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HM2016 Abstract Number: 457

The Spectrum of Clinical Presentations in Systemic Lupus Erythematosus

Case Presentation:   A 29-year-old African-American female presented with two weeks of left neck swelling and fever. Over four months, she had noted fatigue, cough, night sweats, and an unintentional 12-pound weight loss. Two empiric [...]

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HM2016 Abstract Number: 455

‘roids for the Rage

Case Presentation: A 41 year-old African-American woman with recently diagnosed pericarditis presented actively seizing with fixed gaze deviation to the right. When levetiracetam and lorazepam did not break seizure activity, she required sedation with propofol [...]

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HM2016 Abstract Number: 458

The Evil Side of Ertapenem

Case Presentation: A 90 year old female, with diabetes mellitus type 2, hypertension and osteoporosis presented to our emergency room with altered mental status for 5 days. The patient had been treated for jaw osteonecrosis [...]

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HM2016 Abstract Number: 460

Negating a Negative: The Role of Clinical Suspicion in Treating Murine Typhus

Case Presentation: A 71 year-old woman with a past medical history of hypertension was admitted with generalized fatigue, weakness, and decreased concentration and memory for a week and a half. During this time, she also [...]

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HM2016 Abstract Number: 461

Seeing Red Everywhere: Amyloidosis Associated Gastrointestinal Bleeding in a Patient with Multiple Myeloma

Case Presentation: Ms. S is a 64 year old woman recently diagnosed with multiple myeloma following a hip fracture and repair, who was transferred from an outside hospital for hematochezia. She was admitted to the [...]

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HM2016 Abstract Number: 464

Not Just Another Another Dvt

Case Presentation: An 82 year-old woman with past medical history of diabetes and hypertension presented with left lower extremity swelling and fever for 1 day. The patient noted gradual development of leg swelling over 24 [...]

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HM2016 Abstract Number: 462

A Case of Invasive Non-Typhoidal Salmonella (Ints) in an Immunocompetent Adult

Case Presentation: A 24-year-old man with no known past medical history presented with a one week history of nightly fevers to 38.8-39C. Two weeks prior to presentation, he spent the weekend at Fire Island in [...]

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HM2016 Abstract Number: 463

A Case of Abdominal Compartment Syndrome Triggered by Acute Pancreatitis

Case Presentation: A 33 year-old female with a history of alcohol abuse presented to our emergency department with a four day history of abdominal pain, nausea, and vomiting.  This was preceded by intake of 1/5 [...]

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HM2016 Abstract Number: 465

Pituitary Tumor Apoplexy: A Rare Cause of Thunderclap Headache

Case Presentation: A 46-year-old Hispanic male with no significant past medical history presents with acute onset of headache, nausea, and vomiting for the past day, preceded by six months of progressively worsening peripheral vision and [...]

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HM2016 Abstract Number: 467

It’s Not Breast Cancer? A Case of Poems Syndrome Masquerading As Metastatic Cancer with Unknown Primary

Case Presentation: A 40 year old woman with history of stroke at age 35 was admitted from an outside hospital with a CT-PE scan showing diffuse “osteoblastic” lesions and bilateral axillary lymphadenopathy. She complained of [...]

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HM2016 Abstract Number: 466

Mgus-Associated Aquired Angioedema: Quite the Mouthful!

Case Presentation: A 42-year-old African-American G8P5 woman with no significant past medical history developed tongue swelling the day after a preterm labor induction due to hydrops fetalis. The swelling initially resolved on the same day [...]

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HM2016 Abstract Number: 469

A Rare Case of Primary Hyperparathyroidism with Osteitis Fibrosa Cystica

Case Presentation: A 29-year-old female presented with right femoral fracture after twisting her leg. One month prior she saw orthopedic surgery for foot pain. She was referred to endocrinology after DEXA scan showed severe osteoporosis [...]

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HM2016 Abstract Number: 470

Cameron Lesions: An Uncommon Presentation of an Uncommon Disease

Case Presentation: A 61 year old male with a history of hiatal hernia, paroxysmal atrial fibrillation on aspirin, hypertension, and diverticulosis presented with non-bloody emesis and blood-tinged diarrhea. He reported many sick contacts with similar [...]

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HM2016 Abstract Number: 468

Severe Pulmonary Hypertension in a Patient with Human Immunodeficiency Virus

Case Presentation: 45-year-old male presented with complaints of progressive shortness of breath, dry cough and pleuritic chest pain for the last 3 weeks. He was homeless, HIV-positive since 1992 but noncompliant with HAART. On physical [...]

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HM2016 Abstract Number: 471

A Case of E. Coli Endocarditis

Case Presentation: A previously healthy 77 year-old woman with a history of porcine mitral valve repair (MVR) presented with left knee pain.  Three weeks prior to admission she experienced general malaise and intermittent chills. She [...]

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HM2016 Abstract Number: 473

To Anchor or Not to Anchor? – a Case of Thrombosis, Hoarseness, and Orthopnea

Case Presentation: A 58 year-old Hispanic woman presented to an outside hospital with a one-day history of right upper quadrant abdominal pain. The pain was 8/10 in severity, sharp in nature, and radiated to her [...]

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HM2016 Abstract Number: 472

Pyelonephritis in an Immunocompromised Patient: An Uncommon Presentation of the Common Cold

Case Presentation: A 30-year-old woman with a history of a renal transplant for lupus nephritis presented with ten days of painful urination, pain over her transplanted kidney, and “hawaiian punch” urine. She also complained of [...]

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HM2016 Abstract Number: 477

Subacute Bacterial Endocarditis with Abiotrophia Defectiva

Case Presentation: A 59-year-old male with a bicuspid aortic valve presented to the hospital with a syncopal event. One week earlier, a transesophageal echocardiogram (TEE) done for preoperative assessment had confirmed a heavily calcified bicuspid [...]

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HM2016 Abstract Number: 475

Itching for a Heart Attack

Case Presentation: A 64-year-old man with a past medical history of coronary artery disease, type 2 diabetes, hyperlipidemia, and hypertension presented to the Emergency Department with severe, sharp, crampy abdominal pain. The pain was associated [...]

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HM2016 Abstract Number: 476

A Case of Stiff-Person Syndrome: An Elusive Diagnosis

Case Presentation: A generally healthy 36 year old female began experiencing stiffness in her lower back with persistent aching pain. The discomfort progressively worsened over several weeks prompting multiple emergency room visits. She began to [...]

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HM2016 Abstract Number: 479

A Case of Sweet’s Syndrome in a Patient with Inflammatory Bowel Disease That Almost Went Undiagnosed

Case Presentation: A 47-year-old Caucasian woman presented with severe vomiting and abdominal pain for three days. Her past medical history revealed that she was diagnosed in 2010 with ulcerative colitis proctitis and was recently started [...]

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HM2016 Abstract Number: 478

Urothelial Carcinoma Leading to Secondary Retroperitoneal Fibrosis

Case Presentation:  A 91 year-old male with a PMH of prostate cancer status post transurethral resection of the prostate and external beam radiation therapy twenty years prior, radiation prostatitis, intermittent hematuria, and chronic constipation presented [...]

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HM2016 Abstract Number: 480

Babesiosis in Immunocompromised Versus Non-Immunocompromised Patients

Case Presentation: Patient 1. A 71-year-old woman with no significant past medical history presented to the emergency department with 3 weeks of general malaise and subjective fevers after a trip to Connecticut. Her exam was [...]

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HM2016 Abstract Number: 481

A Broken Heart, Too Soon

Case Presentation: A 24-year-old female without significant medical history was admitted with acute substernal, non-pleuritic chest pain accompanied by dyspnea, palpitations, and restlessness. She denied active illicit drug use, but admitted to taking amphetamine/dextroamphetamine (Adderall), [...]

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HM2016 Abstract Number: 482

19 Year Old Female with Diffuse Alveolar Hemorrhage

Case Presentation: A 19 year old female with systemic lupus erythematosus presented to a community hospital with hemoptysis. Bronchoscopy showed diffuse alveolar hemorrhage. She developed tachycardia and hypoxemic respiratory failure requiring ICU transfer, intubation and [...]

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HM2016 Abstract Number: 483

Trueperella Pyocystis in an Immunocompromised Patient

Case Presentation: A 68 year old male with a history of end stage renal disease (ESRD) on hemodialysis, s/p cardiac transplant for refractory ischemic cardiomyopathy, and Cerebrovascular accident presented to the emergency department (ED) with fevers, lethargy and penile discharge. In [...]

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HM2016 Abstract Number: 486

A Destructive Complement

Case Presentation: A 57 year-old woman presented with five days of worsening confusion  and drowsiness associated with headache, generalized abdominal pain,  nausea, and new rash. She had a history of interstitial lung disease treated with [...]

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HM2016 Abstract Number: 488

Colorectal Ischemia in Anaphylaxis

Case Presentation: A 56-year-old woman with a history of asthma, eczema, food and seasonal allergies presented with anaphylaxis. Earlier that day she experienced vomiting and shortness of breath after inadvertently ingesting peanuts. She subsequently lost [...]

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HM2016 Abstract Number: 490

Respiratory Failure: An Uncommon Presenting Symptom in Neurologic Weakness

Case Presentation: A 75 year-old man with history of type II diabetes and hypertension presented with progressive dyspnea. Two weeks prior, he had presented with similar symptoms that were attributed to COPD due to a [...]

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HM2016 Abstract Number: 495

Previously Undiagnosed Diffuse Idiopathic Skeletal Hyperostosis (Dish) in a Patient with Osteoarthritis and Both Protein C and S Deficiency

Case Presentation: A 57 year-old African-American male with past medical history of osteoarthritis, opioid dependence secondary to arthralgia, and chronic bilateral lower extremity venous thrombi secondary to both protein C and protein S deficiency, presented with [...]

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HM2016 Abstract Number: 496

Milking the Diagnosis

Case Presentation: A 67-year-old man presented with a 6-month history of severe episodic weakness. The episodes typically began with nausea and vomiting, followed by severe weakness involving inability to lift his upper or lower extremities [...]

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HM2016 Abstract Number: 497

Sevelamer Crystalopathy: An Under-Recognized Cause of Gastrointestinal Disease

Case Presentation: A 60-year-old female with a history of hypertension, mild hypercalcemia, ESRD on hemodialysis, and pulmonary fibrosis status-post right lung transplant 6 years prior presented with acute on chronic diffuse abdominal pain, nausea, and [...]

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HM2016 Abstract Number: 487

Blood, Immunosuppressive Agents, and Coagulation Factors – Oh, My!

Case Presentation: 59 year old female presented to the emergency department complaining of two weeks of atraumatic, painful bruising to her lower extremities, right shoulder, and lower back. She was unable to bear weight on [...]

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HM2016 Abstract Number: 499

Unusual Presentation of Spinal Cord Infarction in a 21 Year Old Male

Case Presentation: A 21 year old male with no significant past medical or surgical history presented to the hospital with sudden onset of bilateral lower extremity paralysis and paresthesia. He was lifting heavy boxes at [...]

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HM2016 Abstract Number: 500

A Rare Case of Fulvestrant Induced Hepatotoxicity

Case Presentation: A 65 year old female with stage IV poorly differentiated left breast adenocarcinoma presented with ­­a one day history of malaise, nausea, and jaundice. The patient was already undergoing treatment with Anastrozole, however, [...]

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HM2016 Abstract Number: 501

A “Nut” You Do Not Want to Miss!

Case Presentation: A 27-year-old male presented with one year history of nonproductive cough and a 4 week history of expiratory wheezing, dyspnea on exertion, facial swelling and episodic hemoptysis. Past medical history was significant for [...]

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HM2016 Abstract Number: 504

A Modern Case of Scurvy? Vitamin C Deficiency in a Patient with a Pheochromocytoma

Case Presentation: A 78 year old female with Type 2 diabetes, HTN, vitiligo, sacral decubitus ulcers, CHF, and atrial fibrillation presented with fevers and two weeks of malaise, dizziness, progressive somnolence, and altered mental status. [...]

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HM2016 Abstract Number: 503

Salmonella: The Heart of the Problem

Case Presentation: A 64-year-old man with history of coronary artery disease, hypertension, and hyperlipidemia initially presented to outside hospital with complaint of 6 weeks of fever, weakness, anorexia, and left flank pain. He reported recent [...]

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HM2016 Abstract Number: 505

Ticking Time Bomb: A Case of Babesiosis in a Patient Presenting with Direct Hyperbilirubinemia

Case Presentation: A 71 year old woman with a history only significant for Lyme disease in 2005 presented with complaints of malaise and fatigue for two weeks. One week prior to admission, the patient was evaluated [...]

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HM2016 Abstract Number: 506

Bound to Fail: Fluoroquinolone Antibiotics and Calcium Supplementation

Case Presentation: A 55-year-old man with a history of asthma, chronic kidney disease and hypocalcemia presented with dyspnea and hypoxemia to the Emergency Room. The patient reported cough, purulent sputum production, and fever. His symptoms [...]

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HM2016 Abstract Number: 507

Oxalate Nephropathy Causing Acute Renal Failure in a Patient with Gastric Bypass

Case Presentation: A 54-year-old female with hypertension, type 2 diabetes, and morbid obesity with Roux-en-Y gastric bypass (RYGB) in 2009 presented to the hospital with abdominal pain and was found to have choledocolithiasis and acute [...]

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HM2016 Abstract Number: 508

Concurrent Salmonella Empyema and Hypercalcemia: A First Report

Case Presentation: A 70-year-old Caucasian male was admitted to our institution with unremitting malaise and difficulty concentrating. He was found to have a serum calcium of 13.8 mg/dl. His medical history was significant for coronary [...]

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HM2016 Abstract Number: 509

Call It Heavy Metal – It May Not Be Barium

Case Presentation: A 68 year old male with history of hemodialysis dependent chronic kidney disease, stroke and vascular dementia was transferred from a nursing home with increased lethargy and abdominal pain.  In the emergency department [...]

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HM2016 Abstract Number: 510

Constrictive Pericarditis: A Rare Cause of Potentially Reversible Heart Failure

Case Presentation: A 39 year old male with a history of congenital bicuspid aortic valve and ascending aortic aneurysm repair (1 year prior) presented with recurrent bilateral lower extremity edema (LEE). He first presented with [...]

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HM2016 Abstract Number: 513

Don’t Let Hashimoto’s “Fall” Off of the Radar: A Treatable Encephalopathy

Case Presentation: A 66 year-old male with hypothyroidism was admitted for a COPD exacerbation, however his neurological exam was markedly abnormal. He had suffered multiple falls due to gait instability in years past, and recently [...]

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HM2016 Abstract Number: 514

Double Whammy, Triple Scary

Case Presentation: A 74 year old, non-diabetic Singaporean male was hospitalized following 3 weeks of left iliac fossa pain.  Computed tomography showed marked mural thickening and enhancement of descending and sigmoid colon with extensive pericolic [...]

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HM2016 Abstract Number: 512

A Case of the Unseen: Klebsiella Pneumonia Pyogenic Liver Abscess with Pneumonia and Septic Endophthalmitis in a Non-Asian U.S. Resident

Case Presentation: A 53 year old Russian man with no significant past medical history initially presented to an ophthalmology clinic with two days of progressively worsening, near-total left visual field loss associated with a one-week [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts, Finalist|Comments Off on A Case of the Unseen: Klebsiella Pneumonia Pyogenic Liver Abscess with Pneumonia and Septic Endophthalmitis in a Non-Asian U.S. Resident

HM2016 Abstract Number: 517

The Sweet Dance

Case Presentation: A 71 year old woman with a past medical history of type 2 diabetes mellitus, atrial fibrillation, hypothyroidism and hypertension presented for evaluation of one month history of right sided involuntary hyperkinetic movements. [...]

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HM2016 Abstract Number: 516

A Race Against Time with Progressive Decline… and the Ear Holds the Key

Case Presentation: A 47-year-old woman presented to our facility.  Over four months, she had suffered an inexorable decline and multiple hospitalizations with fruitless searches for a diagnosis.  She had right-sided Bell’s palsy, progressive right-sided weakness, [...]

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HM2016 Abstract Number: 515

A Spate of Bacteremia with Bone and Joint Infections: Something Is Fishy!

Case Presentation: Over one month our team (one of 14 in the division) saw 3 cases of Group B Streptococcus (GBS) bacteremia with musculoskeletal (MSK) complications. The first patient was a 65-year-old male admitted with [...]

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HM2016 Abstract Number: 518

Screening for Celiac Disease in Patients with Sarcoidosis?

