II, III, aVF and V4-V6 leads. On subsequent EKG’s, patient had [...]

By | 2018-03-19T13:08:59+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on STEMI IN A YOUNG MALE AFTER USE OF SYNEPHRINE CONTAINING DIETARY SUPPLEMENT

HM2018 Abstract Number: 709

LINEZOLID AS CONTRIBUTING FACTOR IN TACROLIMUS ASSOCIATED POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME

Case Presentation: A 63-year-old woman woman presented after multiple episodes of seizure. She had no prior history of seizures or alcoholism. The patient had a deceased donor renal transplant 6 months prior complicated by persistent [...]

By | 2018-03-19T13:08:55+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on LINEZOLID AS CONTRIBUTING FACTOR IN TACROLIMUS ASSOCIATED POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME

HM2018 Abstract Number: 865

Rare presentation of Natural Killer/T cell lymphoma as acquired angioedema

Case Presentation: A 22 year old man, originally from Guatemala, presented with recurrent episodes of right sided facial swelling associated with superficial oral ulcers and change in voice. He did not have any family history [...]

By | 2018-03-19T13:08:53+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Rare presentation of Natural Killer/T cell lymphoma as acquired angioedema

HM2018 Abstract Number: 719

Fever of unknown origin due to disseminated BCG infection involving the eye and kidney: a case report

Case Presentation: A 69 year-old man with history of high-grade invasive urothelial bladder cancer post tumor resection on Bacillus Calmette-Guérin (BCG) treatment and renal cell carcinoma post left partial nephrectomy presented with high-grade fever, night [...]

By | 2018-03-19T13:08:51+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Fever of unknown origin due to disseminated BCG infection involving the eye and kidney: a case report

HM2018 Abstract Number: 486

HYDRALAZINE INDUCED ANTINEUTROPHIL CYTOPLASMIC ANTIBODY-ASSOCIATED VASCULITIS WITH ACUTE TUBULOINTERSTITIAL NEPHRITIS: A RARE CONSTELLATION

Case Presentation: Introduction: Hydralazine is an adjunctive antihypertensive medication that is associated with antineutrophil cytoplasmic antibody (ANCA) - associated vasculitis. Kidney involvement usually comprises a pauci-immune, necrotizing glomerulonephritis with crescents. We describe a rare case [...]

By | 2018-03-19T13:08:49+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on HYDRALAZINE INDUCED ANTINEUTROPHIL CYTOPLASMIC ANTIBODY-ASSOCIATED VASCULITIS WITH ACUTE TUBULOINTERSTITIAL NEPHRITIS: A RARE CONSTELLATION

HM2018 Abstract Number: 496

What’s in a headache? The unmasking of silent cerebral infarction

Case Presentation: A 31 year old woman with sickle cell disease (SCD), homozygous SS variant, reported infrequent bony vaso-occlusive crises, necessitating the use of ibuprofen at times, when she presented for a routine clinic visit. [...]

By | 2018-03-19T13:08:43+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on What’s in a headache? The unmasking of silent cerebral infarction

HM2018 Abstract Number: 839

Idiopathic Intracranial Hypertension from an elemental cause

Case Presentation: An 18-year-old female with bipolar disorder on Quetiapine and Lithium (started approximately 1 month prior) presents with two weeks of bilateral retrobulbar headache, photophobia, transient blurry vision with diplopia, and posterior neck pain. [...]

By | 2018-03-19T13:08:41+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Idiopathic Intracranial Hypertension from an elemental cause

HM2018 Abstract Number: 856

VANCOMYCIN-INDUCED FIXED DRUG ERUPTION: A RARE CUTANEOUS REACTION

Case Presentation: A 29 year old man with a history of uncontrolled type 1 diabetes and skin picking disorder presented with cellulitis and abscess of the left ankle. He had multiple prior admissions for similar [...]

By | 2018-03-19T13:08:37+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on VANCOMYCIN-INDUCED FIXED DRUG ERUPTION: A RARE CUTANEOUS REACTION

HM2018 Abstract Number: 716

ALECT2: CAUTIONARY TALE IN RENAL AMYLOIDOSIS

Case Presentation: A 64-year-old Pakistani man was referred to nephrology clinic for evaluation of progressive kidney disease. Relevant medical history included well-controlled type 2 diabetes mellitus, gout and hypertension. Six months prior to presentation his [...]

By | 2018-03-19T13:08:35+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on ALECT2: CAUTIONARY TALE IN RENAL AMYLOIDOSIS

HM2018 Abstract Number: 559

The Dangers of Herbal Supplements: A Case of Acute Liver Injury From Fenugreek

Case Presentation: A 34 year-old female without medical history who had an uncomplicated vaginal delivery 3 months prior presented with acute onset right upper quadrant abdominal pain and several episodes of emesis. The patient took [...]

By | 2018-03-19T13:08:33+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on The Dangers of Herbal Supplements: A Case of Acute Liver Injury From Fenugreek

HM2018 Abstract Number: 711

PERSISTENT BACTEREMIA UNMASKING AN INFECTED ANEURYSM IN THE LEFT ATRIOVENTRICULAR GROOVE

Case Presentation: A 63 year old female with history of renal cell carcinoma status post nephrectomy, end stage renal diseases on hemodialysis via permacath, hypertension, stroke with right-sided weakness, bilateral blindness from glaucoma and corneal [...]

By | 2018-03-19T13:08:29+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on PERSISTENT BACTEREMIA UNMASKING AN INFECTED ANEURYSM IN THE LEFT ATRIOVENTRICULAR GROOVE

HM2018 Abstract Number: 437

HUMAN RHINOVIRUSES, NOT AS BENIGN AS WE THINK.

Case Presentation: An 81-year old male with a significant medical history of essential hypertension, type 2 diabetes mellitus and coronary artery disease, was admitted to the hospital complaining productive cough, shortness of breath and pleuritic [...]

By | 2018-03-19T13:08:27+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on HUMAN RHINOVIRUSES, NOT AS BENIGN AS WE THINK.

HM2018 Abstract Number: 482

Don’t go chasing waterfalls An unusual cause of diarrhea in a returning traveler

Case Presentation: A 29-year-old woman presented with a 4-day history of nausea, vomiting, and watery, non-bloody diarrhea. She also had fever, headache, and dark urine. She had traveled to Puerto Rico one-week prior, where she [...]

By | 2018-03-19T13:08:21+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Don’t go chasing waterfalls An unusual cause of diarrhea in a returning traveler

HM2018 Abstract Number: 487

PLEURAL EFFUSION WITH ELECTRONIC CIGARETTE USE: A NOT-SO-SAFE ALTERNATIVE TO TOBACCO

Case Presentation: A 63-year-old male presented to our institution with progressive dyspnea and associated hemoptysis of several days duration. He was a former cigarette smoker, having smoked approximately 1 pack per day for 45 years, [...]

By | 2018-03-19T13:08:19+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on PLEURAL EFFUSION WITH ELECTRONIC CIGARETTE USE: A NOT-SO-SAFE ALTERNATIVE TO TOBACCO

HM2018 Abstract Number: 671

NON-SURGICAL PNEUMOPERITONEUM SECONDARY TO GRAM NEGATIVE SEPSIS, A RARE CASE REPORT

Case Presentation: An 87-year-old Caucasian male with a history of benign prostatic hyperplasia presented to the hospital with urinary incontinence, abdominal discomfort, and altered mentation. The patient required hospitalization for worsening symptoms. On admission, he [...]

