Clinical Vignette Abstracts — Adult

/Tag:Clinical Vignette Abstracts — Adult

HM2015 Abstract Number:

Eosinophilic Colitis: A Rarity

Case Presentation: A 31-year-old African American woman with past medical history of hypertension (HTN), gastro esophageal reflux disease (GERD), bronchial asthma and a diagnosis of Irritable Bowel Syndrome (IBS) for 10 years presented with complaints [...]

By | 2015-04-15T14:56:58+00:00 February 28th, 2015|Uncategorized|Comments Off on Eosinophilic Colitis: A Rarity

HM2015 Abstract Number:

Out of Sight, Out of Mind: The Sleeping Beauty Treated for Herpes

Case Presentation: A 75-year-old man with atrial fibrillation and no neurologic history presented to the emergency department with a one day history of somnolence, aphasia, and generalized weakness. He was nonverbal and minimally responsive to [...]

By | 2015-04-15T15:00:36+00:00 February 28th, 2015|Uncategorized|Comments Off on Out of Sight, Out of Mind: The Sleeping Beauty Treated for Herpes

HM2015 Abstract Number:

Not Your Average Multiple Myeloma

Case Presentation: A 55 year-old male with no known medical history presented to the emergency department after a fall on both knees. He was found to have bilateral patellar tendon ruptures and multiple femoral lytic [...]

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HM2015 Abstract Number:

Pay Heed to the Contaminant: Invasive Achromobacter Xylosoxidans Pneumonia in an Immunocompromised Host

Introduction: Pneumonia in an immunocompromised host is unique with respect to the organisms involved. The emergence of new pathogens has significant impact on therapy. Achromobacter xylosoxidans (A.xylosoxidans) is an uncommon pathogen known to cause serious infections [...]

By | 2015-04-15T15:02:47+00:00 February 28th, 2015|Uncategorized|Comments Off on Pay Heed to the Contaminant: Invasive Achromobacter Xylosoxidans Pneumonia in an Immunocompromised Host

HM2015 Abstract Number:

Staphylococcus Lugdunensis: The Bad and the Ugly Coagulase-Negative Staph

Case Presentation: A 31-year-old woman with a history of rheumatic heart disease and a murmur presented with two months of intermittent subjective fevers, diffuse malaise and inability to walk. Physical exam revealed a systolic 2/6 [...]

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HM2015 Abstract Number:

Non-Uremic Calciphylaxis in the Setting of Alcoholic Liver Disease

Case Presentation: Calciphylaxis is a rare cause of skin necrosis due to calcium deposition within the vasculature, most commonly seen in patients with end stage renal disease.  A 54-year-old male was transferred from a long-term [...]

By | 2015-04-15T15:13:04+00:00 February 28th, 2015|Uncategorized|Comments Off on Non-Uremic Calciphylaxis in the Setting of Alcoholic Liver Disease

HM2015 Abstract Number:

Fatty Formula: Good for the Heart?

Case Presentation: A 27 year-old male called 911 after intentional ingestion of 3g of lamotrigine and 3g of hydroxyzine.   Upon arrival to the ER, approximately one hour after ingestion, the patient had slurred speech and [...]

By | 2015-04-15T15:16:06+00:00 February 28th, 2015|Uncategorized|Comments Off on Fatty Formula: Good for the Heart?

HM2015 Abstract Number:

A Supplemental Case of Hepatotoxicity

Case Presentation: A 37 year old Caucasian man with known peptic ulcer disease and generalized anxiety disorder presented with a three week history of worsening right upper quadrant pain, nausea and generalized malaise.  He denied [...]

By | 2015-04-15T15:19:37+00:00 February 28th, 2015|Uncategorized|Comments Off on A Supplemental Case of Hepatotoxicity

HM2015 Abstract Number:

A Catastrophic Case of Back Pain in a Patient with Atrial Fibrillation

Case Presentation: We report the case of a 69-year-old Honduran male with a long history of non-valvular atrial fibrillation with a CHA2DS2-VASc Score= 2 (Age > 65 and Hypertension) anticoagulated with Rivaroxaban 20 mg po [...]