Case Presentation: 35 year old woman, diagnosed with biopsy proven sarcoidosis, developed a complex clinical course over time. She started experiencing recurrent watery diarrhea, accompanied with abdominal pain and generalized weakness. Physical exam revealed thin [...]

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HM2016 Abstract Number: 519

A 24 Year Old Man with Pulmonary Infiltrates and Sepsis

Case Presentation: A 24-year-old Japanese American male presented with 3-4 weeks of sore throat, fever, vomiting, and fatigue. He was found to be in respiratory distress and was quickly intubated. Physical exam was remarkable for decreased [...]

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HM2016 Abstract Number: 521

A Case of a Nearly-Fatal Pulmonary Embolism in the Setting of Stasis from Extrinsic Venous Compression by a Groin Abscess

Case Presentation: A previously healthy and ambulatory 34-year-old diabetic man presented with left-sided scrotal and groin cellulitis and was admitted to the hospital for intravenous antibiotic therapy. He was placed on appropriate pharmacoprophylaxis for venous [...]

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HM2016 Abstract Number: 523

Severe Adenoviral Pneumonia with Transient Lupus Anticoagulant in an Immunocompetent Adult

Case Presentation: A 19 year old obese African American male with past medical history of asthma presented to the emergency room with sudden onset of shortness of breath. He had cough with expectoration of greenish [...]

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HM2016 Abstract Number: 524

Eosinophilic Granulomatosis with Polyangiitis : Not for the Lighthearted

Case Presentation: A 50 year old caucasian male with past medical history of asthma and chronic sinusitis presented with a 1-week history of worsening gradual onset exertional dyspnea. He denied orthopnea, paroxysmal nocturnal dyspnea, chest pain, palpitations, syncopal episode, [...]

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HM2016 Abstract Number: 526

Attacking the Good with the Bad: Autoimmune Colitis Following Ipilimumab Therapy for Melanoma

Case Presentation: This is a 62 year old male with history of stage IIIc melanoma being treated with the monoclonal antibody ipilimumab. One week after his second cycle, he developed diffuse abdominal pain and 3-4 [...]

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HM2016 Abstract Number: 530

Blastomycosis Masquerading As Metastatic Lung Disease

Case Presentation: A 53-year-old woman, with 30 pack-year smoking history, presented to the hospital with subacute posterior cephalgia associated with nausea, vomiting and photophobia. Review of systems was positive for an unintentional 15 pound weight [...]

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HM2016 Abstract Number: 527

Can’t Cope with the Stress of Nivolumab Therapy: Immune Mediated Adrenal Insufficiency

Case Presentation: This is a 51 year-old male with a past medical history of stage IV NSCLC being treated with Nivolumab, an anti-tumor monoclonal antibody.  He presented to urgent care with nausea, decreased appetite, hypoactivity [...]

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HM2016 Abstract Number: 531

Chronic Leg Weakness in a Patient with Depression. How About Cadasil?

Case Presentation: A 64-year-old woman with a past medical history of type 2 Diabetes Mellitus and depression presented to the hospital with subacute progressive left leg weakness over the past six months. She has had [...]

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HM2016 Abstract Number: 532

A Rare Case of Atypical Ttp!

Case Presentation: A 19-year-old man was admitted with acute non-radiating epigastric pain associated with three episodes of non-bilious/non-bloody emesis. He denied fever, diarrhea or hematuria. Review of systems was positive for muscle aches. His physical [...]

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HM2016 Abstract Number: 533

A Smoker’s Transverse Myelitis: Have You Ordered a Ct Chest?

Case Presentation: A 67-year-old woman with 50 pack-year smoking history presented with a 2-week history of bilateral leg weakness. She had difficulty with ambulation and sustained several falls. Of note, the patient denied cough, phlegm [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Smoker’s Transverse Myelitis: Have You Ordered a Ct Chest?

HM2016 Abstract Number: 534

‘abstinent and Intoxicated’. a Rare Case of Auto-Brewery Syndrome

Case Presentation: A 25-year-old man was found unresponsive at his home and brought to the hospital for further evaluation. In the emergency department, his Glasgow coma scale was 6, for which he was intubated and [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts, Finalist|Comments Off on ‘abstinent and Intoxicated’. a Rare Case of Auto-Brewery Syndrome

HM2016 Abstract Number: 536

A Natural Killer in Disguise!

Case Presentation: A 23 year-old Guatemalan man presented to the hospital with right sided facial swelling, vesicular lesions on the eyelids and ulcers on the tongue. He was admitted with seven similar episodes during the [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Natural Killer in Disguise!

HM2016 Abstract Number: 535

A Curious Case of Encephalopathy

Case Presentation: A 61 year-old-man with type 2 diabetes mellitus and progressive forgetfulness was admitted to the hospital with generalized weakness and difficulty ambulating for one week.  His review of systems was positive for hyperpigmentation [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Curious Case of Encephalopathy

HM2016 Abstract Number: 538

A Bezoar a Day Doesn’t Keep the Doctor Away

Case Presentation: A 69 year old female with history of gallbladder cancer status post cholecystectomy/hepatic wedge resection with roux-en-y choledochojejunostomy and chemoradiation presents with recurrent abdominal pain and fevers of 102oF. She reports 2 prior [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Bezoar a Day Doesn’t Keep the Doctor Away

HM2016 Abstract Number: 537

A Case of Dyspnea Following Remote Renal Transplant

Case Presentation: A 57-year-old man presented with two months of persistent dry cough and progressive dyspnea on exertion. His past medical history was significant for renal transplant, well-managed on rapamycin, mycophenolate and prednisone for the [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Case of Dyspnea Following Remote Renal Transplant

HM2016 Abstract Number: 540

Insulin Under Duress – Diagnosing and Treating Insulin Autoimmune Syndrome

Case Presentation: A 79-year-old Caucasian non-diabetic male with history of renal cell carcinoma, s/p left nephrectomy in 2005 and coronary artery stent placement 2 months prior and on Clopidogrel, presented with acute onset sweating and [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Insulin Under Duress – Diagnosing and Treating Insulin Autoimmune Syndrome

HM2016 Abstract Number: 541

Markedly Elevated Ptt: What to Do First ‘mixing Studies or Hepzyme’

Case Presentation: 49 Yr. F with PMH of asthma transferred from a community hospital where she was admitted with severe epigastric pain and chest pain. CT scan abdomen showed possible Peri-pancreatic mass or changes consistent [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Markedly Elevated Ptt: What to Do First ‘mixing Studies or Hepzyme’

HM2016 Abstract Number: 542

An Outlier of Inflammatory Arthropathy in a Coxsackie B Infection

Case Presentation: An 18-year-old African American male presented to the hospital with complaints of fever, vomiting, weakness in his upper and lower extremities, unsteady gait and joint pain. A few days prior to the onset [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on An Outlier of Inflammatory Arthropathy in a Coxsackie B Infection

HM2016 Abstract Number: 666

Dysphagia, Weight Loss, and a “Mass.” Foregut Vascular Insufficiency Masquerading As Gastric Cancer

Case Presentation:  A 66-year-old woman with a history of hypertension and type 2 diabetes mellitus presented to an outside hospital with persistent nausea and vomiting, a 45 pound weight loss, and dysphagia over a 4-week [...]

By | 2017-04-17T12:10:00+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Dysphagia, Weight Loss, and a “Mass.” Foregut Vascular Insufficiency Masquerading As Gastric Cancer

HM2016 Abstract Number: 667

Take Your Vitamins

Case Presentation: A 36-year-old woman with medical history only significant for obesity presents with confusion and difficulty ambulating one week prior to our evaluation. Two months ago, she underwent an uneventful laparoscopic sleeve gastrectomy for [...]

By | 2017-04-17T12:10:01+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Take Your Vitamins

HM2016 Abstract Number: 668

The Crystalline Fever : Crowned Dens Syndrome Masquerading As Meningitis

Case Presentation: This is a 77/F with Diabetes Mellitus, Hypertension and severe osteoarthritis who was admitted with 1 day history of mental status change, headache and neck pain with progressive pain in her hands, wrist [...]

By | 2017-04-17T12:09:58+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on The Crystalline Fever : Crowned Dens Syndrome Masquerading As Meningitis

HM2016 Abstract Number: 670

Cocaine-Levamisole Induced Vasculitis

Case Presentation: A 67 year- old man presented with three weeks of progressively worsening painful ulcers in bilateral lower extremities and fingers. The lesions started as numerous erythematous lesions on his legs and fingers five months [...]

By | 2017-04-17T12:10:00+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Cocaine-Levamisole Induced Vasculitis

HM2016 Abstract Number: 672

Warm Autoimmune Hemolytic Anemia: An Unusual Presentation of Painless Jaundice

Case Presentation: A 90 year-old man presented with three weeks of progressive weakness and jaundice. He denied abdominal pain, nausea, vomiting or changes in stool color. He denied recent travel or sick contacts. His past [...]

By | 2017-04-17T12:09:59+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Warm Autoimmune Hemolytic Anemia: An Unusual Presentation of Painless Jaundice

HM2016 Abstract Number: 674

Palmoplantar Erythrodysesthesia Syndrome : A Rare Adverse Effect of Docetaxel Chemotherapy

Case Presentation: A 51 year-old Caucasian female with a palpable right breast nodule, underwent biopsy which confirmed invasive ductal carcinoma. Sentinel lymph node biopsy, axillary lymph node dissection (8/14) and a right mastectomy were performed. [...]

By | 2017-04-17T12:10:00+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Palmoplantar Erythrodysesthesia Syndrome : A Rare Adverse Effect of Docetaxel Chemotherapy

HM2016 Abstract Number: 676

A Rare Presentation of Disseminated Cryptococcus

Case Presentation: 67 year old man presented to the emergency room with syncope and melena. He was recently diagnosed with cirrhosis by biopsy. His cirrhosis was attributed to NASH. For several weeks, he noted intermittent black stools, which became [...]

By | 2017-04-17T12:10:00+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Rare Presentation of Disseminated Cryptococcus

HM2016 Abstract Number: 675

An Exceptional Gpa: Granulomatosis with Polyangiitis Presenting As Hypertrophic Pachymeningitis

Case Presentation: A 62 year old male with history of rapidly progressive glomerulonephritis due to anti-glomerular basement membrane (anti-GBM) disease who remains dialysis dependent after failing to respond to steroids and plasmapheresis eight months ago [...]

By | 2017-04-17T12:09:59+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on An Exceptional Gpa: Granulomatosis with Polyangiitis Presenting As Hypertrophic Pachymeningitis

HM2016 Abstract Number: 677

Left Lower Extremity Pain, Swelling and Purpuric Rash in a 37 Year Old Male

Case Presentation: BM is a 37 y.o. male with a past medical history significant for irritable bowel syndrome. He presented to Maine Medical Center from a rheumatology office with the chief complaint of left lower [...]

By | 2017-04-17T12:10:01+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Left Lower Extremity Pain, Swelling and Purpuric Rash in a 37 Year Old Male

HM2016 Abstract Number: 679

When Steroids Aren’t the Right Answer: A Curious Case of Vasculitis

Case Presentation: A 55-year-old man with gastroesophageal reflux disease and prostate cancer status post radical prostatectomy presented with a 3-year history of non-healing skin ulcerations. He was initially diagnosed with vasculitis and started on immunosuppressive [...]

By | 2017-04-17T12:09:59+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on When Steroids Aren’t the Right Answer: A Curious Case of Vasculitis

HM2016 Abstract Number: 680

When Clinical Suspicion and Imaging Don’t Match: An Interesting Case of Fuo

Case Presentation: A 67 year-old man with history of transient ischemic attack, coronary artery disease, and peripheral artery disease status post aorto-iliac graft in 1994 presented with intermittent fevers, chills, and intense rigors. Symptoms started [...]

By | 2017-04-17T12:10:01+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on When Clinical Suspicion and Imaging Don’t Match: An Interesting Case of Fuo

HM2016 Abstract Number: 684

Topiramate As a Rare Cause of Reversible Fanconi Syndrome and Acute Kidney Injury

Case Presentation: A 53 year-old woman with history of depression and chronic kidney disease stage 2 - with baseline serum creatinine (Cr) of 1 mg/dl - presented with a Cr of 2.9 mg/dl obtained as [...]

By | 2017-04-17T12:09:59+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Topiramate As a Rare Cause of Reversible Fanconi Syndrome and Acute Kidney Injury

HM2016 Abstract Number: 687

Guillain-Barré Syndrome Masquerading As Angioedema

Case Presentation: A 64 year-old woman, with history of essential hypertension and hypothyroidism, presented to her primary care physician’s office with cold like symptoms and dry cough for 2 weeks associated with mild numbness in her fingers. She was [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Guillain-Barré Syndrome Masquerading As Angioedema

HM2016 Abstract Number: 685

A Very Rare Cause of Recurrent Hepatic Encephalopathy Due to Zinc Deficiency

Case Presentation: A 74 year old gentleman with known end-stage alcoholic liver disease (MELD 22) presented to the emergency room with lethargy. He had been deemed unsuitable for liver transplantation due to his age and [...]

By | 2017-04-17T12:10:01+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Very Rare Cause of Recurrent Hepatic Encephalopathy Due to Zinc Deficiency

HM2016 Abstract Number: 689

Diagnosis “Probable?” Diagnostic Difficulty in Cardiac Sarcoidosis

Case Presentation: A 47 year-old female with hypertension, dyslipidemia, and diabetes presented with two weeks of dyspnea. An ECG a year prior showed normal sinus rhythm. The rhythm strip from a transthoracic echocardiogram incidentally showed [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Diagnosis “Probable?” Diagnostic Difficulty in Cardiac Sarcoidosis

HM2016 Abstract Number: 688

Horner Syndrome As the Initial Presentation of Spontaneous Bilateral Internal Carotid Artery Dissection with Pseudoaneurysm

Case Presentation: A 56-year old male patient presented with severe persistent left occipital headache for 3 weeks associated with left eye pain. During this period, the patient was evaluated once in the emergency room (ER) [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Horner Syndrome As the Initial Presentation of Spontaneous Bilateral Internal Carotid Artery Dissection with Pseudoaneurysm

HM2016 Abstract Number: 690

It Takes a Village: Diagnosing a Disease Under the Radar

Case Presentation: A 23 year old female with a history of ovarian torsion, s/p ovarian cystectomy, presented to the emergency department in status epilepticus. Over the past week, the patient experienced a rapid deterioration in behavior [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on It Takes a Village: Diagnosing a Disease Under the Radar

HM2016 Abstract Number: 692

Unusual Cause of Anaphylaxis: What Is Hiding in a Belly?

Case Presentation: A 82-year-old woman with a history of well-controlled asthma presented with shortness of breath. She developed acute onset shortness of breath while sitting at home thirty minutes prior to presentation, which was accompanied [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Unusual Cause of Anaphylaxis: What Is Hiding in a Belly?