By | 2018-03-19T13:08:15+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on NON-SURGICAL PNEUMOPERITONEUM SECONDARY TO GRAM NEGATIVE SEPSIS, A RARE CASE REPORT

HM2018 Abstract Number: 843

PRIMARY CEREBRAL NOCARDIA TRANSVALENSIS IN AN IMMUNOCOMPETENT PATIENT: A FIRST IN THE UNITED STATES

Case Presentation: Nocardia cerebral abscesses are uncommon, constituting 1-2% of all cerebral abscesses, with a mortality 3 times higher than other bacterial abscesses. Here we discuss the first reported case of a primary brain abscess [...]

By | 2018-03-19T13:08:07+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on PRIMARY CEREBRAL NOCARDIA TRANSVALENSIS IN AN IMMUNOCOMPETENT PATIENT: A FIRST IN THE UNITED STATES

HM2018 Abstract Number: 805

Varenicline induced seizure in a 29-year-old female switching from bupropion to varenicline for smoking cessation: A-case report

Case Presentation: A 29-year-old female with history of hypothyroidism, Bipolar affective disorder, tobacco use disorder and old head trauma with face reconstruction in 2004 who presented with a first-time seizure. She was trying to quit [...]

By | 2018-03-19T13:08:03+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Varenicline induced seizure in a 29-year-old female switching from bupropion to varenicline for smoking cessation: A-case report

HM2018 Abstract Number: 778

LOOSING BLOOD VESSEL BY TREATING BLOOD PRESSURE!

Case Presentation: A 74-year-old African-American woman presented to our Emergency Department with hemoptysis and severe respiratory distress. Two weeks prior to presentation, she was admitted with persistent cough and blood streaked sputum of 1-month duration [...]

By | 2018-03-19T13:07:55+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on LOOSING BLOOD VESSEL BY TREATING BLOOD PRESSURE!

HM2018 Abstract Number: 831

HYDRALAZINE INDUCED ANCA ASSOCIATED VASCULITIS IN AN OCTOGENARIAN PATIENT

Case Presentation: 80-year-old man with a history of hypertension, atrial fibrillation, chronic kidney disease, multiple strokes with mild residual expressive aphasia and right hemiparesis presented with one week of dyspnea, fatigue and two days of [...]

By | 2018-03-19T13:07:53+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on HYDRALAZINE INDUCED ANCA ASSOCIATED VASCULITIS IN AN OCTOGENARIAN PATIENT

HM2018 Abstract Number: 842

MORE THAN MUSCULAR WEAKNESS: MYOTONIC DYSTROPHY AS A SEVERE MULTI-ORGAN DISORDER

Case Presentation: A 48 year-old male initially presented to an outside hospital with 2 days of cough and lethargy. He was commenced on antibiotic treatment for pneumonia and also found to be rhinovirus positive. While [...]

By | 2018-03-19T13:07:51+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on MORE THAN MUSCULAR WEAKNESS: MYOTONIC DYSTROPHY AS A SEVERE MULTI-ORGAN DISORDER

HM2018 Abstract Number: 635

AN EXOTIC MYCOTIC

Case Presentation: A previously healthy 39-year-old male with a bicuspid aortic valve and mitral valve prolapse presented with three months of intermittent bilateral retro-orbital headache, abdominal discomfort, subjective fevers, night sweats, and 10-kg weight loss. [...]

By | 2018-03-19T13:07:45+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on AN EXOTIC MYCOTIC

HM2018 Abstract Number: 483

HAART Attack: Diagnosing Fever in HIV

Case Presentation: A 41-year-old man with recently diagnosed HIV/AIDS and Pneumocystis jirovecii pneumonia (PCP) was admitted with 5-day history of fever, throat pain, headache, and dry cough. Six weeks prior to admission, the workup was [...]

By | 2018-03-19T13:07:43+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on HAART Attack: Diagnosing Fever in HIV

HM2018 Abstract Number: 681

SEIZURE AS A PRESENTING SYMPTOM OF VITAMIN B12 DEFICIENCY: A CASE REPORT

Case Presentation: A 79-year-old male presented to the emergency department after a witnessed episode of unresponsiveness, jerking motions, urinary incontinence and post-ictal confusion. The patient’s wife denied a history of epilepsy but reported several months [...]

By | 2018-03-19T13:07:39+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on SEIZURE AS A PRESENTING SYMPTOM OF VITAMIN B12 DEFICIENCY: A CASE REPORT

HM2018 Abstract Number: 834

A RARE CAUSE OF A HEART ATTACK: A CASE REPORT OF ATRIAL FIBRILLATION CAUSING MYOCARDIAL INFARCTION

Case Presentation: A 58-year-old obese African American man, non-smoker with past medical history of hypertension and atrial fibrillation (on Coumadin) presents to our emergency room with chest pain. Patient describes the pain as acute onset, [...]

By | 2018-03-19T13:07:37+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A RARE CAUSE OF A HEART ATTACK: A CASE REPORT OF ATRIAL FIBRILLATION CAUSING MYOCARDIAL INFARCTION

HM2018 Abstract Number: 660

AORTIC THROMBOSIS WITH MULTI-ORGAN EMBOLI: COMPLICATION OF CONCOMITANT COCAINE AND K2 ABUSE

Case Presentation: A 54 year old woman with history of substance abuse(cocaine and recent synthetic marijuana use) presented to the emergency room with complaints of sudden onset, severe left upper and lower quadrant abdominal pain. [...]

By | 2018-03-19T13:07:35+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on AORTIC THROMBOSIS WITH MULTI-ORGAN EMBOLI: COMPLICATION OF CONCOMITANT COCAINE AND K2 ABUSE

HM2018 Abstract Number: 438

Histo Can’t Hide: A Case of Severe Disseminated Histoplasmosis

Case Presentation: Disseminated histoplasmosis occurs in about one in two thousand patients affected with acute infection. In most immune competent hosts, histoplasmosis is a self-limited disease contained by our cellular immunity. Disseminated histoplasmosis is seen [...]

By | 2018-03-19T13:07:33+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Histo Can’t Hide: A Case of Severe Disseminated Histoplasmosis

HM2018 Abstract Number: 520

HIV-Associated Cerebral Aneurysms: A Case Report of an Incidental Finding

Case Presentation: A 28 year-old woman with AIDS and a CD4 count of 178 cells/mm3, not on antiretroviral therapy, presented with odynophagia for 2 weeks as well as increased swelling in her neck and inguinal [...]

By | 2018-03-19T13:07:31+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on HIV-Associated Cerebral Aneurysms: A Case Report of an Incidental Finding

HM2018 Abstract Number: 863

A CASE OF DISSEMINATED GONOCOCCAL INFECTION IN A PATIENT WITH SEVERE SYSTEMIC LUPUS ERYTHEMATOSUS, LUPUS NEPHRITIS

Case Presentation: A 31-year-old woman with systemic lupus erythematosus (SLE) with Class IV lupus nephritis presented to the emergency department (ED) from the shelter two weeks after completing induction therapy with cyclophosphamide with a complaint [...]