By | 2015-04-15T15:22:42+00:00 February 28th, 2015|Uncategorized|Comments Off on A Catastrophic Case of Back Pain in a Patient with Atrial Fibrillation

HM2015 Abstract Number:

A Deadly Complication of Peritoneal Dialysis and the Use of Paracentesis As a Palliative Intervention

Case Presentation: A 44-year-old female with end-stage renal disease on hemodialysis presented to the hospital with progressive nausea, vomiting and abdominal pain. The etiology of her renal disease was unknown. She had received a renal [...]

By | 2015-04-15T15:27:40+00:00 February 28th, 2015|Uncategorized|Comments Off on A Deadly Complication of Peritoneal Dialysis and the Use of Paracentesis As a Palliative Intervention

HM2015 Abstract Number: 501

Should’ve, Could’ve, Would’ve Filtered: Pe

Case Presentation: A 35 year-old man presents to the emergency department with left sided chest pain. The pain is pleuritic, tender, and nonpositional. It is associated with exertional dyspnea, which is new for him. He [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Should’ve, Could’ve, Would’ve Filtered: Pe

HM2015 Abstract Number: 502

It’s Never Lupus…?

Case Presentation: A 27 year-old African American female with a history of bipolar disorder, cocaine abuse, Mixed Connective Tissue Disease with Raynaud’s syndrome presented to the emergency department with acute onset of altered mental status. [...]

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HM2015 Abstract Number: 503

Approaching the Limits of Acalculous Cholecystitis

Case Presentation: A 40 year-old woman with HIV (CD4 268) on antiretrovirals and pulmonary MAC on treatment presented to the hospital with abdominal pain and diarrhea. She was subsequently admitted to the intensive care unit [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Approaching the Limits of Acalculous Cholecystitis

HM2015 Abstract Number: 507

A Rare Cause of Abdominal Pain; Epiploic Appendagitis

Case Presentation: A 54 years old female with past medical history of hypertension, frequent UTIs, andhypothyroidism presented with 3 days of sharp LUQ abdominal radiating to the left flank, 8/10in severity and worsened with eating. [...]

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HM2015 Abstract Number: 500

Death by Catfish

Case Presentation: A 70 year-old woman with diabetes and end stage renal disease presented with acute severe left hand pain and swelling. Six hours prior, she incurred a puncture wound from a catfish spine while [...]

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HM2015 Abstract Number: 497

I Do Not Have an Ebola Infection

Case Presentation: A 29 year old gentleman with history of prior malaria infections presented for evaluation after a 3 day history of bodily aches, nausea and bilious vomiting. He had no history of hemetemesis, melena, [...]

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HM2015 Abstract Number: 498

Docetaxel-Associated Colonic Pseudo-Obstruction

Case Presentation: 59 year old man with history of metastatic prostate cancer and hypertension presented with a week's history of progressive abdominal distension, anorexia, nausea and vomiting. He did not have fevers, abdominal pain, diarrhea or [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Docetaxel-Associated Colonic Pseudo-Obstruction

HM2015 Abstract Number: 558

Multifocal Motor Neuropathy in a 35 Year Old Male

Case Presentation: A 35-year-old Chinese male with no significant past medical history presented to our hospital with a 6 year history of bilateral hand weakness. The patient reported that he first noticed the weakness after [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Multifocal Motor Neuropathy in a 35 Year Old Male

HM2015 Abstract Number: 560

Skin Hiccups

Case Presentation: A 63-year-old man was admitted to our hospital because of aspiration pneumonia. The patient had long-standing progressive supranuclear palsy (PSP) with dysphagia and he had had placement of percutaneous endoscopic gastrostomy (PEG). After [...]

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HM2015 Abstract Number: 556

A Triple Hit for Endocarditis

Case Presentation: A 62-year-old man with a history of ulcerative colitis presented to our institution for evaluation of fever, dyspnea, and positive blood cultures. His ulcerative colitis had been controlled with a regimen of mesalamine [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on A Triple Hit for Endocarditis

HM2015 Abstract Number: 551

Periampullary Duodenal Diverticulitis: A Rare Cause of Acute Pancreatitis

Introduction: Duodenal diverticula are fairly common and mostly remain asymptomatic but can elicit potential complications including duodenal diverticulitis, hemorrhage, perforation and abscess formation. Pancreatitis secondary to duodenal diverticulitis is a rare clinical entity. We describe a [...]