HM2016 Abstract Number: 694

Isolated Cns Histoplasmosis in Apparent Immunocompetent Host; Mimicking Brain Metastasis

Case Presentation:   We report a 56-year-old male from New Mexico with a 6-month history of weight loss, night sweats, intermittent confusion, and personality changes.  He also reports new onset headache and progressive right-sided weakness. [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Isolated Cns Histoplasmosis in Apparent Immunocompetent Host; Mimicking Brain Metastasis

HM2016 Abstract Number: 693

Atypical Syphilis Rash Mimicking Psoriasis in the Hiv-Infected Patient – the Great Imitator of Psoriasis –

Case Presentation: We report a case of a 68-year-old Japanese man with an established diagnosis of advanced HIV infection presented with systemic eruption. According to the medical interview of the patient, he had a history [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Atypical Syphilis Rash Mimicking Psoriasis in the Hiv-Infected Patient – the Great Imitator of Psoriasis –

HM2016 Abstract Number: 697

Hacek Me If You Can

Case Presentation: A fifty-three year old woman presented with symptomatic anemia and hemoglobin of 6.8. She also described progressively worsening fatigue, dyspnea on exertion, weight loss and night sweats over the last three months. Given [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Hacek Me If You Can

HM2016 Abstract Number: 699

Xanax or Total Thyroidectomy? A Missed Case of Classic Men2A

Case Presentation: We report a case of a 29 yo female whose initial clinical manifestation of pheochromocytoma/MEN was suspected due to an incidental discovery of bilateral adrenal lesions revealed by abdominal CT instead of a [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Xanax or Total Thyroidectomy? A Missed Case of Classic Men2A

HM2016 Abstract Number: 698

Lymphomatoid Granulomatosis Masquerading As Cellulitis

Case Presentation: A morbidly obese 24 year-old male with two recent hospitalizations for abdominal panniculitis and LE cellulitis presented to the ED with several weeks of worsening left abdominal pain and induration meeting SIRS criteria. [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Lymphomatoid Granulomatosis Masquerading As Cellulitis

HM2016 Abstract Number: 702

It’s the Drinks ,not the Salt

Case Presentation: A 54-year-old male with heavy alcohol abuse was brought to the emergency department by his daughter. He has a long standing history of alcohol abuse for many years and drinks more than 3 [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on It’s the Drinks ,not the Salt

HM2016 Abstract Number: 701

Delayed Neuropsychiatric Syndrome in a Patient with Intentional Carbon Monoxide Intoxication

Case Presentation: A 57 year old man with no significant medical or psychiatric history was admitted to our hospital after a suicide attempt. He was found unconscious in his car with the ignition running in [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Delayed Neuropsychiatric Syndrome in a Patient with Intentional Carbon Monoxide Intoxication

HM2016 Abstract Number: 703

When in Doubt, Check the Thyroid

Case Presentation: 67 years old lady presented with confusion, poor oral intake, subjective fevers and generalized weakness for 4 weeks. Physical examination revealed a lady oriented only to person, who was experiencing visual hallucinations and [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on When in Doubt, Check the Thyroid

HM2016 Abstract Number: 704

Hus-A Common Presentation of a Rare Disease

Case Presentation: A 56 year-old-man with a history of stage IV metastatic pancreatic cancer on gemcitabine/ abraxane for treatment with last dose occurring 8 days prior to admission presented with persistent fatigue. On admission, he [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Hus-A Common Presentation of a Rare Disease

HM2016 Abstract Number: 707

“Fat Burners May Burn the Heart” L-Tryptophan Related Eosinophilia-Myalgia Syndrome (Ems) with Myocarditis: A Case Report Emphasizing the Importance of Detail History About the Use of Dietary Supplements

Case Presentation: 26 year old woman with past medical history of asthma and eczema presented with positional chest pain for 6 days, that was associated with worsening spasm-like pains in her extremities and back for [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on “Fat Burners May Burn the Heart” L-Tryptophan Related Eosinophilia-Myalgia Syndrome (Ems) with Myocarditis: A Case Report Emphasizing the Importance of Detail History About the Use of Dietary Supplements

HM2016 Abstract Number: 706

Electrocardiogram of Bleeding Brain

Case Presentation: We discuss here a 39-year-old female who presented to the emergency department after an unwitnessed fall followed by loss of consciousness due to alcohol intoxication. The physical examination was unremarkable except for a [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Electrocardiogram of Bleeding Brain

HM2016 Abstract Number: 708

Right Atrial Thrombus

Case Presentation: An 89 year-old man presented after being found down at home. His history included hypertension and hyperlipidemia. His exam was notable for an irregularly irregular rhythm at a rate of 150 beats per [...]

By | 2017-04-20T13:47:44+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Right Atrial Thrombus

HM2016 Abstract Number: 709

When a Common Medication, Has Uncommon Side Effects. Cefuroxime Induced Thrombocytopenia

Case Presentation: A 69 y/o male with no known PMH with a complicated hospital course highlighted by PE s/p TPA, AWSTEMI s/p DES to pLAD and septic shock leading to AKI requiring CVVH. For septic shock, [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on When a Common Medication, Has Uncommon Side Effects. Cefuroxime Induced Thrombocytopenia

HM2016 Abstract Number: 710

When Iron Is Not Your Friend: Spontaneous Necrotizing Fasciitis in a Septicemic Male with Liver Cirrhosis

Case Presentation: 40 year-old male with history of alcoholic liver cirrhosis presented with acute onset of fever with severe left lower extremity pain with no history of local wound or trauma. Exam revealed a patient in moderate distress with [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on When Iron Is Not Your Friend: Spontaneous Necrotizing Fasciitis in a Septicemic Male with Liver Cirrhosis

HM2016 Abstract Number: 712

Sepsis and Pustules in a Masquerade Ball

Case Presentation: 62 year old African American male with history of hidradenitis suppurutiva , hypertention and benign prostatic hypertrophy was transferred with c/o multiple abscesses and high grade fevers .They started as skin colored swellings [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Sepsis and Pustules in a Masquerade Ball

HM2016 Abstract Number: 715

“Tear It Up! Exercise Induced Coronary Artery Dissection”

Case Presentation: A 40 year-old female with history of pulmonary embolism during pregnancy presented with sudden onset of substernal chest pain and shortness of breath, which began an hour after she finished a rowing class. [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on “Tear It Up! Exercise Induced Coronary Artery Dissection”

HM2016 Abstract Number: 711

The “Forgotten Disease” Remembered: Lemierres’s Syndrome and the Severe Complications

Case Presentation: A previously healthy 27 year old female was admitted with a severe cough and pleuritic chest pain after being treated as an outpatient for tonsillitis/pharyngitis 3 weeks prior to admission.  Her initial outpatient [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on The “Forgotten Disease” Remembered: Lemierres’s Syndrome and the Severe Complications

HM2016 Abstract Number: 714

A Rare Case of Primary Intravascular B-Cell Lymphoma of the Liver Presenting As Fever of Unknown Origin

Case Presentation: A 62-year-old Caucasian male with history of sarcoidosis presented with three months of low grade fevers, progressively worsening fatigue, headaches, cough, recently developed rash and visual changes.  Physical examination was significant for fever, [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Rare Case of Primary Intravascular B-Cell Lymphoma of the Liver Presenting As Fever of Unknown Origin

HM2016 Abstract Number: 713

A Sleeping Giant Awakens: A Case of Pheochromocytoma Diagnosed After Antihistamine Induced Adrenergic Crisis

Introduction: Pheochromocytoma is a rare adrenal tumor causing hypertensive crisis. The classic triad of symptoms in patients include palpitations, headaches and tremor, however, not every patient manifests with this typical presentation. Here we present a [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Sleeping Giant Awakens: A Case of Pheochromocytoma Diagnosed After Antihistamine Induced Adrenergic Crisis

HM2016 Abstract Number: 716

Cellulitis? Think Again! an Unusual Presentation of Recurrent Mantle Cell Lymphoma

Case Presentation: A 80 year-old male with history of stage IIIBE mantle cell lymphoma (MCL) diagnosed after presenting with left upper quadrant abdominal pain associated with weight loss, night sweats, fevers, and fatigue. He completed [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Cellulitis? Think Again! an Unusual Presentation of Recurrent Mantle Cell Lymphoma

HM2016 Abstract Number: 719

West Nile Neuroinvasive Disease in a Patient with Orthotopic Heart Transplant

Case Presentation: The patient is a 78 year old male with a history of ischemic cardiomyopathy status-post orthotopic heart transplant on tacrolimus and mycophenolic acid, who presented to the emergency department with 4 days of [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on West Nile Neuroinvasive Disease in a Patient with Orthotopic Heart Transplant

HM2016 Abstract Number: 717

“Weight Loss or Brain Loss?”: Long Term Use of Phentermine Possibly Increases Risk for Ischemic Stroke

Case Presentation: A 39 y/o female with no significant past medical history and long term use of phentermine for weight loss presented to our hospital with complaints of transient right sided weakness and right sided [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on “Weight Loss or Brain Loss?”: Long Term Use of Phentermine Possibly Increases Risk for Ischemic Stroke

HM2016 Abstract Number: 720

Lithium Related Transient Aphasia: A Lesser Known Face of a Well Known Drug

Case Presentation: A 60-year-old lady presented with worsening confusion, recurrent falls, polyuria, and abnormal speech. She was recently started on lithium for bipolar disorder and she endorsed taking some extra lithium tablets in an attempt [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Lithium Related Transient Aphasia: A Lesser Known Face of a Well Known Drug

HM2016 Abstract Number: 721

Pulmonary Sarcoidosis: Defying Diagnosis and Thwarting Therapy

Case Presentation: A 37-year-old man presented with fevers, chills, pleuritic chest pain, productive cough, and hemoptysis. He endorsed a six-month history of worsening cough, night sweats, and 25-pound weight loss despite a course of antibiotics [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Pulmonary Sarcoidosis: Defying Diagnosis and Thwarting Therapy

HM2016 Abstract Number: 722

Can a Verse (Poem) Get Any Worse!

Case Presentation: A 52 year old male presented with insidious onset of abdominal distention for two months prior to presentation. His past medical history was significant for hypothyroidism and sensory motor polyneuropathy diagnosed five years [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Can a Verse (Poem) Get Any Worse!

HM2016 Abstract Number: 724

Pancytopenia and Bizzare Behavior: Admit to Psychiatry or Medicine?

Case Presentation: A 46 year-old caucasian man presented with one week of altered mental status and bizarre behavior. He had no personal or familial psychiatric history. His past medical history included documented asthma, thalassemia, and celiac [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Pancytopenia and Bizzare Behavior: Admit to Psychiatry or Medicine?

HM2016 Abstract Number: 732

Pott’s Disease Following Intravesical Bcg Therapy

Case Presentation: Intravesical administration of Bacillus Calmette-Guerin (BCG), a live attenuated strain of Mycobacterium bovis, is used as an adjunctive therapy for superficial bladder cancer. Although mostly well tolerated, disseminated infections can occur rarely. We [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Pott’s Disease Following Intravesical Bcg Therapy

HM2016 Abstract Number: 733

Is the Patient Bleeding Again? A Curious Case of GI Bleeding

Case Presentation: 53-year-old female with past medical history of alcohol induced chronic pancreatitis who had multiple admissions with hematemesis and melena, abdominal pain, fatigue and severe microcytic anemia. During her first admission patient was found [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Is the Patient Bleeding Again? A Curious Case of GI Bleeding

HM2016 Abstract Number: 734

A “Poor” Option for a Classic Pentad

Case Presentation: A 43-year-old female Jehovah’s Witness was admitted for 30 minutes of blurred vision, dysarthria, and left upper extremity weakness. She had two similar episodes in the past 2-3 weeks, each transient with full [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A “Poor” Option for a Classic Pentad

HM2016 Abstract Number: 737

Alloiococcus Otitidis Causing Purulent Pericarditis Presenting As Pericardial Tamponade

Case Presentation: A 54-year-old Caucasian female with a history of obesity hypoventilation syndrome on 2L/min home oxygen therapy, breast cancer status post lumpectomy and radiation, and deep vein thrombosis on warfarin, presented to the emergency [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Alloiococcus Otitidis Causing Purulent Pericarditis Presenting As Pericardial Tamponade

HM2016 Abstract Number: 738

A Male with Signs of Pregnancy: A Case of Ivc Syndrome

Case Presentation: A 63-year-old male presented with symptomatic orthostatic hypotension and acute kidney injury (AKI). On the day of hospital admission, the patient visited his neurosurgeon for a follow up appointment and was found to [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Male with Signs of Pregnancy: A Case of Ivc Syndrome

HM2016 Abstract Number: 739

Cat Got Your Tongue

Case Presentation: A 56 year old man presented to the emergency department (ED) with acute, left-sided tongue swelling for one day. The patient had a past medical history of hyperlipidemia and recurrent ottis media and [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Cat Got Your Tongue

HM2016 Abstract Number: 740

Babesiosis Without the Tick

Case Presentation: 47 year old black female presented to the hospital with one week of generalized weakness, body aches and malaise. Her medical history was significant for large hemorrhoids that were resected one month prior [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Babesiosis Without the Tick

HM2016 Abstract Number: 741

Move It or Burst It: Fatal Complication of Benign Symptom

Case Presentation: A 56 year-old-female with past history of schizoaffective disorder on clozapine after failure of many antipsychotic medications for around 3 years got voluntarily hospitalized in a psychiatric facility for over 2 months and [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Move It or Burst It: Fatal Complication of Benign Symptom

HM2016 Abstract Number: 743

Listen to Your Brain but Follow Your Heart

Case Presentation: A 39-year-old man with pulmonary sarcoidosis presents with two days of progressive change in mental status. He is admitted to the medical ICU after initial attempts to resolve hypotension with intravenous isotonic resuscitation [...]

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HM2016 Abstract Number: 746

A Rare Cause of Gastrointestinal Bleeding in a Young Adult

Case Presentation: An 18-year-old female was admitted with generalized weakness and pallor. She was born with a bluish nodule on her back. Since birth, the patient developed recurrent bluish nodules in the skin, which increased [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Rare Cause of Gastrointestinal Bleeding in a Young Adult

HM2016 Abstract Number: 747

The Truth Is in the Smear

Case Presentation: A 34-year-old Liberian woman with a history of HIV and AIDS diagnosed 10 years prior had not been taking anti-retroviral therapy for the past four years when she presented with two weeks of [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on The Truth Is in the Smear

HM2016 Abstract Number: 745

Tender Skin Macules: Case of Early Cutaneous Polyarteritis Nodosa

Case Presentation: A 25-year-old African American female presented with a 1-month history of recurrent fevers, sweats, myalgias, arthralgias, and fatigue accompanied by the development of small, tender, indurated plaques occurring on both arms and legs [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Tender Skin Macules: Case of Early Cutaneous Polyarteritis Nodosa

HM2016 Abstract Number: 749

Sarcoidosis in a Patient on Adalimumab

Case Presentation: A 34-year-old male patient with a history of psoriatic arthritis on treatment with methotrexate was started on leflunomide. After few months, because of the persistent symptoms and lack of response to leflunamide, he [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Sarcoidosis in a Patient on Adalimumab

HM2016 Abstract Number: 748

A Classic Case of Invasive Klebsiella Pneumoniae Liver Abscess Syndrome with Metastatic Septic Arthritis

Case Presentation: A 53 year old Chinese female with no PMH presented with 1 week history of nausea, abdominal pain, fever, chills and fatigue. Abdominal pain was not related to food and she denied headache [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Classic Case of Invasive Klebsiella Pneumoniae Liver Abscess Syndrome with Metastatic Septic Arthritis

HM2016 Abstract Number: 750

An Unusual Presentation of a Rare Disease: Are We Underdiagnosing Creutzfeldt-Jakob Disease?

Case Presentation: A 67-year-old female with history of chronic kidney disease presented with 3 weeks history of confusion, difficulty walking, and visual hallucinations. Initially, she was alert and oriented without any focal neurologic deficit. Her [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on An Unusual Presentation of a Rare Disease: Are We Underdiagnosing Creutzfeldt-Jakob Disease?

HM2016 Abstract Number: 751

An Emerging Diagnosis: A Mysterious Encephalitis

Case Presentation: A 35-year-old Hispanic female, with no significant past medical history, first presented after a witnessed seizure but rapidly developed confusion, flat affect, agitation, and suicidal ideation necessitating inpatient psychiatric hold and high dose [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on An Emerging Diagnosis: A Mysterious Encephalitis

HM2016 Abstract Number: 752

Angiotension Receptor Blocker Induced Focal Myositis in the Setting of Vitamin D Deficiency

Case Presentation: A 47 year-old African American male presented with lower extremity pain and swelling. Three weeks prior he started azilsartan/chlorthalidone for hypertension. A week later, pain and swelling of his right leg began, worsening [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Angiotension Receptor Blocker Induced Focal Myositis in the Setting of Vitamin D Deficiency

HM2016 Abstract Number: 731

Sepsis with a Twist of Lyme

Case Presentation: A 57 year-old man living in the Northeastern U.S. with hepatitis C and rheumatoid arthritis, neither treated, underwent surgery for retinal detachment. 1 week post-operatively he developed severe frontal headache, arthalgias, myalgias, malaise, [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Sepsis with a Twist of Lyme

HM2016 Abstract Number: 729

A C”Urea”Ous Case of Post-Partum Hepatic Encephalopathy

Case Presentation: A 30 year old woman with history of benign essential hypertension, hyperlipidemia, gastroesophageal reflux disease and fatty liver disease who was four days post-partum after a vaginal delivery complicated by post-partum depression presented [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A C”Urea”Ous Case of Post-Partum Hepatic Encephalopathy

HM2016 Abstract Number: 753

Aortic Root Abscess with Valve Endocarditis Presenting As Transient Ischemic Attack in an Elderly Patient

Case Presentation: This is an 82-year-old male presented to the ER with chief complains of unable to speak with left-sided weakness. Past medical history with Positive for hypertension, hypothyroidism,dyslipidemia and aortic valve replacement with bovine [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Aortic Root Abscess with Valve Endocarditis Presenting As Transient Ischemic Attack in an Elderly Patient

HM2016 Abstract Number: 757

Neurogenic Myocardial Stunning – an Interesting Case of Troponemia

Case Presentation: We present an interesting case of troponemia in a patient with acute stroke that was initially treated as Non-STEMI but eventually turned out to be a presentation of neurogenic myocardial stunning.71-year-old male with [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Neurogenic Myocardial Stunning – an Interesting Case of Troponemia

HM2016 Abstract Number: 756

A Fatal Case of Arthroprosthetic Cobaltism

Case Presentation: A 65-year-old female was admitted to the hospital with weakness and difficulty ambulating. One year prior, she underwent revision of a previous right hip arthroplasty, and the femoral components were replaced with a [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Fatal Case of Arthroprosthetic Cobaltism

HM2016 Abstract Number: 759

Dunbar Syndrome: A Rare Case of Post Prandial Abdominal Pain

Case Presentation: A 28-year-old male presented with a 10-year history of intermittent post-prandial abdominal pain and fullness, forcing him to adopt a fetal position. He denied alcohol, tobacco, marijuana, or NSAID use. He reported worsening [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Dunbar Syndrome: A Rare Case of Post Prandial Abdominal Pain

HM2016 Abstract Number: 758

As Molly Takes the Party Toll: Mdma Toxicity Presenting As Pulmonary Hemorrhage

Case Presentation: A 33-year-old asthmatic female presented with a one-day history of productive cough and dyspnea. She reported occasional blood tinged sputum on the day of admission. Clinical exam revealed crackles on the right side. [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on As Molly Takes the Party Toll: Mdma Toxicity Presenting As Pulmonary Hemorrhage

HM2016 Abstract Number: 760

It’s Not Just Another Back Pain!