By | 2018-03-19T13:07:27+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A CASE OF DISSEMINATED GONOCOCCAL INFECTION IN A PATIENT WITH SEVERE SYSTEMIC LUPUS ERYTHEMATOSUS, LUPUS NEPHRITIS

HM2018 Abstract Number: 611

KISS OF DEATH: A CASE OF EPSTEIN-BARR VIRUS INDUCED HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS

Case Presentation: A 19 year old male with no significant medical history presented to the emergency department with one week of fatigue and 2 days of jaundice. He noted new nosebleeds, new shortness of breath [...]

By | 2018-03-19T13:07:25+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on KISS OF DEATH: A CASE OF EPSTEIN-BARR VIRUS INDUCED HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS

HM2018 Abstract Number: 700

TOO FAST TOO FURIOUS

Case Presentation: A 70 year-old woman with hyperthyroidism, hypertension and diabetes presented with subacute progressive altered mental status and frequent falls. History obtained from family revealed a previously independently functioning woman until 4 months prior, [...]

By | 2018-03-19T13:07:21+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on TOO FAST TOO FURIOUS

HM2018 Abstract Number: 687

NEPHRITIC-NEPHROTIC SYNDROME ASOCIATION WITH BK VIRUS INFECTION

Case Presentation: A 69-year-old Africa-America female presented with one month of worsening bilateral lower extremity swelling/edema. She was nonoliguric. She denied chest pain, orthopnea or dysuria. The patient was diagnosed with adult T-cell leukemia/lymphoma two [...]

By | 2018-03-19T13:07:17+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on NEPHRITIC-NEPHROTIC SYNDROME ASOCIATION WITH BK VIRUS INFECTION

HM2018 Abstract Number: 584

Code STEMI! A unique case of Thrombosed coronary artery aneurysm in an adult patient with undiagnosed Kawasaki disease as a child.

Case Presentation: A 24-year-old man without significant past medical history presented to the hospital by EMS after a syncopal event at the gym while running on a treadmill. On admission, a routine syncope work-up was [...]

By | 2018-03-19T13:07:14+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Code STEMI! A unique case of Thrombosed coronary artery aneurysm in an adult patient with undiagnosed Kawasaki disease as a child.

HM2018 Abstract Number: 747

A DOCTOR’S OBJECTIVE – “BE GOOD AND DO GOOD”

Case Presentation: A 44-year-old male with a medical history of active injection drug use (IDU) and three prior admissions for native mitral valve endocarditis was admitted to the hospital for sepsis. On physical examination, the patient had JVP [...]

By | 2018-03-19T13:07:08+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A DOCTOR’S OBJECTIVE – “BE GOOD AND DO GOOD”

HM2018 Abstract Number: 616

MALE GYNECOMASTIA: A RARE CASE OF FEMINIZING ADRENAL CORTICAL CARCINOMA

Case Presentation: A 55-year old man with a history of hypertension presented to the hospital with pleuritic left chest pain for 1 day and enlarging bilateral breasts for 2 months. Initial vital signs were notable [...]

By | 2018-03-19T13:07:02+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on MALE GYNECOMASTIA: A RARE CASE OF FEMINIZING ADRENAL CORTICAL CARCINOMA

HM2018 Abstract Number: 615

The use of Nalbuphine in the treatment of opioid-induced urinary retention

Case Presentation: Urinary retention affects 4.5% and 0.07% of hospitalized men and women, respectively (Verhamme et al, 2008). The causes vary widely; however, it may occur as a result of opioid use. Opioid-induced urinary retention [...]

By | 2018-03-19T13:07:00+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on The use of Nalbuphine in the treatment of opioid-induced urinary retention

HM2018 Abstract Number: 634

CLOT CRISIS: A CASE OF BILATERAL CENTRAL RETINAL ARTERY OCCLUSION FROM CATASTROPHIC ANTIPHOSPHOLIPID SYNDROME

Case Presentation: Twenty three year old female presented with complaints of severe headache and dizziness since past 2 weeks. Her past medical history was significant for SLE, heart failure with reduced ejection fraction and lupus [...]

By | 2018-03-19T13:06:56+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on CLOT CRISIS: A CASE OF BILATERAL CENTRAL RETINAL ARTERY OCCLUSION FROM CATASTROPHIC ANTIPHOSPHOLIPID SYNDROME

HM2018 Abstract Number: 917

A BAD BITE: CAT BITE AS A RARE CAUSE OF THROMBOCYTOPENIC THROMBOTIC PURPURA (TTP)

Case Presentation: A 76-year-old female presented with generalized fatigue and purpuric rash over her left arm and both lower extremities. She also gives a history of cat bite 1 week back for which she did [...]

By | 2018-03-19T13:06:50+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A BAD BITE: CAT BITE AS A RARE CAUSE OF THROMBOCYTOPENIC THROMBOTIC PURPURA (TTP)

HM2018 Abstract Number: 846

QUERY FEVER- STILL QUESTIONABLY UNDERESTIMATED CAUSE OF ZOONOTIC FEVER

Case Presentation: 19-year-old slaughterhouse worker from Pennsylvania presented to the hospital with recurrent episodes of fever, myalgias, dysphagia, headache, and diarrhea. He denied recent travel, tick bites and sick contacts. He was febrile at 102.6F [...]

By | 2018-03-19T13:06:46+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on QUERY FEVER- STILL QUESTIONABLY UNDERESTIMATED CAUSE OF ZOONOTIC FEVER

HM2018 Abstract Number: 436

Infective endocarditis in a patient with monoclonal gammopathy membranoproliferative glomerulonephritis

Case Presentation: 54 years old man with a history of hypertension was hospitalized due to elevated BUN/creatinine of 33/4.6 mg/dL and Hb of 9.9 mg/dL (baseline 15). He endorsed dyspnea on exertion, anorexia and weight [...]

By | 2018-03-19T13:06:40+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Infective endocarditis in a patient with monoclonal gammopathy membranoproliferative glomerulonephritis

HM2018 Abstract Number: 605

DON’T ACCUSE THE LIVER: AN ELUSIVE, OCCLUSIVE CASE OF ENCEPHALOPATHY

Case Presentation: A hospitalized 71-year-old female became acutely encephalopathic after an esophagogastroduodenoscopy under conscious sedation which was performed to evaluate a chronic esophageal ulcer and other potential causes of dysphagia. Her past medical history was [...]

By | 2018-03-19T13:06:30+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on DON’T ACCUSE THE LIVER: AN ELUSIVE, OCCLUSIVE CASE OF ENCEPHALOPATHY

HM2018 Abstract Number: 619

A Diagnostic Delay: Consequences of HIV screening limitations.

Case Presentation: A 22 year old man with no past medical history presented to our emergency department with three weeks of nausea, vomiting and abdominal pain. He also reported subjective fevers, hematochezia, hematemesis, oral ulcers, [...]

By | 2018-03-19T13:06:22+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A Diagnostic Delay: Consequences of HIV screening limitations.

HM2018 Abstract Number: 702

FAILURE TO THRIVE, AT A ‘CROSSROAD’

Case Presentation: A 58-year-old Caucasian man with Stage I pancreatic cancer, who underwent Whipple procedure, now presents with 50 pound weight loss over 11 months, abdominal pain, diarrhea, and failure to thrive. The patient’s symptoms [...]