Case Presentation: : A 60 year old man presented for the third time with acute worsening of back pain and lower extremity weakness, night sweats, and weight loss. During the first similar presentation 3 three [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on It’s Not Just Another Back Pain!

HM2016 Abstract Number: 761

Precipitation of Primary Adrenal Insufficiency by Thyroid Supplementation in a Patient with Undiagnosed Autoimmune Polyglandular Syndrome Type Ii

Case Presentation: A 42 year-old woman with a history of hypothyroidism, remote type II diabetes mellitus, and premature ovarian failure (POF) presented to the Emergency Department of an academic community hospital with the one day [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Precipitation of Primary Adrenal Insufficiency by Thyroid Supplementation in a Patient with Undiagnosed Autoimmune Polyglandular Syndrome Type Ii

HM2016 Abstract Number: 763

Sepsis Imposters in the Medicated Psyciatric Patient

Case Presentation: A 45 year old, homeless man with poly-substance use disorder, schizoaffective disorder, and hypertension, was brought in by police for assaultive and hypersexual behavior and admitted to the psychiatry service, where he was [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Sepsis Imposters in the Medicated Psyciatric Patient

HM2016 Abstract Number: 764

Cultural Idiosyncrasies: A Threat to Medical Autonomy?

Case Presentation: This is the case of a 52-year-old Korean female diagnosed with non-invasive high-grade papillary urothelial carcinoma. Due to unknown reasons, she refused initial tumor resection and opted for alternative medical therapy. Unfortunately, the [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Cultural Idiosyncrasies: A Threat to Medical Autonomy?

HM2016 Abstract Number: 765

Culprit in Camo: Kshv-Associated Multicentric Castleman’s Disease

Case Presentation: A 49-year-old man diagnosed with human immunodeficiency virus (HIV) two years earlier and started on antiretroviral therapy two months prior presented to a clinic with fever, diffuse palpable lymphadenopathy, and shortness of breath. [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Culprit in Camo: Kshv-Associated Multicentric Castleman’s Disease

HM2016 Abstract Number: 766

Stumped by the Shunt

Case Presentation:  63-year-old female admitted to neurosurgery for lumboperitoneal (LP) shunt placement for cerebrospinal fluid (CSF) leak, 35 days after craniotomy for epidermoid tumor resection. Patient had no relevant prior history. After LP shunt placement, [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Stumped by the Shunt

HM2016 Abstract Number: 769

A “Good” Case of Thymoma

Case Presentation: A 66 year old woman with history of iron deficiency anemia, tuberculosis (TB), pulmonary mycobacterium avium complex (MAC) and thymoma presented to the ED for symptomatic anemia.  She was well until 6 months [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A “Good” Case of Thymoma

HM2016 Abstract Number: 768

Pitfalls of Travel Medicine: A Case of Multiple Endemic Exposures

Case Presentation: A 66 year-old man presented with fever, chills, and a diffuse erythematous truncal rash for five days. His symptoms began upon returning from travelling to Morocco and Thailand, and six weeks after a [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Pitfalls of Travel Medicine: A Case of Multiple Endemic Exposures

HM2016 Abstract Number: 770

A Rare Cause of Chest Pain and St Elevation in a Patient with Metastatic Lung Cancer

Case Presentation: A 73 years old male who was recently diagnosed with metastatic squamous cell carcinoma of the right lung presented with worsening pressure like nonpositional central chest pain associated with some shortness of breath [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Rare Cause of Chest Pain and St Elevation in a Patient with Metastatic Lung Cancer

HM2016 Abstract Number: 771

Not so Special K

Case Presentation: A 36 year old homeless Asian man with history of polysubstance abuse and frequent urinary tract infections presented to the emergency department with altered mental status and oliguria that had worsened over the [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Not so Special K

HM2016 Abstract Number: 773

Empyema Without Pneumonia?

Case Presentation: A 64-year-old man with a history of cryptogenic cirrhosis and prior right-sided hepatic hydrothorax presents with a 2-day history of right-sided pleuritic chest pain and subjective fevers.  On admission, the patient was afebrile, [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Empyema Without Pneumonia?

HM2016 Abstract Number: 772

To Anticoagulate or Not?: A Case Reviewing Granulomatosis with Polyangiitis Induced Atial Fibrillation

Case Presentation: 65-year-old female with hypertension and   smoking history presented with a gradual onset of painful, edematous feet for 4-days.  She continued to develop erythema and a constant, nonradiating pain in her feet. The patient also noted an increase [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on To Anticoagulate or Not?: A Case Reviewing Granulomatosis with Polyangiitis Induced Atial Fibrillation

HM2016 Abstract Number: 774

The Four Year Itch: Recrudescent Malaria in a Patient with Sarcoidosis

Case Presentation: A 49-year-old Nigerian woman with sarcoidosis not on immunosuppressants presented to the emergency department with one week of fever and right upper quadrant pain.  The fevers occurred nightly and were as high as [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on The Four Year Itch: Recrudescent Malaria in a Patient with Sarcoidosis

HM2016 Abstract Number: 775

Not Your Typical Complements: Atypical Hemolytic Uremic Syndrome Secondary to Streptococcus Pneumoniae

Case Presentation: A previously healthy 36-year-old woman presented to the emergency room with one day of fever and an episode of presyncope in the setting of 3 weeks of sinus pressure and headache.  She denied [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Not Your Typical Complements: Atypical Hemolytic Uremic Syndrome Secondary to Streptococcus Pneumoniae

HM2016 Abstract Number: 776

A Rare Case of Bilateral Endophthalmitis

Case Presentation: A 69-year old male with a past medical history of diabetes mellitus type II and cryptogenic cirrhosis with esophageal varices presented to the emergency department with one day of acute bilateral vision loss. [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Rare Case of Bilateral Endophthalmitis

HM2016 Abstract Number: 777

Cat Got Your Tongue?: An Unusual Case of Pasteurella Multocida Bacteremia in an Immunocompetent Patient

Case Presentation: A 56 year old Caucasian male presented to the ED with left tongue swelling. His symptoms started 3 days prior with left neck and facial pain, and he had gone to an ENT [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Cat Got Your Tongue?: An Unusual Case of Pasteurella Multocida Bacteremia in an Immunocompetent Patient

HM2016 Abstract Number: 778

Diagnosis of Disseminated Gonococcal Infection Complicated by Acute Hepatitis B Infection

Case Presentation: A 49-year-old Caucasian male presented with a two-week history of progressive asymmetrical arthralgias. He denied trauma, fevers or rashes. He endorsed night sweats. Symptoms progressed such that he was unable to walk due [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Diagnosis of Disseminated Gonococcal Infection Complicated by Acute Hepatitis B Infection

HM2016 Abstract Number: 779

“Hashimoto’s Heart”: Cardiac Tamponade As Presenting Symptom in Patient with Severe Hypothyroidism

Case Presentation: A 52 y.o with a past medical history of uncontrolled, untreated hypertension presented to our hospital with a 3 week history of progressively worsening lower extremity edema and shortness of breath. Review of [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on “Hashimoto’s Heart”: Cardiac Tamponade As Presenting Symptom in Patient with Severe Hypothyroidism

HM2016 Abstract Number: 780

Surreptitious Venous Microthrombi Associated with Transient Acute Kidney Injury

Case Presentation: A 27-year-old woman with a remote diagnosis of essential hypertension treated with hydrochlorothiazide-triamterene presented with five days of bilateral flank pain and nausea. On admission she was found to have a creatinine of [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Surreptitious Venous Microthrombi Associated with Transient Acute Kidney Injury

HM2016 Abstract Number: 785

A Hawk Strikes from Beyond the Grave

Case Presentation: A 40 year old diabetic Native American male presented with progressive confusion of a few days duration.  Patient was transferred from an outside facility with concern for lymphoma due to associated lymphadenopathy and [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Hawk Strikes from Beyond the Grave

HM2016 Abstract Number: 781

Cutaneous Manifestations As the Initial Presentation of Ulcerative Colitis in the Post-Partum Period

Case Presentation: A 39 year old woman with a history of an uncomplicated pregnancy 3 months prior presented to the Emergency Department with recurrent crampy abdominal pain, poor appetite, and alternating constipation and diarrhea with [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Cutaneous Manifestations As the Initial Presentation of Ulcerative Colitis in the Post-Partum Period

HM2016 Abstract Number: 784

Bilateral Adrenal Masses: Diagnosis and Treatment of a Rare Malignancy

Case Presentation: A 68 year-old female known to have hypertension, nephrolithiasis, and chronic urinary incontinence presented to a tertiary-care hospital with three days of left sided flank pain, unilateral headache, diaphoresis, and a recent history [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Bilateral Adrenal Masses: Diagnosis and Treatment of a Rare Malignancy

HM2016 Abstract Number: 786

The Shaky Side of Infliximab: A Case Report of Rheumatoid Meningitis Associated with Infliximab

Case Presentation: A 66-year-old female with a history of rheumatoid arthritis on infliximab developed acute onset expressive aphasia and was diagnosed with a transient ischemic attack after a noncontrast CT head was negative. During this [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on The Shaky Side of Infliximab: A Case Report of Rheumatoid Meningitis Associated with Infliximab

HM2016 Abstract Number: 787

Chylothorax and Chylous Ascites As a Result of Chronic Lymphocytic Leukemia

Case Presentation: Chylothorax and chylous ascites are lymphatic complications characterized by leakage of triglyceride-rich fluid secondary to damage of the thoracic duct. Few cases in the literature exist regarding chylous complications from chronic lymphocytic leukemia [...]

By | 2016-02-25T12:39:45+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Chylothorax and Chylous Ascites As a Result of Chronic Lymphocytic Leukemia

HM2016 Abstract Number: 454

A Mixer of Over-Drinking and Under-Diagnosisp

Case Presentation: A 40-year-old man initially presented with a headache and was admitted for hypertensive emergency. He rapidly developed altered mental status, acute kidney injury, fever, and weakness. After 12 days of supportive care, he [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Mixer of Over-Drinking and Under-Diagnosisp

HM2016 Abstract Number: 449

Hhv-8-Negative, Idiopathic Multicentric Castleman’s Disease: A Rare Case of Fever of Unknown Origin

Case Presentation: A 30-year-old male with type two diabetes mellitus and morbid obesity presented with one month of generalized weakness, fatigue and fever. This was his third hospitalization with these same symptoms; no definitive diagnosis [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Hhv-8-Negative, Idiopathic Multicentric Castleman’s Disease: A Rare Case of Fever of Unknown Origin

HM2016 Abstract Number: 451

Stolen from the Source: A Mysterious Cause of Hypotension

Case Presentation: Hypotension in the hospital setting is a common finding with a broad differential diagnosis.  The workup includes evaluation for cardiac and infectious etiologies, among others.  We present an infrequent cause of hypotension to [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Stolen from the Source: A Mysterious Cause of Hypotension

HM2016 Abstract Number: 456

Wernicke’s Encephalopathy After Bariatric Surgery in a Patient with Psychiatric Comorbidities

Case Presentation: A 31-year-old female with history of generalized anxiety disorder (GAD), morbid obesity, and eight weeks status-post sleeve gastrectomy presented with 50-pound weight loss and mental status changes. Other symptoms included nausea, vomiting, and [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Wernicke’s Encephalopathy After Bariatric Surgery in a Patient with Psychiatric Comorbidities

HM2016 Abstract Number: 453

A Case of GI Bleed Due to Cmv Colitis in an Immunocompetent Patient

Case Presentation: A 65 year old African American male with a past medical history of non-obstructive CAD and chronic hepatitis C with cirrhosis presented to the emergency room with one episode of hematochezia.  Vital signs [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Case of GI Bleed Due to Cmv Colitis in an Immunocompetent Patient

HM2016 Abstract Number: 450

A Case of Jamaican Stone

Case Presentation: 43 year old male with history of HTN and HLD presented to the emergency room with abdominal pain, nausea, vomiting, and tongue numbness two hours after ingesting one centimeter of “Jamaican stone”. He [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Case of Jamaican Stone

HM2016 Abstract Number: 664

A “Strong(Y)” Case of Diffuse Alveolar Hemorrhage

Purpose:To recognize Strongyloides stercoralis hyperinfection as a fatal cause of diffuse alveolar hemorrhage (DAH) in immunocompromised individuals. Case Presentation: A 47-year-old Hispanic female with MPO-ANCA-positive pauci-immune RPGN status post plasma exchange now well controlled on [...]

By | 2017-04-17T12:09:59+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A “Strong(Y)” Case of Diffuse Alveolar Hemorrhage

HM2016 Abstract Number: 663

A Super-Antigen-Mediated Mimic of Acute Appendicitis

Case Presentation: A 23 year-old man with schizophrenia presented to the emergency department complaining of nausea, vomiting, headache, and subjective fever, followed by acute onset of right lower quadrant abdominal pain. His medications included chlorpromazine [...]

By | 2017-04-17T12:10:00+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts, Finalist|Comments Off on A Super-Antigen-Mediated Mimic of Acute Appendicitis

HM2016 Abstract Number: 662

A Case of Hydralazine-Induced Anca Vasculitis

Case Presentation: KW is a 64 year old female with chronic obstructive pulmonary disease and hypertension who presented with progressive dyspnea in the setting of cardiac tamponade, but with persistent hypoxic respiratory failure despite pericardiocentesis. [...]

By | 2017-04-17T12:10:00+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Case of Hydralazine-Induced Anca Vasculitis

HM2016 Abstract Number: 661

A Royal Pain in the Neck

Case Presentation: A 81 year old Asian woman with past medical history of diabetes, hypertension, coronary artery disease, and arthritis presented with fever and five days of worsening neck stiffness and pain, worsened by neck [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Royal Pain in the Neck

HM2016 Abstract Number: 659

Truly Not an Abscess! Unusual Presentation of Pyoderma Gangrenosum

Case Presentation: A 55 year old male with history of ulcerative colitis and iron deficiency anemia presented to the emergency department with a 1 week history of progressive swelling, tenderness and erythema of a circumscribed [...]

By | 2017-04-17T12:10:00+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Truly Not an Abscess! Unusual Presentation of Pyoderma Gangrenosum

HM2016 Abstract Number: 660

Gallstones from a ‘pseudo’ Gallbladder: Choledochal Cyst Causing Recurrent Choledocholithiasis and Cholangitis

Case Presentation: A 78 year old female with history of previous cholecystitis s/p cholecystectomy in 1950s complicated by recurrent choledocholithiasis and cholangitis presented with a 1 day history of chills, epigastric abdominal pain, nausea and [...]

By | 2017-04-17T12:10:02+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Gallstones from a ‘pseudo’ Gallbladder: Choledochal Cyst Causing Recurrent Choledocholithiasis and Cholangitis

HM2016 Abstract Number: 658

Three Infections, One Brain: Aids Patient with Cerebral Vasculitis

Case Presentation: A 30 year old male with history of recently diagnosed AIDS presented with altered mental status, fevers and 3 witnessed tonic-clonic seizures. His family reported that he had been complaining of progressive headaches [...]

By | 2017-04-17T12:10:00+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Three Infections, One Brain: Aids Patient with Cerebral Vasculitis

HM2016 Abstract Number: 656

Atypical Presentation of Acute Lymphoblastic Leukemia (All) in a Young Adult with Hepatitis and Acute Kidney Injury

Case Presentation: An 18 year old male with no past medical history presented with one month history of nausea and vomiting, 10 pound weight loss, and abdominal pain. Vital signs were normal and physical exam [...]

By | 2017-04-17T12:10:01+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Atypical Presentation of Acute Lymphoblastic Leukemia (All) in a Young Adult with Hepatitis and Acute Kidney Injury

HM2016 Abstract Number: 657

Multicentric Castleman’s Disease in an Immunocompromised Patient

Case Presentation: A 21-year-old Hispanic male with no past medical history presented to our hospital with worsening abdominal pain for approximately two months.  He described the pain as initially intermittent but progressive and was not [...]

By | 2017-04-17T12:10:02+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Multicentric Castleman’s Disease in an Immunocompromised Patient

HM2016 Abstract Number: 654

Rare Complicated Case of Fungal Ball in Urinary Bladder and Its Successful Management

Case Presentation: An 80 yo African-American female with past medical history of hypertension, uterine cancer s/p radiation and mild cognitive impairment presented to the hospital with fatigue and non-specific symptoms for 2 weeks. On examination, vital signs [...]

By | 2017-04-17T12:10:01+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Rare Complicated Case of Fungal Ball in Urinary Bladder and Its Successful Management

HM2016 Abstract Number: 655

Acute Encephalopathy Secondary to Tuberculosis Induced Hypercalcemia

Case Presentation: 53-yo Male with past medical history of poly-substance abuse presented with weakness, shortness of breath and productive cough for 1 month. He also reported low-grade fever, chills, fatigue, and weight loss of 30 [...]

By | 2017-04-17T12:10:00+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Acute Encephalopathy Secondary to Tuberculosis Induced Hypercalcemia

HM2016 Abstract Number: 651

Tragic Prophylactic: Intrathecal-Methotrextate Induced Leukoencephalopathy Presenting As an Acute Stroke

Case Presentation: A 42 year old male presented with fatigue, dyspnea on exertion, and bleeding gums for two weeks. Initial labs showed a white cell count of 96.1k/uL with blasts, Hgb 6.6 g/dL, and a [...]

By | 2017-04-17T12:10:01+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Tragic Prophylactic: Intrathecal-Methotrextate Induced Leukoencephalopathy Presenting As an Acute Stroke

HM2016 Abstract Number: 652

Simple Carbs, Complex Case

Case Presentation: 72 year old woman presented for evaluation of recurrent hypoglycemia for 6 weeks. Hypoglycemic episodes were almost always post prandial. She has history of gastric restriction surgery 4 years ago due to obesity [...]

By | 2017-04-17T12:10:00+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Simple Carbs, Complex Case

HM2016 Abstract Number: 649

Rare Case of Cutaneous Metastasis from Prostate Carcinoma

Case Presentation: A 75 year old African American male was diagnosed with metastatic prostate cancer and refused treatment with leuprorelin and radiation, and was eventually lost to follow up.  He represented to emergency department greater [...]

By | 2017-04-17T12:10:01+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Rare Case of Cutaneous Metastasis from Prostate Carcinoma

HM2016 Abstract Number: 648

Achromobacter Xylosoxidans Healthcare-Associated Pneumonia in an Immunocompromised Patient

Case Presentation: We present a case of a 46-year-old Hispanic male with history of B-cell Acute Lymphocytic Leukemia, Philadelphia chromosome negative and CD20 positive, on remission, receiving maintenance chemotherapy (6-mercaptopurine, vincristine, methotrexate, and prednisone), with [...]

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HM2016 Abstract Number: 647

An Atypical Presentation of a Metastatic Papillary Thyroid Carcinoma of the Brain

Case Presentation: We report a case of an asymptomatic 65-year-old Hispanic male with a left neck mass. Ultrasound and fine needle aspiration were compatible with thyroid cancer. He underwent a total thyroidectomy with modified radical [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on An Atypical Presentation of a Metastatic Papillary Thyroid Carcinoma of the Brain

HM2016 Abstract Number: 645

Drug Reaction with Eosinophilia and Systemic Symptoms If the Dress Fits

Case Presentation: 69-year old female with a history of diabetes, breast cancer, and status post meningioma resection four months earlier complicated by seizures presented with generalized weakness and a diffuse rash.  Six weeks ago she [...]

By | 2017-04-17T12:10:02+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Drug Reaction with Eosinophilia and Systemic Symptoms If the Dress Fits

HM2016 Abstract Number: 646

From Sore Throat to Asystole: An Unusual Case of Vasovagal Bradycardia

Case Presentation: A 63 year male with no significant cardiac history presented to our hospital due to attacks of severe right-sided throat pain for 5 weeks.  The pain was described as “sharp” and “stabbing,” with [...]

By | 2017-04-17T12:10:00+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on From Sore Throat to Asystole: An Unusual Case of Vasovagal Bradycardia

HM2016 Abstract Number: 642

Lactobacillus Jensenii, an Unlikely Pathogen Causing Pyelonephritis and Baceteremia in an Immunocompetent Patient: A Case Report

Case Presentation: 54 y.o female with a pmh of DM and HTN presented with 3 days of fever, chills and left flank discomfort. The patient reported the pain to be indolent in onset, dull and [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Lactobacillus Jensenii, an Unlikely Pathogen Causing Pyelonephritis and Baceteremia in an Immunocompetent Patient: A Case Report

HM2016 Abstract Number: 640

The Pneumonia That Wasn’t

Case Presentation: A 51-year-old female with a history of asymptomatic sarcoid presented with one day of shortness of breath and a dry cough. The patient was treated two weeks previously for pneumonia after developing shortness [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on The Pneumonia That Wasn’t

HM2016 Abstract Number: 641

Pylephlebitis: A Challenging Diagnosis

Case Presentation:   We present a case of 37y.o.  woman, a  previously healthy visiting scholar from China, who presented with nausea, vomiting, diarrhea and vague diffuse abdominal discomfort . Her initial laboratory results were essentially normal.  Emergency room [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Pylephlebitis: A Challenging Diagnosis

HM2016 Abstract Number: 639

The Madness of King Elizabeth: A Case of Elizabethkingia Meningoseptica Bacteremia

Case Presentation: A 72-year-old man with a history of severe COPD presented to the ER with 2 weeks of shortness of breath and productive cough. He denied sick contacts, hospitalizations, antibiotic use, or travel. On [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on The Madness of King Elizabeth: A Case of Elizabethkingia Meningoseptica Bacteremia

HM2016 Abstract Number: 638

Do Not Anca Your Diagnosis: Subacute Bacterial Endocarditis with Positive Anca

Case Presentation: A 64-year-old male with past medical history of hypertension (HTN), hyperlipidemia, coronary artery disease, and end stage renal disease, secondary to HTN, on hemodialysis presented with a 3-day history of nonproductive cough and [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Do Not Anca Your Diagnosis: Subacute Bacterial Endocarditis with Positive Anca

HM2016 Abstract Number: 634

Et: Don’t Call Home, Call the Doctor

Case Presentation: A 68-year-old female with infrequent medical follow-up and a past medical history of chronic back pain presented to the ED with right-sided weakness and slurred speech. On the day of presentation she woke [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Et: Don’t Call Home, Call the Doctor

HM2016 Abstract Number: 636

Hearing Hoofbeats and Finding a Crab: A Case of Paraneoplastic Pemphigus As a Rare Presentation of Malignancy Recurrence

Case Presentation: A 58-year-old male with previously treated non-Hodgkin lymphoma and multiple myeloma was admitted with 3 weeks of progressively worsening mucocutaneous blisters. The initial pruritic blister was located on the right arm and progressively [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Hearing Hoofbeats and Finding a Crab: A Case of Paraneoplastic Pemphigus As a Rare Presentation of Malignancy Recurrence

HM2016 Abstract Number: 635

A Dual Approach to the Treatment of Hypertriglyceride Induced Pancreatitis: A Case Report

Case Presentation: A 39 year old man with type 2 diabetes, known hypertriglyceridemia with past episodes of pancreatitis presented to the Emergency Room with severe, diffuse abdominal pain for two days. Despite an outpatient medication [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Dual Approach to the Treatment of Hypertriglyceride Induced Pancreatitis: A Case Report

HM2016 Abstract Number: 630

Contained Rupture of Proximal Descending Thoracic Aorta Masquerading As Necrotizing Pneumonia

Case Presentation: 59 year old African American male presented to our emergency department with chills, night sweats and not feeling well.  Chest x-ray showed a left upper lobe opacity and was diagnosed with community acquired [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Contained Rupture of Proximal Descending Thoracic Aorta Masquerading As Necrotizing Pneumonia

HM2016 Abstract Number: 631

A Rare Western Occurrence of a Common Eastern Illness

Case Presentation: A 58-year-old Korean female with history significant for splenectomy 20 years ago for “enlarged spleen” and recurrent pyelonephritis presented with chills, nausea, and vomiting. She had severe sepsis with tachycardia, fever, and hypotension [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Rare Western Occurrence of a Common Eastern Illness

HM2016 Abstract Number: 629

Fluid Balance and Electrolyte Management for Life Threatening Electrolyte Abnormalities in Patients with Bulimia Nervosa

Case Presentation: A 27 year old female with bulimia nervosa (self induced vomiting and laxative abuse) and major depressive disorder presented to the emergency department because of chest pain and lower extremity twitching.  Initial evaluation was remarkable for multiple [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Fluid Balance and Electrolyte Management for Life Threatening Electrolyte Abnormalities in Patients with Bulimia Nervosa

HM2016 Abstract Number: 628

A Sloppy “Disappearing Act”: Clues in a Case of Candida Endocarditis

Case Presentation: A 63-year-old man with a history of intravenous drug use (IVDU) and non-ischemic cardiomyopathy presented with one month of fevers, night sweats, and chest pain. Exam was notable for tachycardia (HR = 128), [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Sloppy “Disappearing Act”: Clues in a Case of Candida Endocarditis

HM2016 Abstract Number: 626

Fungus Causing Bleed in a Healthy Stomach- an Unusual Case of Bleeding Gastric Ulcer

Case Presentation: A 66 year old Caucasian female with history of dementia, HTN on amlodipine, HLD on lipitor, spinal stenosis on Meloxicam and GERD on Omeprazole also non alcoholic or non -smoker; was admitted from [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Fungus Causing Bleed in a Healthy Stomach- an Unusual Case of Bleeding Gastric Ulcer

HM2016 Abstract Number: 627

Joining the Big Five: Adding Gastric Volvulus in a Para-Esophageal Hernia to the List of Potentially Fatal Causes of Chest Pain

Case Presentation: A 62-year-old female with no known past medical history presented with 3-days of multiple episodes of vomiting after consuming Chinese food.She was in atrial fibrillation with a rapid ventricular response.Significant lab analyses included [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Joining the Big Five: Adding Gastric Volvulus in a Para-Esophageal Hernia to the List of Potentially Fatal Causes of Chest Pain

HM2016 Abstract Number: 625

Group B Streptococcus Septic Arthritis and Osteomyelitis of the Sternoclavicular Joint in a Healthy Postpartum Woman

Case Presentation:  A 38-year-old para 2 healthy female presented with left shoulder pain 4 weeks after an uncomplicated vaginal delivery at 41 weeks gestation.  Rectovaginal swab and culture obtained at 37 weeks gestation was negative [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Group B Streptococcus Septic Arthritis and Osteomyelitis of the Sternoclavicular Joint in a Healthy Postpartum Woman

HM2016 Abstract Number: 624

Management of West Nile Virus Encephalitis with Bulbar Weakness in a Renal Transplant Recipient

Case Presentation: A 40-year-old-male with history of diabetes type 1 and renal transplant on immunosuppression presents with 2 weeks of weakness, anorexia, and cough. Initial exam revealed temperature 102.8 but was otherwise normal. He was [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Management of West Nile Virus Encephalitis with Bulbar Weakness in a Renal Transplant Recipient

HM2016 Abstract Number: 623

Beyond Crack Lung: A Case of Acute Eosinophilic Pneumonia After Crack Cocaine Use

Case Presentation: A 19-year-old female with mild persistent asthma, borderline personality disorder, and substance abuse presented with three days of a non-productive cough and dyspnea. She endorsed generalized malaise and body aches, without fever or [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Beyond Crack Lung: A Case of Acute Eosinophilic Pneumonia After Crack Cocaine Use

HM2016 Abstract Number: 622

What Is That Retroperitoneal Mass?

Case Presentation: A 54-year-old female with hypertension and tobacco use presented with two months of new onset constipation and progressively worsening, diffuse, generalized abdominal pain, early satiety, and a 30-pound weight loss. She was found [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on What Is That Retroperitoneal Mass?

HM2016 Abstract Number: 621

Don’t Judge a Book by Its Cover; a Case of Anchoring Bias

Case Presentation: A 75-year-old man with diabetes mellitus and recently detected pancreatic “cancer” presented with abdominal pain, vomiting and significant weight loss.  Two weeks prior he presented to another hospital with laboratory values indicating obstructive [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Don’t Judge a Book by Its Cover; a Case of Anchoring Bias

HM2016 Abstract Number: 620

Tick, Tock, Septic Shock: An Alcoholic Case of Rocky Mountain Spotted Fever

Case Presentation: 53 year old male with a history of alcohol abuse presented to the ED with hyponatremia and elevated LFTs after a week of nausea, vomiting, and diarrhea. The patient had a previous drinking [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Tick, Tock, Septic Shock: An Alcoholic Case of Rocky Mountain Spotted Fever

HM2016 Abstract Number: 618

The Smoking Woman

Case Presentation: A 27 year-old woman who is approximately 10 weeks pregnant presents with 8 week history of dry cough, shortness of breath, and mediastinal pain, worsened dramatically in the last 3 days. She was [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts, Finalist|Comments Off on The Smoking Woman

HM2016 Abstract Number: 617

Dehydration and Dysphagia As Acute Precipitants of Low-Dose Methotrexate-Mediated Toxicity

Case Presentation: An 84-year-old female with a past medical history of Sjogren’s syndrome, cutaneous vasculitis and rheumatoid arthritis on methotrexate presented with a three day history of oral pain associated with mild pruritic rash and [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Dehydration and Dysphagia As Acute Precipitants of Low-Dose Methotrexate-Mediated Toxicity

HM2016 Abstract Number: 615

Sensorineural Hearing Loss After Chronic Azithromycin Use

Case Presentation: A 33 yo male with PMH of AIDS and disseminated mycobacterium avium complex (MAC) presented with 1.5 weeks of sudden, bilateral hearing loss.  The hearing loss was symmetric, non-progressive, and he reported difficulty [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Sensorineural Hearing Loss After Chronic Azithromycin Use

HM2016 Abstract Number: 616

Ectopic Cushing Syndrome Complicated by Pulmonary Nocardiosis

Case Presentation: A 70-year-old male former smoker with diabetes mellitus and hypertension presented with cognitive impairment, lower extremity edema, weakness, and 20-pound weight loss over two months. The patient was alert and oriented but had [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Ectopic Cushing Syndrome Complicated by Pulmonary Nocardiosis

HM2016 Abstract Number: 614

A Not so Minimal Change Disease

Case Presentation: A 63 year old African-American Male with a history of well-controlled hypertension and hyperlipidemia presented with a four day history of new-onset lower extremity, upper extremity, and abdominal swelling. He denied shortness of breath, chest [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Not so Minimal Change Disease

HM2016 Abstract Number: 613

Monoclonal Gammopathy of Renal Significance

Case Presentation: A 61 year old African American man with past medical history of hyptertension, diabetes mellitus type 2, chronic kidney disease stage 3, remote intravenous drug use, Hepatitis C presented with worsening hypertension, new [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Monoclonal Gammopathy of Renal Significance

HM2016 Abstract Number: 611

Multiple Myeloma Presenting with Acquired Hemophilia

Case Presentation: A 70 year old woman with no personal or family history of bleeding diathesis presented to emergency room with month long history of intermittent epistaxis. Her initial laboratory investigation showed severe macrocytic anemia [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Multiple Myeloma Presenting with Acquired Hemophilia

HM2016 Abstract Number: 610

Disseminated Mycobacterium Bovis Post Intravesical Bcg Immunotherapy for Urothelial Carcinoma

Case Presentation: An 88-year-old man presented with fevers, chills, weight loss, and acute confusion. The patient had a history of non invasive high grade papillary urothelial carcinoma of the bladder treated with transurethral resection of [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Disseminated Mycobacterium Bovis Post Intravesical Bcg Immunotherapy for Urothelial Carcinoma

HM2016 Abstract Number: 609

Posterior Reversible Encephalopathy Syndrome(Pres) Presenting As Status Epileptics; Role of Bevacizumab

Case Presentation: A 52 year-old male with a history of stage IV rectal cancer, who was recently started on systemic chemotherapy (FOLFOX-Bevacizumab), presented with elevated blood pressure and new onset generalized tonic-clonic seizures.  Benzodiazepines were [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Posterior Reversible Encephalopathy Syndrome(Pres) Presenting As Status Epileptics; Role of Bevacizumab

HM2016 Abstract Number: 608

Iatrogenic Takostubo Cardiomyopathy in a Patient with Angioedema

Case Presentation: A 21 year old Caucasian female with an unremarkable medical history presented with sudden onset of throat, lip and tongue angioedema. Due to concern for complications, she was given intravenous (IV) diphenhydramine, solumedrol [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Iatrogenic Takostubo Cardiomyopathy in a Patient with Angioedema

HM2016 Abstract Number: 607

Beware of Diphtheroids! C. Striatum Causing Native Mitral Valve Endocarditis

Case Presentation: A 59-year-old female with history of well-controlled type 2 diabetes mellitus and hypertension presented with one-week history of high-grade fever (Temp 101 F), nausea, generalized weakness, and postural hypotension. She denied any diarrhea, [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Beware of Diphtheroids! C. Striatum Causing Native Mitral Valve Endocarditis

HM2016 Abstract Number: 606

It’s Just the Flu!