By | 2018-03-19T13:06:20+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on FAILURE TO THRIVE, AT A ‘CROSSROAD’

HM2018 Abstract Number: 820

AORTIC VALVE PAPILLARY FIBROELASTOMA PRESENTING AS RECURRENT CEREBROVASCULAR ACCIDENT

Case Presentation: Patient is a 63 year old female with medical history of migraines and a right corona radiata infarct diagnosed about a year prior who presented to the emergency department with slurred speech, left [...]

By | 2018-03-19T13:06:18+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on AORTIC VALVE PAPILLARY FIBROELASTOMA PRESENTING AS RECURRENT CEREBROVASCULAR ACCIDENT

HM2018 Abstract Number: 811

“MY THYROID CAUSED THE STROKE”: A CASE OF HYPERTHYROIDISM TRIGGERING A STROKE IN PATIENT WITH MOYAMOYA DISEASE

Case Presentation: Stroke in young patients are fortunately less common but have a disproportionately large economic and healthcare impact by leaving the victims disabled before their most productive years. Here we present a case of [...]

By | 2018-03-19T13:06:16+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on “MY THYROID CAUSED THE STROKE”: A CASE OF HYPERTHYROIDISM TRIGGERING A STROKE IN PATIENT WITH MOYAMOYA DISEASE

HM2018 Abstract Number: 552

TERIFLUNAMIDE INDUCED CLOSTRIDIUM DIFFICILE SEPSIS: A RARE ADVERSE REACTION WITH AN INTERESTING SOLUTION

Case Presentation: Teriflunomide is a pyrimidine synthesis inhibitor used in management of Relapsing Remitting Multiple Sclerosis (RRMS). Leflunomide is the active agent which has been used in rheumatoid arthritis. Chronic diarrhea has been associated with [...]

By | 2018-03-19T13:06:14+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on TERIFLUNAMIDE INDUCED CLOSTRIDIUM DIFFICILE SEPSIS: A RARE ADVERSE REACTION WITH AN INTERESTING SOLUTION

HM2018 Abstract Number: 633

AN UNEXPECTED CRISIS: A RARE CASE REPORT OF CARCINOID CRISIS IN A LUNG NEUROENDOCRINE TUMOR

Case Presentation: 63-year-old woman with 80-pack year smoking history presented with right flank pain for two days and weight loss of 35lbs in 6 months. Chest X-ray as a part of the workup was found [...]

By | 2018-03-19T13:06:12+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on AN UNEXPECTED CRISIS: A RARE CASE REPORT OF CARCINOID CRISIS IN A LUNG NEUROENDOCRINE TUMOR

HM2018 Abstract Number: 551

A DIAGNOSTIC CONUNDRUM: PARANEOPLASTIC SWEET’S SYNDROME MASQUERADING AS NECROTIZING FASCIITIS IN MULTIPLE MYELOMA

Case Presentation: The patient was a 57 year old male with IgG lambda MM (Multiple Myeloma) without remission after autologous hematopoietic stem cell transplant. One month after transplantation, he developed erythematous right flank swelling, high [...]

By | 2018-03-19T13:06:08+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A DIAGNOSTIC CONUNDRUM: PARANEOPLASTIC SWEET’S SYNDROME MASQUERADING AS NECROTIZING FASCIITIS IN MULTIPLE MYELOMA

HM2018 Abstract Number: 464

TUMOR LYSIS SYNDROME AFTER HEPATIC ARTERY EMBOLIZATION IN A PATIENT WITH NEUROENDOCRINE CANCER OF UNKNOWN PRIMARY

Case Presentation: A 60-year-old male patient who presented with hemoptysis 1-year prior, was found to have sub-centimeter lung nodules and multiple liver lesions on CT chest. The largest hepatic lesion on abdominal MRI was 3.2 [...]

By | 2018-03-19T13:06:06+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on TUMOR LYSIS SYNDROME AFTER HEPATIC ARTERY EMBOLIZATION IN A PATIENT WITH NEUROENDOCRINE CANCER OF UNKNOWN PRIMARY

HM2018 Abstract Number: 728

A RENAL INFARCT IN DISGUISE

Case Presentation: A 37 year-old female with history of menorrhagia on oral contraceptives (OCP) for 2 months, presented with abrupt onset of right lower quadrant abdominal pain (RLQ) for 1 day. Pain was 10/10, constant, [...]

By | 2018-03-19T13:06:02+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A RENAL INFARCT IN DISGUISE

HM2018 Abstract Number: 588

A ZEBRA OF A ZEBRA

Case Presentation: A 48-year-old female with no significant medical history presented to an outside hospital with epigastric pain of 3 weeks duration. The pain was constant and severe, associated with nausea, vomiting and a 20 [...]

By | 2018-03-19T13:05:56+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A ZEBRA OF A ZEBRA

HM2018 Abstract Number: 458

LET IT HEAL SPONTANEOUSLY; A CASE OF SPONTANEOUS CORONARY ARTERY DISSECTION

Case Presentation: A 40 year old woman (G4P4A0) with hypertension and hypothyroidism presented with sudden onset, severe, substernal chest pain while lifting heavy garbage bag. She was diagnosed with NSTEMI in the context of typical [...]

By | 2018-03-19T13:05:55+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on LET IT HEAL SPONTANEOUSLY; A CASE OF SPONTANEOUS CORONARY ARTERY DISSECTION

HM2018 Abstract Number: 488

SQUAMOUS CELL CARCINOMA OF THE LUNG WITH PITUITARY METASTASIS: A HEADACHE FOR PATIENTS AND PHYSICIANS

Case Presentation: A 75-year-old male presented to our institution with lethargy and unremitting headache of several weeks duration. His history was significant for squamous cell carcinoma of the lung status post lobectomy with recurrence 4 [...]

By | 2018-03-19T13:05:50+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on SQUAMOUS CELL CARCINOMA OF THE LUNG WITH PITUITARY METASTASIS: A HEADACHE FOR PATIENTS AND PHYSICIANS

HM2018 Abstract Number: 494

WHY ARE MY ARMS PURPLE?

Case Presentation: A 68-year-old man presented with dyspnea, wheezing and productive cough. He was hypoxemic and a chest radiograph revealed a left lower lobe infiltrate and he was admitted with a Chronic Obstructive Pulmonary Disease [...]

By | 2018-03-19T13:05:40+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on WHY ARE MY ARMS PURPLE?

HM2018 Abstract Number: 553

BeWARe of Skin Necrosis

Case Presentation: A 56-year-old female with a history of a deep vein thrombosis (DVT) during pregnancy and dementia presented with dyspnea and acute hypoxemia. Shortly thereafter, she developed persistent fevers and acute encephalopathy. Initial testing, [...]

By | 2018-03-19T13:05:38+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on BeWARe of Skin Necrosis

HM2018 Abstract Number: 460

PARANEOPLASTIC GASTROPARESIS: AN UNUSUAL PRESENTATION OF AN OCCULT LUNG CARCINOMA

Case Presentation: A 61-year-old African American man with no significant medical history came to medical attention in December 2016 with severe post prandial bloating and vomiting for 2 months. On admission, vital signs and physical [...]