Case Presentation: A 19 y/o woman presents with dyspnea and chest pain that began one week ago. Dyspnea is worse on exertion. She also complains of substernal chest pain, worse upon breathing. Associated symptoms are [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on It’s Just the Flu!

HM2016 Abstract Number: 604

Late-Onset Robust Curly Hair Growth in a Patient with Braf-Mutated Metastatic Melanoma Responding to Dabrafenib

Case Presentation: A 64-year-old man presented to us with newly metastatic melanoma in 6/2014. PMHx included localized melanoma, CAD, type II DM, HTN, GERD, mitral valve prolapse, migraines, and bipolar disorder. Restaging PET/CT scan in [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Late-Onset Robust Curly Hair Growth in a Patient with Braf-Mutated Metastatic Melanoma Responding to Dabrafenib

HM2016 Abstract Number: 605

Synchronous Hodgkin Lymphoma and Diffuse Large B Cell Lymphoma: A Rare Coexistence

Case Presentation: A 79-year-old Caucasian female presented with recurrent abdominal pain. Her past medical history was significant for low-grade adenocarcinoma of the rectum and sigmoid colon that was resected one year ago. Four months prior [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Synchronous Hodgkin Lymphoma and Diffuse Large B Cell Lymphoma: A Rare Coexistence

HM2016 Abstract Number: 602

Cardiac Arrest As the Initial Presentation of Spontaneous Coronary Artery Dissection

Case Presentation: A 33-year-old woman with no cardiac risk factors, who was 8-weeks post-partum with an unremarkable peripartum course, suddenly collapsed at a park. Bystander CPR was initiated and the initial cardiac rhythm, which was [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Cardiac Arrest As the Initial Presentation of Spontaneous Coronary Artery Dissection

HM2016 Abstract Number: 603

Tachycardia Induced Cardiomyopathy- a Rare but Reversible Cause of Heart Failure

Case Presentation: A 54-year-old woman presented to the emergency department with a 1-week history of exertional dyspnea and chest heaviness. Review of systems was remarkable for bilateral leg swelling and a 7-lbs weight gain over [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Tachycardia Induced Cardiomyopathy- a Rare but Reversible Cause of Heart Failure

HM2016 Abstract Number: 601

Coagulase-Negative Staphylococcus: Contaminant or Pathogen?

Case Presentation: A 77-year-old man with hypertension and sick sinus syndrome status post pacemaker implantation was evaluated in the outside hospital for four month history of chills. Review of systems was negative for other symptoms. [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Coagulase-Negative Staphylococcus: Contaminant or Pathogen?

HM2016 Abstract Number: 598

Reconsider “Idiopathic” Thrombocytopenic Purpura When It’s Refractory

Case Presentation: A 77 year old Jehovah’s Witness woman presented with one month of petechial rash, epistaxis and oral mucosal bleeding. There was no recent travel or infectious illness. She denied herbal or toxic ingestions. [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Reconsider “Idiopathic” Thrombocytopenic Purpura When It’s Refractory

HM2016 Abstract Number: 594

A Candid Breast Talk: A Rare Case of Septic Shock Secondary to Fungal Mastitis

Case Presentation:  A 32 year old female with history of gestational diabetes presented with fevers, chills and swelling of the left breast. She delivered a healthy boy 2 weeks prior to admission by cesarean section. [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Candid Breast Talk: A Rare Case of Septic Shock Secondary to Fungal Mastitis

HM2016 Abstract Number: 596

The Tip of the Iceberg: A Rare Cause of Acute Liver Failure

Case Presentation: A 53 year-old man with a history of sickle cell trait and stroke presented with subacute, progressively worsening generalized abdominal pain and distension. He had recently been diagnosed with cirrhosis due to autoimmune [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts, Finalist|Comments Off on The Tip of the Iceberg: A Rare Cause of Acute Liver Failure

HM2016 Abstract Number: 595

Steroid Dependent Cryptogenic Acute Interstitial Nephritis- One of the First Cases Reported

Case Presentation: 69-year-old Caucasian female was admitted with acute malaise, poor appetite and nausea with 20 pound weight loss and vague abdominal discomfort for 2 months. Her background medical history included hypothyroidism on Levothyroxine 75 [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Steroid Dependent Cryptogenic Acute Interstitial Nephritis- One of the First Cases Reported

HM2016 Abstract Number: 593

Lactic Acidosis – Who Is to Blame?

Case Presentation: A 30 year-old woman with a history of severe asthma presented with two weeks of progressively worsening dyspnea. She has a history of multiple hospitalizations and intubations in the setting of asthma exacerbations. [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Lactic Acidosis – Who Is to Blame?

HM2016 Abstract Number: 591

Sagging Brain: An Unusual Cause of Headache

Case Presentation: 70-year-old lady presented with one-month history of progressively worsening headaches, nausea and dizziness necessitating an emergency room visit. Patient underwent CT of the brain which revealed chronic subdural hematoma requiring admission for further [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Sagging Brain: An Unusual Cause of Headache

HM2016 Abstract Number: 592

Shock Induced Anterior Ischemic Optic Neuropathy (Siaion) in a Jehovah’s Witness Patient with Upper Gastrointestinal Bleed and Severe Anemia

Case Presentation: A 56 y/o male Jehovah’s Witness with history of gout treated with daily NSAIDs, presented to the ED with melena.  Hemoglobin on admission was 9.3 g/dL.  He was started on IV proton pump [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Shock Induced Anterior Ischemic Optic Neuropathy (Siaion) in a Jehovah’s Witness Patient with Upper Gastrointestinal Bleed and Severe Anemia

HM2016 Abstract Number: 590

An Unusual Etiology Pericardial Effusion in a Liver Transplant Patient

Case Presentation: 69-year-old gentleman presented to the emergency room with 6-week history of progressive dyspnea, lower limb edema and weight gain. Patient had a relevant past history of melanoma on the scalp treated with surgery, [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on An Unusual Etiology Pericardial Effusion in a Liver Transplant Patient

HM2016 Abstract Number: 589

Brucellosis–A “Cheesy” Infection

Case Presentation: A 39 y/o Hispanic man presented with 1 week of fever, headache, photophobia, and mild confusion. His complaints and physical examination were consistent with possible meningitis, so empiric treatment with vancomycin, ceftriaxone and [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Brucellosis–A “Cheesy” Infection

HM2016 Abstract Number: 587

Joint Pain in a Patient with Sle: Not Always a Flare

Case Presentation: A 42 year-old woman with history significant for systemic lupus erythematous (SLE) for 20 years complicated by pleurisy and thrombocytopenia on belimumab presented with a 10-day history of migratory polyarthritis. Her pain started [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Joint Pain in a Patient with Sle: Not Always a Flare

HM2016 Abstract Number: 586

Thyroid Storm – the Sly Impersonator

Introduction: Thyrotoxic crisis is rare and presents as a life-threatening exacerbation of hyperthyroidism. It can have a myriad of manifestations affecting multiple organ systems. The mortality rate is as high as 30% even with treatment. Thyrotoxic crisis [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Thyroid Storm – the Sly Impersonator

HM2016 Abstract Number: 584

Recurrent Pericarditis: A Case of Idiopathic Recurrent Acute Pericarditis or Hsv Pericarditis?

Case Presentation: Here, we describe a 34 year-old female admitted with five days of worsening left sided pleuritic chest pain and shortness of breath.  Her medical history is significant for four presentations to the emergency [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Recurrent Pericarditis: A Case of Idiopathic Recurrent Acute Pericarditis or Hsv Pericarditis?

HM2016 Abstract Number: 583

Squamous Cell Carcinoma of the Foot Presenting As Osteomyelitis

Case Presentation: A 56-year-old Caucasian male presented to the emergency department with progressively worsening pain, erythema, and swelling of the left hallux after trauma resulting in loss of the nail bed one month prior to [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Squamous Cell Carcinoma of the Foot Presenting As Osteomyelitis

HM2016 Abstract Number: 582

Proptosis Following Nasal Spray Use: A Rare Case of Proptosis Secondary to Intranasal Aspergillosis Following Acute Oversuse of Nasal Steroids

Case Presentation: 23- year old Latino male with no known history presented to the ER complaining of worsening left eye pain. Patient stated that he has been cleaning manmade lakes and for one week started [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Proptosis Following Nasal Spray Use: A Rare Case of Proptosis Secondary to Intranasal Aspergillosis Following Acute Oversuse of Nasal Steroids

HM2016 Abstract Number: 581

An Unnoticed Bite: A 38 Year Old Female with Diarrhea and Hemolytic Anemia

Case Presentation: A 38-year-old female with no significant PMH presented with diarrhea, chills, and hematuria. One week prior to admission, she developed profuse, watery, non-bloody diarrhea three hours after consuming raw oysters. The next day, [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on An Unnoticed Bite: A 38 Year Old Female with Diarrhea and Hemolytic Anemia

HM2016 Abstract Number: 579

Eosinophilic Meningitis Following Medulloblastoma Resection

Case Presentation: A 21 year-old man on the rehabilitation service was evaluated for fever and headache. Approximately 1 year previously he was found to have a posterior fossa medulloblastoma that was resected and repaired with [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Eosinophilic Meningitis Following Medulloblastoma Resection

HM2016 Abstract Number: 578

A Case of Pulmonary Mucormycosis Masquerading As Pulmonary Aspergillosis

Case Presentation: An 80 year old man with pauci-immune glomerulonephritis for one year presented with fatigue and dyspnea. He had been treated with cyclophosphamide and corticosteroids in the last year; at presentation he was taking [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Case of Pulmonary Mucormycosis Masquerading As Pulmonary Aspergillosis

HM2016 Abstract Number: 577

A Case of Pulmonary Artery Sarcoma (Pas) Presenting As Pulmonary Embolism

Case Presentation: A 59yo woman with past medical history of Diabetes Mellitus, Hypertension and hyperlipidemia presented to her primary care physician with a 2 week history of acute onset left sided chest pain and difficulty [...]

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HM2016 Abstract Number: 576

‘sprue-Cing’ Up the Evaluation of Chronic Diarrhea: Let’s Look at the Medication List

770,000 people are admitted due to adverse drug events annually, with an annual cost of 5.6 around million dollars per hospital, making the patient’s medication list an object of scrutiny. Olmesartan is an angiotensin receptor [...]

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HM2016 Abstract Number: 574

Not Your Usual Hypertensive Crisis

Case Presentation: A 61 year old female with history of metastatic breast carcinoma presented to the hospital for an elective vertebral cryoablation and kyphoplasty to treat her painful bony metastasis. She has known vertebral lytic [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Not Your Usual Hypertensive Crisis

HM2016 Abstract Number: 575

Morganella Morganii Osteomyelitis, an Uncommon Pathogen Causing Osteomyelitis

Case Presentation: A 50 year-old male had past medical history of type 1 diabetes mellitus complicated with diabetic nephropathy and neuropathy on insulin; and history of simultaneous kidney and pancreas transplant on immunosuppression medications. He [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Morganella Morganii Osteomyelitis, an Uncommon Pathogen Causing Osteomyelitis

HM2016 Abstract Number: 573

Tracking to the Surface: An Unusual Case of Hydatid Cystic Disease

Case Presentation: Hydatid cyst, also termed as Echinococcal cyst, is caused by the tapeworm, Echinococcus. Echinococcus granulosus is the most common specie to cause cystic disease.  The cyst can be found in any site of [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Tracking to the Surface: An Unusual Case of Hydatid Cystic Disease

HM2016 Abstract Number: 572

Lactic Acidosis in Asthma

Case Presentation: A 38 year-old female with history of asthma presented to the emergency department (ED) with symptoms of progressive dyspnea, wheezing, and dry cough, consistent with asthma exacerbation. In the ED, she was treated [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts, Finalist|Comments Off on Lactic Acidosis in Asthma

HM2016 Abstract Number: 571

Ehrlichia Chaffeensis in an Elderly Patient Presenting with Confusion

Case Presentation: A previously independent and active 89-year-old male without past medical history was brought to the hospital by his son with a 6-day history of progressively worsening confusion. Per the son, the patient lived [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Ehrlichia Chaffeensis in an Elderly Patient Presenting with Confusion

HM2016 Abstract Number: 569

Csf Ada : A Useful Tool in the Diagnosis of Tuberculosis Meningitis (Tbm)

Case Presentation: 71 year-old African-American female, retired EMS paramedic, with hypertension, history of ischemic stroke, Hepatitis C, colon cancer s/p resection several years ago was hospitalized for fever, chills and altered mental status. Treatment was [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Csf Ada : A Useful Tool in the Diagnosis of Tuberculosis Meningitis (Tbm)

HM2016 Abstract Number: 570

A Unique Case of Hemorrhagic Pericardial Effusion

Case Presentation:  An 83 year old male presented with new onset shortness of breath, generalized weakness and fatigue for 4 days. Physical examination revealed mild hypotension and diminished heart sounds. Chest radiology showed enlargement of [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Unique Case of Hemorrhagic Pericardial Effusion

HM2016 Abstract Number: 568

Pe or No Pe? A Rare Diagnosis of Microvascular Thrombosis in Sickle Cell Disease – a Case Report

Case Presentation: We describe a 54-year-old male with past medical history of sickle cell disease, who initially presented with worsening dyspnea over the span of two weeks. He had no history of fevers, chills, chest [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Pe or No Pe? A Rare Diagnosis of Microvascular Thrombosis in Sickle Cell Disease – a Case Report

HM2016 Abstract Number: 567

An Uncommon Case of Acute Central and Peripheral Demyelination

Case Presentation: A 23 year old female with no significant medical history  presented to another hospital with progressive paresthesisas and lower extremity weakness for 6 weeks. Within 24 hours of admission she rapidly declined, requiring [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on An Uncommon Case of Acute Central and Peripheral Demyelination

HM2016 Abstract Number: 566

Uncommon Pathogen with an Affinity to the Heart; Rothia Mucilaginosa

Rothia mucilaginosa is an emerging opportunistic pathogen increasingly associated with prosthetic device infections. We report a case of R. mucilaginosa prosthetic  device endocarditis and review the literature of infections caused by this organism. Case Presentation: 23 year [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Uncommon Pathogen with an Affinity to the Heart; Rothia Mucilaginosa

HM2016 Abstract Number: 563

Hidden Beneath the Surface: A Case of Visceral Kaposi’s Sarcoma

Case Presentation: A 50-year-old male with Human Immunodeficiency Virus (HIV) was admitted with complaints of 1-2 months of progressive dyspnea on exertion, dry cough, subjective fevers, night sweats and approximately 15 pounds of weight loss. [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Hidden Beneath the Surface: A Case of Visceral Kaposi’s Sarcoma

HM2016 Abstract Number: 564

Trials and Confabulations

Case Presentation: A 55-year-old man was found altered in his truck in front of an abandoned building.  Neighbors called EMS after noting that the patient had not moved from his position in 4 hours.  On [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Trials and Confabulations

HM2016 Abstract Number: 562

Who Moved My Potassium?

Case Presentation: A 39 year-old man, medically free but experiencing chronic left hip pain from a work-related injury, received a Trigger Point Injection (TPI) with Methylprednisolone and Bupivacaine. Within 12 hours he presented with severe [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Who Moved My Potassium?