By | 2018-03-19T13:05:34+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on PARANEOPLASTIC GASTROPARESIS: AN UNUSUAL PRESENTATION OF AN OCCULT LUNG CARCINOMA

HM2018 Abstract Number: 546

ICE ICE BABY: A CALL FOR STANDARDIZATION OF CRYOGLOBULIN LAB COLLECTION

Case Presentation: An 18 year old male with Diabetes Mellitus 1 was admitted for management of painful foot ulcerations after having submerged his feet daily in 20 hour ice baths for relief of chronic foot [...]

By | 2018-03-19T13:05:28+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on ICE ICE BABY: A CALL FOR STANDARDIZATION OF CRYOGLOBULIN LAB COLLECTION

HM2018 Abstract Number: 929

LIVER LACERATION AS A COMPLICATION OF CPR IN AN ALCOHOLIC PATIENT WITH HEPATOMEGALY

Case Presentation: A 29-year-old Caucasian woman with chronic alcohol abuse presented to the emergency department with a 1-day history of confusion, epigastric pain and dyspnea following excessive alcohol ingestion for 3 days. Vital signs were [...]

By | 2018-03-19T13:05:24+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on LIVER LACERATION AS A COMPLICATION OF CPR IN AN ALCOHOLIC PATIENT WITH HEPATOMEGALY

HM2018 Abstract Number: 459

TRUE OR FALSE? A CASE OF LEFT VENTRICULAR ANEURYSM

Case Presentation: A 44-year-old man with no known medical conditions presented with acute, painless, left monocular blurred vision. There was no history of smoking or illicit drug use. Physical examination indicated blood pressure of 200/135 [...]

By | 2018-03-19T13:05:22+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on TRUE OR FALSE? A CASE OF LEFT VENTRICULAR ANEURYSM

HM2018 Abstract Number: 443

‘Dark cloud before a thunderstorm’- A tricky diagnosis of malignant peritoneal mesothelioma.

Case Presentation: A 58 year old female with past medical history of microcytic hypochromic anemia and thrombocytosis presented with progressive abdominal distention and pedal edema of 5 months duration. There was no significant history of [...]

By | 2019-03-11T16:20:34+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on ‘Dark cloud before a thunderstorm’- A tricky diagnosis of malignant peritoneal mesothelioma.

HM2018 Abstract Number: 730

SHORTNESS OF BREATH – A CRITICAL CAUSE OBFUSCATED BY COMORBIDITIES

Case Presentation: A 47-year-old woman presented with two days of shortness of breath and hemoptysis following two weeks of nonproductive cough. Associated symptoms included bilateral lower extremity edema and malaise. She was a nursing home [...]

By | 2018-03-19T13:05:16+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on SHORTNESS OF BREATH – A CRITICAL CAUSE OBFUSCATED BY COMORBIDITIES

HM2018 Abstract Number: 442

DIABETIC KETOACIDOSIS TRIGGERED BY PEMBROLIZUMAB IN A PATIENT WITH BLADDER CANCER

Case Presentation: We are presenting a case of a 71-year-old male patient with a history of hypertension, non-insulin dependent type 2 diabetes mellitus (DM) well controlled on metformin, and non-invasive high grade urothelial bladder cancer [...]

By | 2018-03-19T13:05:06+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on DIABETIC KETOACIDOSIS TRIGGERED BY PEMBROLIZUMAB IN A PATIENT WITH BLADDER CANCER

HM2018 Abstract Number: 930

MYASTHENIA GRAVIS THAT MIMICS PRESENTATION OF CEREBRAL VASCULAR ACCIDENT

Case Presentation: An 88-year-old Japanese female with a history of treated breast cancer, palate squamous cell carcinoma and meningioma presented with acute on subacute worsening of left-sided facial droop, dysarthria, and dysphagia. Two weeks prior to admission, [...]

By | 2018-03-19T13:04:58+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on MYASTHENIA GRAVIS THAT MIMICS PRESENTATION OF CEREBRAL VASCULAR ACCIDENT

HM2018 Abstract Number: 670

PHILADELPHIA CHROMOSOME POSITIVE T-CELL ACUTE LYMPHOBLASTIC LEUKEMIA VERSUS T CELL LYMPHOBLASTIC CRISES OF CHRONIC MYELOID LEUKEMIA: A DIAGNOSTIC DILEMMA!

Case Presentation: A 59 year old man with no past history presented with continuous gingival bleeding for 3 days. He underwent dental cleaning and tooth extraction 3 days prior and since then had been having [...]

By | 2018-03-19T13:04:56+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on PHILADELPHIA CHROMOSOME POSITIVE T-CELL ACUTE LYMPHOBLASTIC LEUKEMIA VERSUS T CELL LYMPHOBLASTIC CRISES OF CHRONIC MYELOID LEUKEMIA: A DIAGNOSTIC DILEMMA!

HM2018 Abstract Number: 548

Multiple Sclerosis and Dysphagia: When the Truth is Tough to Swallow

Case Presentation: A 37-year-old female veterinarian with past medical history of migraines was diagnosed with multiple sclerosis (MS) in December 2015. In April 2016, she was admitted with 3weeks of progressive dysphagia and 20lb weight [...]

By | 2018-03-19T13:04:50+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Multiple Sclerosis and Dysphagia: When the Truth is Tough to Swallow

HM2018 Abstract Number: 554

FOOLED BY FAT: A DELAY IN APPROPRIATE TRIAGING IN HYPERTRIGLYCERIDEMIA-INDUCED PANCREATITIS

Case Presentation: A thirty-four year-old man with a past medical history of hyperlipidemia initially presented with sharp, ten-out-of-ten in intensity, epigastric pain associated with nausea and non-bloody emesis. He had never experienced this pain before [...]

By | 2018-03-19T13:04:46+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on FOOLED BY FAT: A DELAY IN APPROPRIATE TRIAGING IN HYPERTRIGLYCERIDEMIA-INDUCED PANCREATITIS

HM2018 Abstract Number: 457

IT’S JUST THE AIR; A CASE OF TRAUMATIC INTUBATION MASQUERADING AS NECROTIZING FASCITIS

Case Presentation: A 58-year-old male with hypertension, morbid obesity and obstructive sleep apnea (OSA) was shifted to MICU for monitoring of his respiratory status following elective vitrectomy under general anesthesia. He was managed with non-invasive [...]

By | 2018-03-19T13:04:40+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on IT’S JUST THE AIR; A CASE OF TRAUMATIC INTUBATION MASQUERADING AS NECROTIZING FASCITIS

HM2018 Abstract Number: 481

Cold Gone Crazy

Case Presentation: A 25 year-old man presented with agitation and altered mental status. He was placed in physical restraints and given Ativan due to severe agitation. He was found to be tachycardic, with dilated pupils, [...]

By | 2018-03-19T13:04:32+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Cold Gone Crazy

HM2018 Abstract Number: 638

INTRACTABLE PAIN IN A LETTUCE FARMER: A CASE REPORT

Case Presentation: A 29-year-old Caucasian male lettuce farmer with no significant past medical history presented to our ED with acutely worsening holocranial throbbing headache, polyarthralgias, intermittent migrating burning rashes, and severe paresthesia to tips of [...]