HM2016 Abstract Number: 561

Mycobacterium Delirium: An Interesting Diagnosis of Tuberculosis Meningitis

Case Presentation: A 76-year-old Hispanic man with poorly-controlled diabetes mellitus complicated by nephropathy presented to a hospital with 2 weeks of nausea, vomiting, and progressive lethargy. During the initial evaluation, he developed a focal right-sided [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Mycobacterium Delirium: An Interesting Diagnosis of Tuberculosis Meningitis

HM2016 Abstract Number: 560

Hepatobronchial Fistula Formation from a Hydatid Cyst

Case Presentation: An 85-year-old Middle Eastern woman with an intermittently treated solitary hepatic hydatid cyst diagnosed 40 years ago presented to a hospital for 1 month of progressive nausea, vomiting, abdominal pain, and new onset [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Hepatobronchial Fistula Formation from a Hydatid Cyst

HM2016 Abstract Number: 558

Bleed Versus Clot: The Tenuous Balance in Antiphospholipid Syndrome and Severe Refractory Immune-Mediated Thrombocytopenia

Case Presentation: A 65 year-old man with primary antiphospholipid syndrome (APS) was transferred to our hospital for management of refractory thrombocytopenia and thrombosis. His disease was diagnosed by positive lupus anticoagulant, anti-cardiolipin antibody, beta-2-glycoprotein IgM [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Bleed Versus Clot: The Tenuous Balance in Antiphospholipid Syndrome and Severe Refractory Immune-Mediated Thrombocytopenia

HM2016 Abstract Number: 556

Pain Just Not a Sprain

Case Presentation: 18 year old healthy male developed acute onset of anterior left knee pain after jogging. Due to ongoing pain for several weeks he was evaluated at his local ER and diagnosed with a [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Pain Just Not a Sprain

HM2016 Abstract Number: 555

Reactive Airway Disease: While Horses Are More Likely You Can Never Forget About the Zebras, Especially Zebras Named Strongyloides

Case Presentation: A 91-year-old Puerto Rican female presents with a productive cough for 3 weeks and progressively worsening shortness of breath for 1 week. Over the course of 1 year she was admitted to the [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Reactive Airway Disease: While Horses Are More Likely You Can Never Forget About the Zebras, Especially Zebras Named Strongyloides

HM2016 Abstract Number: 553

Exercise Induced Syncope: When an Artery Runs an Anomalous Course

Case Presentation: A 23 year-old man with no prior medical history presented with witnessed syncope.  Patient was playing basketball when he suddenly collapsed, initially unresponsive, regaining consciousness after minutes.  No seizure activity was observed.  VS [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Exercise Induced Syncope: When an Artery Runs an Anomalous Course

HM2016 Abstract Number: 552

Thinking Outside of the Box: Invasive Nocardiosis in an Immunocompetent Patient

Case Presentation: A 67 year-old man with history of hypertension and hyperlipidemia presented with two weeks history of slurred speech and a transient left facial numbness and twitching for one day. Three months prior he [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Thinking Outside of the Box: Invasive Nocardiosis in an Immunocompetent Patient

HM2016 Abstract Number: 551

When It’s Not an Allergic Reaction: An Unusual Case of Ecthyema Gangrenosum Associated with Proteus Bacteremia

Case Presentation: A 51-year-old woman with multiple medical co-morbidities including morbid obesity with body mass index of 84, hepatitis C cirrhosis, urinary retention requiring chronic indwelling foley catheter and bilateral non-obstructing renal calculi presented from [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts, Finalist|Comments Off on When It’s Not an Allergic Reaction: An Unusual Case of Ecthyema Gangrenosum Associated with Proteus Bacteremia

HM2016 Abstract Number: 550

Henoch-Schonlein Purpura Presenting As a Large Pericardial Effusion in an Adult

Case Presentation: A 49 year old Male presented with a two month history of progressive dyspnea, polyarthralgia, fatigue, and skin rash. Physical exam showed cardiac dullness beyond the apical point of maximal impulse, elbow joints [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Henoch-Schonlein Purpura Presenting As a Large Pericardial Effusion in an Adult

HM2016 Abstract Number: 547

Ttp or Not Ttp? A Case of Tumor Emboli Syndrome Mimicking Thrombotic Thrombocytopenic Purpura

Case Presentation: A 24-year-old female with a history of ovarian cancer 4 years ago, s/p salpingo-oophorectomy and chemotherapy presents with acute onset of shortness of breath x 1 day.  She denied any fevers, chest pain, [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Ttp or Not Ttp? A Case of Tumor Emboli Syndrome Mimicking Thrombotic Thrombocytopenic Purpura

HM2016 Abstract Number: 548

A Case of Dress Myocarditis

Case Presentation: A 24 year-old male presented with rash and fever for one month. He was recently diagnosed with bipolar disorder and started on fluphenazine, lithium, and benztropine. Four weeks after starting these medications he [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Case of Dress Myocarditis

HM2016 Abstract Number: 549

Esophago-Atrial Fistula After Atrial Fibrillation Catheter Ablation: Not Just a Chest Pain!

Case Presentation: A 65-year-old male presented with sharp severe chest pain, worsened with respiratory movements. One day prior to admission, patient had catheter ablation due to persistent atrial fibrillation. He had no other medical history. [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Esophago-Atrial Fistula After Atrial Fibrillation Catheter Ablation: Not Just a Chest Pain!

HM2016 Abstract Number: 546

Refractory Diverticular Hemorrhage in an Initially Stable ICU Admission

Case Presentation: A 79 year-old man presented with one day of spontaneous hematochezia. He denied abdominal pain, abdominal distention, or weight loss. His past medical history included chronic kidney disease. Notable findings on his admission [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Refractory Diverticular Hemorrhage in an Initially Stable ICU Admission

HM2016 Abstract Number: 544

Don’t Close the Door on the Fibromyalgia Patient

Case Presentation: 40-year-old woman with history of pernicious anemia, fibromyalgia and depression presented with progressive fatigue and weakness with associated myalgias and bilateral hip and shoulder girdle pain. Outpatient evaluation initially attributed these symptoms to [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Don’t Close the Door on the Fibromyalgia Patient

HM2016 Abstract Number: 545

The Heme of Heyde’s Syndrome

Case Presentation: An 80-year-old man with a past medical history of chronic lymphocytic leukemia, coronary artery disease, diabetic chronic kidney disease and heart failure reduced ejection fractionwith two months of intermittent hematochezia. Since onset of [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on The Heme of Heyde’s Syndrome

HM2016 Abstract Number: 543

Paget Schroetter Syndrome – a Rarer Cause of Upper Extremity Deep Venous Thrombosis

Case Presentation: We present a case of a 36 year old non-smoking female with history of hypothyroidism, two spontaneous abortions (with negative hypercoagulability workup), no recent travel, or OCP use, who came to the ED [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Paget Schroetter Syndrome – a Rarer Cause of Upper Extremity Deep Venous Thrombosis

HM2016 Abstract Number: 448

A Case of Ogilvie’s, or Not

Case Presentation: A 94-year-old man with no significant past medical history presented to the Emergency Department with a two week history of progressively worsening constipation accompanied by nausea, vomiting, and abdominal pain. He denied any [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Case of Ogilvie’s, or Not

HM2016 Abstract Number: 447

Yes, No, Maybe

Case Presentation: A 45 year-old woman presented with 4 hours of lower back pain, after a fall from standing. She did not report a loss of consciousness, and did not injure her head. She had [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Yes, No, Maybe

HM2016 Abstract Number: 446

A Fleeting Rash Solved the Paradox

Case Presentation: A 36-year-old Caucasian male, a construction worker, presented with three weeks of high-spiking daily fevers, myalgias and fatigue. He endorsed a water-skiing trip, and tick and dog bites within recent weeks. He was [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Fleeting Rash Solved the Paradox

HM2016 Abstract Number: 445

An Atypical Presentation of Extrapulmonary Pleural Tuberculosis

Case Presentation: A 61-year-old African American male with history of recent atopic dermatitis treated with topical corticosteroids presented with 4 days of fevers, night sweats and worsening exertional dyspnea. On admission, he was febrile with decreased left lower lobe breath [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on An Atypical Presentation of Extrapulmonary Pleural Tuberculosis

HM2016 Abstract Number: 444

Often Imitated, Rarely Duplicated: Igg4-Related Inflammatory Mediastinal Pseudotumor

Case Presentation: An asymptomatic 27 year-old male with no past medical history presented with an incidental finding of a IV/VI systolic ejection murmur best heard at the left lower sternal border with parasternal heave. Physical [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Often Imitated, Rarely Duplicated: Igg4-Related Inflammatory Mediastinal Pseudotumor

HM2016 Abstract Number: 443

A Case of Gabapentin-Induced Angioedema

Case Presentation: A 65 year old male with a history of diabetes mellitus type II complicated by neuropathy presented with profound facial and oropharyngeal edema after ingesting his usual medications. He was hemodynamically stable and [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Case of Gabapentin-Induced Angioedema

HM2016 Abstract Number: 442

Crossfit Catastrophe: Chest Pain in a Healthy Young Woman

Case Presentation: A 48-year-old physically active woman presented with acute-onset, severe, retrosternal chest pain radiating to her arms and back. The pain started during an intensive CrossFit workout, in which she ran up nineteen flights [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts, Finalist|Comments Off on Crossfit Catastrophe: Chest Pain in a Healthy Young Woman

HM2016 Abstract Number: 440

“It’s Not Lupus..Until It’s Lupus!” ~ Acute Disseminated Lupus Presenting As Sepsis

Case Presentation: A 45 year old AA Male with PMHx of hypertension and ESRD on HD for 10 years with severe (8/10), diffuse epigastric pain associated with nausea, vomiting, high fever and chills for 2 [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on “It’s Not Lupus..Until It’s Lupus!” ~ Acute Disseminated Lupus Presenting As Sepsis

HM2016 Abstract Number: 439

A Rare Case of Complicated Achromobacter Xylosoxidans Endocarditis and Its Successful Management

Case Presentation: A 37-year-old woman with significant history of intravenous substance abuse, six-year-old mechanical mitral valve replaced for mitral regurgitation and non-adherence to medications presented with shortness of breath and fever (103 F). She was [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Rare Case of Complicated Achromobacter Xylosoxidans Endocarditis and Its Successful Management

HM2016 Abstract Number: 438

Chyloperitoneum and Chylothorax After Aortobifemoral Bypass Surgery and Its Successful Conservative Management

Case Presentation: A 68-year-old man presented with worsening abdominal distention, lower extremity edema and shortness of breath 8 weeks after undergoing uneventful aortobifemoral bypass graft (AFBG). The patient was cachectic man, who had significant abdominal [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Chyloperitoneum and Chylothorax After Aortobifemoral Bypass Surgery and Its Successful Conservative Management

HM2016 Abstract Number: 436

A Cocaine Component’s Complications

Case Presentation: A 51-year-old male with a history of recent pneumonia and cocaine use (most recently 4 weeks prior) presented to the emergency department for shortness of breath. Exam demonstrated decreased left sided breath sounds [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Cocaine Component’s Complications

HM2016 Abstract Number: 435

Bulls-Eye Marks the Spot: Lyme Carditis Presenting As Rash and Presyncope

Case Presentation: An otherwise healthy 58 year-old female presented to the emergency department (ED) from her primary care physician’s (PCP) office with new onset bradycardia, heart block, and a progressive rash. Two weeks prior at [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts, Finalist|Comments Off on Bulls-Eye Marks the Spot: Lyme Carditis Presenting As Rash and Presyncope

HM2016 Abstract Number: 434

Infectious Sacroiliitis As a Cause of Lower Back Pain in an Immunocompromised Patient

Case Presentation: 43 year old HIV positive, type I diabetic female (on lopinavir-ritonavir, efavirenz; last CD4 count 942; negative viral load), presented to Emergency Department (ED) with lower back pain radiating bilaterally to buttocks for [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Infectious Sacroiliitis As a Cause of Lower Back Pain in an Immunocompromised Patient

HM2016 Abstract Number: 433

Bevacizumab Induced Persistent Renal Microangiopathy- Is Stopping the Drug Enough?

Case Presentation: A 26-year-old male with metastatic cecal adenocarcinoma received pre-operative FOLFOX (5-Fluorouracil, Oxaliplatin, leucovorin) for 4 cycles followed by cytoreductive surgery with hyperthermic intraperitoneal chemotherapy 9 months earlier. Post- operatively he received FOLFOX and [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Bevacizumab Induced Persistent Renal Microangiopathy- Is Stopping the Drug Enough?

HM2016 Abstract Number: 431

Not a Good Syndrome

Case Presentation: A 46 year-old man presented with one week of headache and shortness of breath. He also reported generalized fatigue, productive cough, and 40 lb weight loss. There were no sick contacts and review of [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Not a Good Syndrome

HM2016 Abstract Number: 432

Varicella Zoster Vasculitis: An Unusual Cause of Ischemic Stroke

Case Presentation: A 27-year-old man with HIV/AIDS was directly admitted to the hospital by his infectious disease specialist for worsening and recurrent headaches accompanied by a multitude of episodic neurologic symptoms, including off-balance sensations, left [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Varicella Zoster Vasculitis: An Unusual Cause of Ischemic Stroke

HM2016 Abstract Number: 430

A 53 Year-Old Man with Culture-Negative Endocarditis, Endophthalmitis, and Epididymitis

Case Presentation: A 53 year-old man with a history of Hodgkin’s lymphoma status post splenectomy, mantle radiation, and ABVD chemotherapy, severe aortic stenosis, and moderate mitral stenosis attributed to chemoradiation presented with recurrent fevers and [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A 53 Year-Old Man with Culture-Negative Endocarditis, Endophthalmitis, and Epididymitis

HM2016 Abstract Number: 429

Metastatic Choriocarcinoma with Paraneoplastic Hyperthyroidism

Case Presentation: A 28 year old male presented to clinic with a painless, progressively enlarging mass in his right testis for 4-6 weeks.  On examination a large, firm, right scrotal swelling was present. Testicular ultrasound [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Metastatic Choriocarcinoma with Paraneoplastic Hyperthyroidism

HM2016 Abstract Number: 428

That’s Not a Good Way to B (12)

Case Presentation: A 73 year-old female presented with significant lethargy and orthostasis with progressive generalized weakness over one week. The patient related that she had experienced increasing fatigue over one year, but that it had [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on That’s Not a Good Way to B (12)

HM2016 Abstract Number: 427

Listeria Monocytogenes Meningitis in the Young and Healthy

Case Presentation: A 31-year-old male with no past medical history presented with fevers and headaches for two days. Patient also complained of malaise, neck stiffness and photophobia. Physical exam notable for positive Kernig’s sign. Labs [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Listeria Monocytogenes Meningitis in the Young and Healthy

HM2016 Abstract Number: 426

Early Treatment of Subacute Combined Degeneration of the Spinal Cord in Pernicious Anemia Will Improve the Outcome

Case Presentation: 45 year old Polish male with a past medical history of hyperthyroidism who presented to the emergency room complaining of two weeks history of upper and lower extremity numbness and stiffness involving his [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Early Treatment of Subacute Combined Degeneration of the Spinal Cord in Pernicious Anemia Will Improve the Outcome

HM2016 Abstract Number: 425

Hypertroponemia and Right Heart Failure in Septic Pulmonary Emboli

Case Presentation: A 38-year-old previously healthy man presented with left flank and arm pain 72 hours after donating plasma. He noted a blister at the site of the needle insertion followed by chills. He denied [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Hypertroponemia and Right Heart Failure in Septic Pulmonary Emboli

HM2016 Abstract Number: 424

Hypercalcemia and Hiv

Case Presentation: A 37-year-old man with AIDS on HAART and chronic therapy for history of mycobacterium avium infection (MAI) presented with altered mental status 4 weeks after stopping his medications. Family reported progressive confusion and weight [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Hypercalcemia and Hiv

HM2016 Abstract Number: 423

Necrotizing Granulomatous Pneumonia Caused by Candida Albicans: A Case Report

Case Presentation: : A 60-year-old male with history of emphysema was admitted to the hospital because of   worsening dyspnea, cough with yellow sputum production, fever and night sweats.The patient was hospitalized 9 days before this [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Necrotizing Granulomatous Pneumonia Caused by Candida Albicans: A Case Report

HM2016 Abstract Number: 422

Tamoxifen Induced Disseminated Intravascular Coagulation in Breast Cancer Patient: A Case Report

Case Presentation: A 88-year-old female presented to an outpatient office with 3 weeks history of severe progressive bruising and ecchymosis which initially developed on left wrist and then spread to bilateral upper extremities, upper trunk [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Tamoxifen Induced Disseminated Intravascular Coagulation in Breast Cancer Patient: A Case Report

HM2016 Abstract Number: 421

Retropharyngeal Abscess Caused by Pasteurella Multocida: A Case Report

Case Presentation: A 58-year-old male presented to the emergency department with shortness of breath, aggravated by supine position, cough with white sputum production, sore throat, dysphagia  for solid food and odynophagia for last 2 weeks. [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Retropharyngeal Abscess Caused by Pasteurella Multocida: A Case Report

HM2016 Abstract Number: 419

Unexplained Psychosis: A Modern Day Encounter with an Ancient Disease

Case Presentation: This is the complicated and unusual story of a 41-year-old white female and mother of two children with a prior history of hypertension. Over the span of 2 months, the patient’s family noticed [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Unexplained Psychosis: A Modern Day Encounter with an Ancient Disease

HM2016 Abstract Number: 417

Exparel-Ized

Case Presentation: A 73 year-old man had two episodes of syncope on post-operative day one following a left total hip arthroplasty. The episodes occurred with physical therapy as he sat on the side of his [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Exparel-Ized

HM2016 Abstract Number: 415

Thrombotic Thrombocytopenic Purpura Complicated by Anca Induced Vasculitis

Case Presentation: A 68-year-old woman with a past medical history of hypertension and relapsing Thrombotic Thrombocytopenic Purpura (TTP) presented with acute kidney injury. She was diagnosed nine years ago with TTP and had three subsequent [...]

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HM2016 Abstract Number: 414

Metastatic Breast Cancer Associated with Granulomatosis with Polyangiitis

Case Presentation: A 66-year-old woman with a past medical history of scleroderma, inflammatory lung disease, and remote bilateral breast cancer status post bilateral mastectomy and chemotherapy was admitted for lung biopsy. The patient developed flu-like [...]

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HM2016 Abstract Number: 413

Lytic Lesions: Looking Lethal but Leaving Room for a Simple Cure

Case Presentation: A 67-year-old man with a history of previously treated prostate cancer presented with two weeks of low back pain. The pain had progressed and was now associated with bilateral lower extremity shooting pain and weakness. [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Lytic Lesions: Looking Lethal but Leaving Room for a Simple Cure

HM2016 Abstract Number: 411

A Case Report of Topical Anesthetic-Induced Methemoglobinemia After Tee Managed with Methylene Blue

Introduction:Methemoglobinemia is a rare, potentially life-threatening medical condition that occurs due to increased methemoglobin production or decreased elimination and can be hereditary or acquired. Methemoglobin is a derivative of hemoglobin in which the normal ferrous [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Case Report of Topical Anesthetic-Induced Methemoglobinemia After Tee Managed with Methylene Blue

HM2016 Abstract Number: 408

Got Milk? A Case of Denosumab Induced Severe Hypocalcemia

Case Presentation: A 72 year old man with stage 4 metastatic prostate cancer, on Abiraterone acetate and prednisone status post bilateral orchiectomy presented with severe hypocalcemia at 5.2mg/dL. Patient denied muscle twitching or cramping, nausea, [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Got Milk? A Case of Denosumab Induced Severe Hypocalcemia

HM2016 Abstract Number: 409

Angina of Abdominal Origin

Case Presentation: Exercise-induced chest pain is a hallmark of coronary artery ischemia. When unusual ischemic symptoms predominate however, they point to rare extrathoracic vascular compression syndromes. A 28-year-old Caucasian man reported worsened daily left-sided chest and [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts, Finalist|Comments Off on Angina of Abdominal Origin

HM2016 Abstract Number: 407

Unusually Coupled: Itp and Hodgkin’s Disease

Case Presentation: A 36-year-old healthy woman with no past medical history presented to the emergency department with generalized purpura and petechiae. She also reported 4 month long history of painless right-sided neck swelling, drenching night [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Unusually Coupled: Itp and Hodgkin’s Disease

HM2016 Abstract Number: 406

Mycobacterium Abscessus Presenting As Cavitary Lung Lesion: An Emerging Pathogen

Case Presentation: A 70 year-old Moroccan male with a history of gastrointestinal stromal tumor treated with resection and chemotherapy was admitted for dyspnea on exertion and non-productive cough for two weeks. He complained of subjective [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Mycobacterium Abscessus Presenting As Cavitary Lung Lesion: An Emerging Pathogen

HM2016 Abstract Number: 405

It’s Not “All” Virus

Case Presentation:  46 year-old-male with no past medical history presented with 1-day-history of dyspnea on exertion, productive cough, and fever. The patient also complained of several weeks of generalized weakness and lower back pain radiating [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on It’s Not “All” Virus

HM2016 Abstract Number: 402

A Dangerous Engima Rarely Seen (Purpura Fulminans with Acral Gangrene from Paraneoplastic Syndrome Versus Post Chemotherapy for Sarcomatiod Mesothelioma

Case Presentation: A 78-year-old white female with sarcomatoid mesothelioma status post gemcitabine and carboplatin presented to an urgent care center with sudden onset of low grade fever and fatigue. She reported a puppy bite 1 [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Dangerous Engima Rarely Seen (Purpura Fulminans with Acral Gangrene from Paraneoplastic Syndrome Versus Post Chemotherapy for Sarcomatiod Mesothelioma

HM2016 Abstract Number: 401

Dysphagia with Extreme Thrombocytosis

Case Presentation: 77 year old man with history of renal cell cancer status post ablation a year ago presented to primary care physician with difficulty swallowing and weight loss for 3 weeks. Examination was normal. [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Dysphagia with Extreme Thrombocytosis

HM2016 Abstract Number: 398

Phos-Fate

Case Presentation: 62 year-old HIV positive man with Hepatitis B co-infection was admitted to the internal medicine service for self-neglect and profound deconditioning resulting in a fall and subsequent fracture of right tibia and fibula [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Phos-Fate

HM2016 Abstract Number: 400

Thyrotoxic Periodic Paralysis: A Rare Manifestation of a Relatively Common Grave’s Disease

Case Presentation: A 30 year-old Hispanic male with no past medical history was brought to ER status post fall after sudden onset of muscle weakness in extremities. He experienced mild intermittent muscles cramps and soreness [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Thyrotoxic Periodic Paralysis: A Rare Manifestation of a Relatively Common Grave’s Disease

HM2016 Abstract Number: 399

Guillain Barre Syndrome Rare Subtypes

Case Presentation: 40 year old male patient with known history of IVDU and Hepatitis C infection presented with shortness of breath, worsening bilateral weakness in his lower limbs and difficulty walking for two weeks prior [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Guillain Barre Syndrome Rare Subtypes

HM2016 Abstract Number: 396

A Case of Non-Psychiatric Psychosis

Case Presentation: A 19-year-old Caucasian female with hypothyroidism on synthroid was transferred from an outside emergency department for evaluation of psychosis. The patient’s father first noted changes in her behavior several months prior to admission [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Case of Non-Psychiatric Psychosis

HM2016 Abstract Number: 397

A Case of Non-Bacterial Thrombotic Endocarditis (Nbte). Often a Post Mortem Diagnosis!

Case Presentation: A 62 year old male with past medical history of DVT, prostate cancer diagnosed 2 years ago, presented to the hospital complaining of 1 day weakness in his left upper and lower extremities. [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on A Case of Non-Bacterial Thrombotic Endocarditis (Nbte). Often a Post Mortem Diagnosis!

HM2016 Abstract Number: 393

Common Drug Unmasks Uncommon Disease

Case Presentation: An 83 year old woman presented with acute anemia on outpatient testing. One week prior, during hospitalization for a pelvic fracture, she had been started on antibiotics for a suspected urinary tract infection. When this failed to resolve [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Adult, Clinical Vignettes Abstracts|Comments Off on Common Drug Unmasks Uncommon Disease

HM2016 Abstract Number: 391

Designing Hospitalist Shifts Around Admission Demand Reduces Patient Wait Times and Cost

Background: In 2014 we recognized that the pace of admissions frequently exceeded our ability to assign a hospitalist. Long patient wait times occurred at admission, especially for patients arriving in the late afternoon when hospitalist [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Finalist, Innovations Abstracts, Value in Hospital Medicine|Comments Off on Designing Hospitalist Shifts Around Admission Demand Reduces Patient Wait Times and Cost

HM2016 Abstract Number: 390

Clinical Utility of Routine Cbc Testing in Patients with Community Acquired Pneumonia

Background: Avoiding repeated complete blood count (CBC) tests in the face of clinical and lab stability is a focus of the Choosing Wisely initiatives endorsed by the Society of Hospital Medicine. The goal of this [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Research Abstracts, Value in Hospital Medicine|Comments Off on Clinical Utility of Routine Cbc Testing in Patients with Community Acquired Pneumonia

HM2016 Abstract Number: 389

Towards Accurate Value-Based Care Metrics: Failings of Medicare Reporting

Background: Increasing the value of health care, typically regarded as maximizing quality of care while minimizing unnecessary costs, has been an increasing focus of hospitals nationwide.  Ways of reliably measuring unnecessary utilization, however, have not [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Research Abstracts, Value in Hospital Medicine|Comments Off on Towards Accurate Value-Based Care Metrics: Failings of Medicare Reporting

HM2016 Abstract Number: 388

Cost Conscious Care Committee: Using a Modified Nominal Group Technique to Reduce Wasteful Spending at an Academic Internal Medicine Residency

Background: It is estimated that 30% of US healthcare cost is wasteful spending. In order to reduce this cost, there have been initiatives by SHM (evidence based recommendations), ABIM (Choosing Wisely campaign), and ACP (High [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Innovations Abstracts, Value in Hospital Medicine|Comments Off on Cost Conscious Care Committee: Using a Modified Nominal Group Technique to Reduce Wasteful Spending at an Academic Internal Medicine Residency

HM2016 Abstract Number: 387

A Multidisciplinary Approach to High Value Cardiac Biomarkers

Background: Cardiac biomarkers, such as myoglobin and B-type natriuretic peptide (BNP), are frequently ordered in the emergency room and inpatient settings. Newer studies and guidelines have called into question the value of these tests in [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Finalist, Innovations Abstracts, Value in Hospital Medicine|Comments Off on A Multidisciplinary Approach to High Value Cardiac Biomarkers

HM2016 Abstract Number: 385

Sustainability of a Hospitalist Led Intervention to Reduce Length of Stay on Telemetry

Background: As part of the Choosing Wisely campaign, the Society of Hospital Medicine highlights use of telemetry monitoring as one of the top interventions that physicians and patients should use judiciously.  While telemetry is invaluable [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Research Abstracts, Value in Hospital Medicine|Comments Off on Sustainability of a Hospitalist Led Intervention to Reduce Length of Stay on Telemetry

HM2016 Abstract Number: 383

Site Related Bleeding and Health Outcome Metrics in Patients Admitted with Bleeding to a Large Academic Medical Center

Background: Patients who are admitted through the emergency department with a primary diagnosis of bleeding represent a group with significant morbidity and mortality. Of those patients admitted with a primary bleeding diagnosis, those on anticoagulants [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Research Abstracts, Value in Hospital Medicine|Comments Off on Site Related Bleeding and Health Outcome Metrics in Patients Admitted with Bleeding to a Large Academic Medical Center

HM2016 Abstract Number: 384

Hospital Based Population Health Management Program: Why It Makes Sense and How to Set It Up?

Background:   Five percent of Medicare's patients account for almost 50 percent of its cost. The same 5:50 rule holds true for other insurances. The ongoing changes in health care like Affordable Care Act, Meaningful [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Innovations Abstracts, Value in Hospital Medicine|Comments Off on Hospital Based Population Health Management Program: Why It Makes Sense and How to Set It Up?

HM2016 Abstract Number: 382

Unsurprise the Surprise: Prognosticate Chronically Ill Hospitalized Patients

Background: As chronic illnesses are claiming majority of deaths in United States, it is very important that we identify patients with chronic illnesses who have shortened life expectancy and prioritize their needs for palliative care. [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Research Abstracts, Value in Hospital Medicine|Comments Off on Unsurprise the Surprise: Prognosticate Chronically Ill Hospitalized Patients

HM2016 Abstract Number: 380

Making Every Drop Count: Drivers of Laboratory Overutilization

Background: As health systems focus on providing high-value, cost-conscious care, efforts to optimize laboratory testing are increasing.  In order to improve safe and effective utilization of the laboratory, it is informative to understand the prevalence [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Research Abstracts, Value in Hospital Medicine|Comments Off on Making Every Drop Count: Drivers of Laboratory Overutilization

HM2016 Abstract Number: 381

30-Day Readmission Rate for Patients Discharged with Sickle Cell Crisis: An Analysis of 369,103 Admissions

Background: Sickle cell crisis is a acute medical emergency, which may require management in the ICU. Sickle cell anemias are remarkable in their clinical heterogeneity. Some people remain asymptomatic in their adult life, whereas others [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Research Abstracts, Value in Hospital Medicine|Comments Off on 30-Day Readmission Rate for Patients Discharged with Sickle Cell Crisis: An Analysis of 369,103 Admissions

HM2016 Abstract Number: 379

Improving Capture of Major Comorbidities in Provider Documentation Using an Integrated Template

Background: On October 1, 2007, Medicare changed their payment structure from Diagnosis Related Group (DRG) to Medicare Severity-Diagnosis Related Group (MS-DRG) based reimbursement. This led institutions to prioritize clinical documentation improvement (CDI) programs in an [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Innovations Abstracts, Value in Hospital Medicine|Comments Off on Improving Capture of Major Comorbidities in Provider Documentation Using an Integrated Template

HM2016 Abstract Number: 376

Syncope Evaluation: Overuse of Head Ct, Underuse of Orthostatics

Background: Syncope is a common diagnosis for hospitalists and often accompanied by extensive and unnecessary diagnostic workup. Neurally-mediated syncope and orthostatic hypotension account for over 75% of causes. Most causes of syncope can be diagnosed [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Research Abstracts, Value in Hospital Medicine|Comments Off on Syncope Evaluation: Overuse of Head Ct, Underuse of Orthostatics

HM2016 Abstract Number: 375

Out Reach Hospitalist Coverage for Community Hospitals by Major Academic Center:

Background: There is a huge desire to have hospitalist program in smaller community and rural hospitals. Few hospitals will be reluctant to have their own hospitalist program due to multiple issues. Bothwell Regional Health Center [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Innovations Abstracts, Value in Hospital Medicine|Comments Off on Out Reach Hospitalist Coverage for Community Hospitals by Major Academic Center:

HM2016 Abstract Number: 374

Development and Implementation of an Evidence-Based Pathway for the Evaluation of Catheter Associated UTI (Cauti) in an Academic Health System

Background: Misdiagnosis of catheter associated asymptomatic bacteriuria as CAUTI leads to inappropriate use of antibiotics and related consequences, including medication side effects, antibiotic resistance, C. difficile infection, and potential financial penalties to hospitals. Purpose: To [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Innovations Abstracts, Value in Hospital Medicine|Comments Off on Development and Implementation of an Evidence-Based Pathway for the Evaluation of Catheter Associated UTI (Cauti) in an Academic Health System

HM2016 Abstract Number: 373

Reducing Unnecessary Phlebotomy on an Inpatient Medical Teaching Service

Background: The ABIM’s Choosing Wisely campaign targets daily phlebotomy in medical inpatients as an area of potential wasteful care.  Unnecessary phlebotomy increases labor and costs while negatively impacting patient’s through hospital-acquired anemia, intravenous access issues, and false-positive [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Innovations Abstracts, Value in Hospital Medicine|Comments Off on Reducing Unnecessary Phlebotomy on an Inpatient Medical Teaching Service

HM2016 Abstract Number: 372

Hospital Based Restrictive Blood Transfusion Program Proves to Be Effective in Reducing Healthcare Costs by Limiting Blood Product Usage

Background: It is known that blood product transfusions can be harmful to some patients and should be administered only in medically justified circumstances (Ferraris, et al. 2015). In keeping with current recommendations set forth by [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Research Abstracts, Value in Hospital Medicine|Comments Off on Hospital Based Restrictive Blood Transfusion Program Proves to Be Effective in Reducing Healthcare Costs by Limiting Blood Product Usage

HM2016 Abstract Number: 371

Use of a Hospitalist Clinical Community to Facilitate Dissemination of an Early Mobility Quality Improvement Program

Background: To facilitate interdisciplinary collaboration targeting specific quality improvement (QI) and patient safety goals, the Armstrong Institute of Johns Hopkins Medicine has facilitated development of “clinical communities”—interdisciplinary groups of clinicians and administrators from across the [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Finalist, Innovations Abstracts, Value in Hospital Medicine|