By | 2018-03-19T13:04:30+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on INTRACTABLE PAIN IN A LETTUCE FARMER: A CASE REPORT

HM2018 Abstract Number: 528

AN UNUSUAL CAUSE OF NEUTROPENIC FEVER

Case Presentation: A 24 year-old woman with history of breast cancer status post mastectomy and adjuvant chemoradiation therapy presented with one week of fevers and cervical lymph node enlargement. On presentation, she was febrile with [...]

By | 2018-03-19T13:04:24+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on AN UNUSUAL CAUSE OF NEUTROPENIC FEVER

HM2018 Abstract Number: 441

OH MYROIDES! : AN UNIQUE PRESENTATION OF MDR-MYROIDES BACTEREMIA

Case Presentation: 63-year-old male with past medical history of diabetes mellitus complicated by neuropathy, hypertension and recurrent UTIs presented with 1 week history of nausea, decreased oral intake and malaise. He endorsed dysuria and left [...]

By | 2018-03-19T13:04:22+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on OH MYROIDES! : AN UNIQUE PRESENTATION OF MDR-MYROIDES BACTEREMIA

HM2018 Abstract Number: 586

MULTILEVEL VERTEBRAL PROTEUS OSTEOMYELITIS IN AN IMMUNOCOMPETENT HOST

Case Presentation: A 73 year old male with a history of hypertension and osteoarthritis presented to the hospital with progressively worsening back pain. He has chronic back pain, but suddenly woke up and noticed a [...]

By | 2018-03-19T13:04:20+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on MULTILEVEL VERTEBRAL PROTEUS OSTEOMYELITIS IN AN IMMUNOCOMPETENT HOST

HM2018 Abstract Number: 855

INFLUENZA A INDUCED PANCYTOPENIA

Case Presentation: The following case highlights a rare complication, pancytopenia, in a common disease entity, Influenza A. A 73-year-old Mandarin speaking male with a past medical history of diabetes presented to the emergency department following [...]

By | 2018-03-19T13:04:18+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on INFLUENZA A INDUCED PANCYTOPENIA

HM2018 Abstract Number: 745

WHEN LOWER EXTREMITY EDEMA GOES BEYOND VENOUS INSUFFICIENCY: A RARE CASE OF MAY THURNER SYNDROME VARIANT

Case Presentation: A 59-year-old male patient with no significant past medical history presented to our hospital with left foot swelling that started almost four weeks prior to presentation. The swelling was progressive, ascending, and associated [...]

By | 2018-03-19T13:04:14+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on WHEN LOWER EXTREMITY EDEMA GOES BEYOND VENOUS INSUFFICIENCY: A RARE CASE OF MAY THURNER SYNDROME VARIANT

HM2018 Abstract Number: 735

AN ATYPICAL PRESENTATION OF SECONDARY HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS

Case Presentation: A 69-year-old female with a medical history of morbid obesity presented to a rural hospital with a one-week history of extreme fatigue, malaise, jaundice, and anorexia. Her initial vital signs were unremarkable. Physical [...]

By | 2018-03-19T13:04:12+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on AN ATYPICAL PRESENTATION OF SECONDARY HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS

HM2018 Abstract Number: 612

THE TISSUE IS THE ISSUE

Case Presentation: A 60-year-old man presented with progressive fatigue, 30-pound weight loss, and arthralgias over six months. He also noted more recent onset of left upper quadrant abdominal discomfort and nonproductive cough. Past medical history [...]

By | 2018-03-19T13:04:04+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on THE TISSUE IS THE ISSUE

HM2018 Abstract Number: 505

PD-1 INHIBITOR INDUCED COLITIS REFRACTORY TO STEROIDS

Case Presentation: A 60 year old male with stage IV lung adenocarcinoma metastatic to the brain being treated with carboplatin/pemetrexed and 3 doses of pembrolizumab presented to the emergency department with frequent watery and bloody [...]

By | 2018-03-19T13:04:02+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on PD-1 INHIBITOR INDUCED COLITIS REFRACTORY TO STEROIDS

HM2018 Abstract Number: 727

Chronic back pain secondary to Brucellosis, common presentation of an uncommon cause

Case Presentation: A 62-year-old man presented with six months of progressive lower back pain. He noticed weight loss, sweats, and subjective fevers, but denied neurological symptoms or a other complaints. Patient lives in Texas, but [...]

By | 2018-03-19T13:03:58+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Chronic back pain secondary to Brucellosis, common presentation of an uncommon cause

HM2018 Abstract Number: 744

Electrifying Left Ventricular Non-Compaction: A Case for Intervention?

Case Presentation: A 60-year-old man with no comorbidities presented with multiple episodes of substernal chest pressure and reduced exercise tolerance. Cardiac catheterization was notable for severe systolic dysfunction with left ventricular dilatation without coronary disease. [...]

By | 2018-03-19T13:03:56+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Electrifying Left Ventricular Non-Compaction: A Case for Intervention?

HM2018 Abstract Number: 710

CONFUSION AND ATAXIA AFTER A TROPICAL VACATION: A CASE OF VIRAL NEURINVASIVE DISEASE

Case Presentation: A 64-year-old Caucasian male with hypertension and diabetes mellitus presented to the emergency room with confusion, ataxia, and urinary retention after a 10-day cruise to Aruba. During the cruise, he developed fever, diarrhea, [...]

By | 2018-03-19T13:03:40+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on CONFUSION AND ATAXIA AFTER A TROPICAL VACATION: A CASE OF VIRAL NEURINVASIVE DISEASE

HM2018 Abstract Number: 872

LACRIMAL GLAND TUMOR MASQUERADING AS GIANT CELL ARTERITIS

Case Presentation: A 64-year-old male presented with gradually increased swelling of his left eye associated with tearing and left temporal tenderness. Five months prior, he initially presented with similar symptoms and was discharged home with [...]

By | 2018-03-19T13:03:38+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on LACRIMAL GLAND TUMOR MASQUERADING AS GIANT CELL ARTERITIS

HM2018 Abstract Number: 381

Know Thy Selfie, Know Thy Diagnosis: A Picture Perfect Presentation of Horner Syndrome

Case Presentation: A 46 year-old man with a past medical history of untreated hypertension presented with right ptosis and miosis. The patient was in his usual state of health until one month prior to presentation, [...]

By | 2018-03-22T15:50:11+00:00 March 19th, 2018|Adult, Clinical Vignettes, Finalist Posters, Hospital Medicine 2018|Comments Off on Know Thy Selfie, Know Thy Diagnosis: A Picture Perfect Presentation of Horner Syndrome

HM2018 Abstract Number: 797

IT’S ALWAYS IN THE LAST PLACE YOU LOOK: AA AMYLOIDOSIS SECONDARY TO TB LYMPHADENITIS

Case Presentation: A 67-year-old Fijean woman presented to the emergency department with three weeks of fevers, chills, weakness, watery non-bloody diarrhea, and unintentional 15lb weight loss. She had no recent travel, sick contacts, changes in [...]

By | 2018-03-19T13:03:20+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on IT’S ALWAYS IN THE LAST PLACE YOU LOOK: AA AMYLOIDOSIS SECONDARY TO TB LYMPHADENITIS

HM2018 Abstract Number: 886

A RARE CASE OF AN UPPER EXTREMITY DEEP VENOUS THROMBOSIS – PAGET-SCHROETTER’S SYNDROME

Case Presentation: A 26-year-old healthy right-handed female presented to the hospital with a sudden onset of right arm swelling and discoloration. She was visiting the US from Australia and flew about two weeks prior. On [...]

By | 2018-03-19T13:03:16+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A RARE CASE OF AN UPPER EXTREMITY DEEP VENOUS THROMBOSIS – PAGET-SCHROETTER’S SYNDROME

HM2018 Abstract Number: 623

FACIAL ANGIOEDEMA HERALDING THE DIAGNOSIS OF SYSTEMIC LUPUS ERYTHEMATOSUS

Case Presentation: A 24 year old Afro-Caribbean woman with no medical history presented with intermittent facial swelling of one month, several months of fatigue, anorexia and unintentional weight loss of 65 pounds. The swelling initially [...]

By | 2018-03-19T13:03:08+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on FACIAL ANGIOEDEMA HERALDING THE DIAGNOSIS OF SYSTEMIC LUPUS ERYTHEMATOSUS

HM2018 Abstract Number: 666

Mending a Broken Heart: A Heart-Stopping Case of Cardiac Sarcoid

Case Presentation: A 45 year old African American male with sarcoidosis (2009 lung biopsy) was brought by EMS after an out of hospital ventricular fibrillation cardiac arrest. With ACLS, ROSC was attained after 20minutes. He [...]

By | 2018-03-19T13:03:04+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Mending a Broken Heart: A Heart-Stopping Case of Cardiac Sarcoid

HM2018 Abstract Number: 617

URETRITIS CYSTICA: AN UNUSUAL PRESENTATION IN AN OTHERWISE HEALTHY FEMALE

Case Presentation: A 23-year-old woman presented with left lower abdominal pain with mildly elevated creatinine that was identified on routine blood draw at her urology appointment. She had no urinary symptoms; UA and pregnancy test [...]

By | 2018-03-19T13:02:58+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on URETRITIS CYSTICA: AN UNUSUAL PRESENTATION IN AN OTHERWISE HEALTHY FEMALE

HM2018 Abstract Number: 431

LEUKEMIA CUTIS: A RARE PRESENTATION IN CHRONIC MYELOID LEUKEMIA MASQUERADING AS CELLULITIS

Case Presentation: A 48-year-old female with tyrosine kinase inhibitor-resistant CML on hydroxyurea therapy admitted with 3 weeks of fever, skin redness, and swelling. Her physical examination was remarkable for the temperature of 100.1 F, localized [...]

By | 2018-03-19T13:02:52+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on LEUKEMIA CUTIS: A RARE PRESENTATION IN CHRONIC MYELOID LEUKEMIA MASQUERADING AS CELLULITIS

HM2018 Abstract Number: 555

PSYCHOSIS INDUCED CARDIOMYOPATHY- A NON-TRADITIONAL CAUSE OF TAKOTSUBO CARDIOMYOPATHY

Case Presentation: 78-year-old female with a past medical history of diabetes, hypertension, and vascular dementia was brought to the hospital by her family for worsening dementia, behavioral disturbances including agitation, insomnia, hallucinations and delusions. Her [...]

By | 2018-03-19T13:02:48+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on PSYCHOSIS INDUCED CARDIOMYOPATHY- A NON-TRADITIONAL CAUSE OF TAKOTSUBO CARDIOMYOPATHY

HM2018 Abstract Number: 556

A CASE OF AMYOPATHIC DERMATOMYOSITIS (ANTI-MDA 5 DISEASE) WITH PULMONARY FIBROSIS AND FEATURES OF LUPUS, WITHOUT EVIDENCE OF MALIGNANCY

Case Presentation: A 44 year-old Hispanic female with a past medical history of hypothyroidism presented from her endocrinologist with a diffuse, maculopapular rash, including the face, hands, wrists, torso, arms and legs. The rash had [...]

By | 2018-03-19T13:02:42+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A CASE OF AMYOPATHIC DERMATOMYOSITIS (ANTI-MDA 5 DISEASE) WITH PULMONARY FIBROSIS AND FEATURES OF LUPUS, WITHOUT EVIDENCE OF MALIGNANCY

HM2018 Abstract Number: 698

HYPERTENSIVE CRISIS FROM HEMATOLOGIC PHENOMENA

Case Presentation: Hypertensive Emergency is a common condition encountered in the hospital. Identifying the underlying etiology is very important because it can alter clinical outcome and management.A 42-year-old man with History of Hypertension presented to [...]

By | 2018-03-19T13:02:36+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on HYPERTENSIVE CRISIS FROM HEMATOLOGIC PHENOMENA

HM2018 Abstract Number: 655

PRIMARY EFFUSION LYMPHOMA IN A HIV NEGATIVE AND HUMAN HERPESVIRUS 8 POSITIVE POST-CARDIAC TRANSPLANT PATIENT

Case Presentation: A 63 year-old gentleman had a history of ischemic cardiomyopathy treated with Orthotopic Heart Transplant (OHT), on tacrolimus & prednisone; cutaneous Kaposi Sarcoma (KS); & negative pre-transplant Human Herpesvirus 8 (HHV8) serology. He [...]

By | 2018-03-19T13:02:22+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on PRIMARY EFFUSION LYMPHOMA IN A HIV NEGATIVE AND HUMAN HERPESVIRUS 8 POSITIVE POST-CARDIAC TRANSPLANT PATIENT

HM2018 Abstract Number: 462

DRESSLER SYNDROME: A EMERGING COMPLICATION OF ABLATIVE THERAPY FOR ATRIAL FIBRILLATION.

Case Presentation: A 53 year old female originally underwent an ablation for atrial fibrillation with post procedure course pericardial effusion requiring drain placement for 3 days. Patient recovered from original effusion and was sent home [...]

By | 2018-03-19T13:02:20+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on DRESSLER SYNDROME: A EMERGING COMPLICATION OF ABLATIVE THERAPY FOR ATRIAL FIBRILLATION.

HM2018 Abstract Number: 468

NOT SO BENIGN AFTER ALL: CARDIAC ARREST IN APICAL HYPERTROPHIC CARDIOMYOPATHY

Case Presentation: 49 year old Caucasian male was admitted to the hospital after suffering an outside hospital cardiac arrest due to ventricular fibrillation. His electrocardiogram (EKG) showed findings of left ventricular hypertrophy (LVH) with giant [...]

By | 2018-03-19T13:02:18+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on NOT SO BENIGN AFTER ALL: CARDIAC ARREST IN APICAL HYPERTROPHIC CARDIOMYOPATHY

HM2018 Abstract Number: 652

HIDDEN IN PLAIN SIGHT; RARE TUBERCULOUS GRANULOMA AND MILIARY TUBERCULOSIS IN A HOSPITALIZED PATIENT WITH NO RESPIRATORY SYMPTOMS

Case Presentation: A 36-year-old Kenyan female, who immigrated to the United States 18 months ago, with no significant past medical history presented to our hospital with worsening occipital headaches. 6 months prior, she had a [...]

By | 2018-03-19T13:02:16+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on HIDDEN IN PLAIN SIGHT; RARE TUBERCULOUS GRANULOMA AND MILIARY TUBERCULOSIS IN A HOSPITALIZED PATIENT WITH NO RESPIRATORY SYMPTOMS

HM2018 Abstract Number: 557

A CASE REPORT OF CEREBRAL SALT WASTING IN A 32 YEAR-OLD, FOLLOWING A MOTOR-VEHICLE ACCIDENT, WITHOUT INTRACEREBRAL HEMORRHAGE

Case Presentation: A 32 year-old female without significant medical history presented with nausea and vomiting, 1 week after being a pedestrian struck by a vehicle. The original accident caused loss of consciousness, and post-concussive syndrome [...]

By | 2018-03-19T13:02:12+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A CASE REPORT OF CEREBRAL SALT WASTING IN A 32 YEAR-OLD, FOLLOWING A MOTOR-VEHICLE ACCIDENT, WITHOUT INTRACEREBRAL HEMORRHAGE

HM2018 Abstract Number: 387

CALL THAT DASH! ACUTE NONRHEUMATIC STREPTOCOCCAL MYOCARDITIS MIMICKING STEMI

Case Presentation: A 50 year old male with no past medical history presented with severe chest pain that progressively worsened over 2 days. His chest pain was described as left sided, non-radiating, and constant. He [...]

By | 2018-03-22T15:50:13+00:00 March 19th, 2018|Adult, Clinical Vignettes, Finalist Poster, Finalist Posters, Hospital Medicine 2018|Comments Off on CALL THAT DASH! ACUTE NONRHEUMATIC STREPTOCOCCAL MYOCARDITIS MIMICKING STEMI

HM2018 Abstract Number: 651

F-‘LOCO’-QUINOLONES! LEVOFLOXACIN INDUCED DELIRIUM WITH PSYCHOTIC FEATURES

Case Presentation: A 66 year old female with history of Multiple Sclerosis and Sjogren's syndrome presented with fever, hypotension and abdominal pain and was admitted for severe urosepsis secondary to a urinary tract infection. On [...]

By | 2018-03-19T13:02:04+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on F-‘LOCO’-QUINOLONES! LEVOFLOXACIN INDUCED DELIRIUM WITH PSYCHOTIC FEATURES

HM2018 Abstract Number: 923

NON-ARTICULAR FELTY’S SYNDROME AS THE INITIAL PRESENTATION OF RHEUMATOID ARTHRITIS

Case Presentation: A 65 year-old female with a history of hyperlipidemia presented with odynophagia, fevers, weight loss and two months of neutropenia. A hematologist had evaluated the neutropenia with a negative outpatient workup, including ANA, [...]

By | 2018-03-19T13:01:58+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on NON-ARTICULAR FELTY’S SYNDROME AS THE INITIAL PRESENTATION OF RHEUMATOID ARTHRITIS

HM2018 Abstract Number: 650

A FATAL CASE OF CRIZOTINIB INDUCED FULMINANT LIVER FAILURE

Case Presentation: A 69-year-old woman with a past medical history of metastatic ovarian cancer receiving treatment with crizotinib for 4 weeks presented to the hospital with weakness, lightheadedness, and hypotension. She denied any abdominal pain, [...]

By | 2018-03-19T13:01:54+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A FATAL CASE OF CRIZOTINIB INDUCED FULMINANT LIVER FAILURE

HM2018 Abstract Number: 530

“An untimely wear and tear ” A case of spontaneous coronary artery dissection in a young female .

Case Presentation: A 32 year old female presented with 2 month history of acute onset pressure-like chest pain occurring after yelling at her children and radiating to the back. The symptoms recurred and become progressive [...]

By | 2018-03-19T13:01:52+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on “An untimely wear and tear ” A case of spontaneous coronary artery dissection in a young female .

HM2018 Abstract Number: 873

DOUBLE STRIKE- A CASE OF BABESIOSIS AND ANAPLASMOSIS PRESENTING AS SEVERE HEMOLYTIC ANEMIA AND SEPTIC SHOCK IN A HEALTHY 25 YEAR OLD MALE

Case Presentation: A healthy, pleasant 25 years old male, dog-owner, with Down syndrome presented with generalized malaise, intermittent fevers, chills, sweating, abdominal pain, intermittent neck pain that progressively worsened over a week. His fever was [...]

By | 2018-03-19T13:01:48+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on DOUBLE STRIKE- A CASE OF BABESIOSIS AND ANAPLASMOSIS PRESENTING AS SEVERE HEMOLYTIC ANEMIA AND SEPTIC SHOCK IN A HEALTHY 25 YEAR OLD MALE

HM2018 Abstract Number: 723

ATRAUMATIC SPLENIC RUPTURE ASSOCIATED WITH APIXABAN

Case Presentation: An 86-year-old man with a history of atrial fibrillation on apixaban and aspirin for coronary artery disease presented with orthostatic syncope leading to a fall. Patient had complained of left upper quadrant abdominal [...]

By | 2018-03-19T13:01:47+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on ATRAUMATIC SPLENIC RUPTURE ASSOCIATED WITH APIXABAN

HM2018 Abstract Number: 786

MYOPERICARDITIS: AN UNUSUAL PRESENTATION OF MIXED CONNECTIVE TISSUE DISEASE

Case Presentation: A 44 year-old female with a history of essential hypertension presented with one month of progressive chest pain, dyspnea and fevers. These symptoms were associated with a dry cough, sore throat and symmetric [...]

By | 2018-03-19T13:01:45+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on MYOPERICARDITIS: AN UNUSUAL PRESENTATION OF MIXED CONNECTIVE TISSUE DISEASE

HM2018 Abstract Number: 721

PSEUDOHYPERKALEMIA IN EXTREME LEUKOCYTOSIS OF CHRONIC LYMPHOCYTIC LEUKEMIA

Case Presentation: A 56-year-old man with history of hypertension on amlodipine, hydralazine, losartan, spironolactone, and torsemide, uncontrolled insulin dependent type 2 diabetes mellitus, chronic kidney disease (CKD) stage IIIb, and chronic lymphocytic leukemia (CLL) with [...]

By | 2018-03-19T13:01:44+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on PSEUDOHYPERKALEMIA IN EXTREME LEUKOCYTOSIS OF CHRONIC LYMPHOCYTIC LEUKEMIA

HM2018 Abstract Number: 824

A NEW DIAGNOSIS OF TOTAL ANOMALOUS PULMONARY VENOUS RETURN IN A 56 YEAR OLD MAN

Case Presentation: A 56 year old male with no prior medical or surgical history presented to the hospital with fatigue, palpitations, shortness of breath, and bilateral ankle swelling for 2 months. He had also developed [...]

By | 2018-03-19T13:01:42+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A NEW DIAGNOSIS OF TOTAL ANOMALOUS PULMONARY VENOUS RETURN IN A 56 YEAR OLD MAN

HM2018 Abstract Number: 450

THE GALL OF A VILLAINOUS STONE

Case Presentation: A 64-year-old woman with a history of cholecystectomy and chronic intermittent abdominal pain presented with acute onset of right upper quadrant pain and vomiting. On admission, she was afebrile and nontoxic appearing with [...]

By | 2018-03-19T13:00:16+00:00 March 19th, 2018|