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HM2015 Abstract Number: 559

Herpes Zoster As a Rare Cause of Unilateral Diaphragmatic Paralysis

Case Presentation: A 69 year old male who lives in Michigan with a past medical history significant for chronic pulmonary obstructive disease and hypertension presented with worsening dyspnea that began while vacationing in Florida. Prior [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Herpes Zoster As a Rare Cause of Unilateral Diaphragmatic Paralysis

HM2015 Abstract Number: 504

The Unusual Facial Rash

Case Presentation: A 72-year-old woman with hypertension, Hodgkin's lymphoma status post one dose of chemotherapy with adriamycin/bleomycin/vinblastine/dacarbazine developed an asymptomatic, erythematous, circular rash on her forehead four days after chemotherapy. Patient first presented to a [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on The Unusual Facial Rash

HM2015 Abstract Number: 511

“Dinner with a Side of Digoxin”

Case Presentation: 58 year old female with no significant past medical history presents to the emergency room with slow heart rate. Patient initially presented to primary care physician with malaise, nausea, and vomiting.  She reported [...]

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HM2015 Abstract Number: 512

“Deadly” Rash of Fusariosis

Case Presentation: A 67-year-old male with acute myelogenous leukemia (AML) with chronic neutropenia presented with acute onset of fevers accompanied by rapidly progressing violaceous lesions with a central eschar within a period of 48-72 hours. [...]

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HM2015 Abstract Number: 537

Dettol Poisoning: A Case Report and Review of the Literature

Background: Dettol liquid (4.8% chloroxylenol, pine oil, isopropyl alcohol) is a commonly used liquid disinfectant. Various effects have been associated with its ingestion and this includes central nervous system depression, airway obstruction, gastro-esophagitis and cardiac [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Dettol Poisoning: A Case Report and Review of the Literature

HM2015 Abstract Number: 515

Is It Hot in Here or Is It Just Me? The Difficulty in Diagnosing Pituitary Tumors

Case Presentation: A 38 year-old male with diet controlled diabetes presented with 3 months of unprovoked episodes of sweats. He noted that these episodes would come on at any time of day, last several minutes [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Is It Hot in Here or Is It Just Me? The Difficulty in Diagnosing Pituitary Tumors

HM2015 Abstract Number: 557

A Rare Presentation of Sarcoidosis

Case Presentation: A 46 year old female with a history of hypertension presented to the ED with recurrent abdominal pain for a month located in the epigastric region and occasionally radiating to the back. She [...]

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HM2015 Abstract Number: 540

Pertussis and Postpericardiotomy Syndrome, a Coughing Matter

Case Presentation: A 75 year old male presented with 4 syncopal episodes occurring over the 3 days prior to admission. Each syncope lasted 2-3 minutes and followed a coughing fit.  The patient had an aortic [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Pertussis and Postpericardiotomy Syndrome, a Coughing Matter

HM2015 Abstract Number: 538

A Case of Right Atrial Obliteration by Direct Extension of Hepatocellular Carcinoma

Case Presentation: A 78 year old man with atrial fibrillation and hemochromatosis complicated by locally advanced hepatocellular carcinoma (HCC) was admitted from a skilled nursing facility with new onset bilateral lower extremity edema.  He was [...]

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HM2015 Abstract Number: 514

Disseminated Cryptococcal Infection in a Patient on Ruxolitinib

Case Presentation: A 74 year old male with a history of cerebral vascular disease as well essential thrombocythemia that had progressed to myelofibrosis maintained on ruloxitinib for 13 months presented with four months of intermittent [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Disseminated Cryptococcal Infection in a Patient on Ruxolitinib

HM2015 Abstract Number: 513

Basilar Artery Stroke in the Setting of Submassive Pulmonary Embolus and Patent Foramen Ovale

Case Presentation: A 45 yo male with PMH of morbid obesity, hypertension, congestive heart failure, diabetes mellitus type II,  and obstructive sleep apnea presented for evaluation of shortness of breath and hemoptysis x24hrs. The patient had completed a 22hr [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Basilar Artery Stroke in the Setting of Submassive Pulmonary Embolus and Patent Foramen Ovale

HM2015 Abstract Number: 542

A Heart Too Tightly Hugged: A Case of Pericarditis Presenting As Heart Failure

Case Presentation: An 83 year old male with history of uncomplicated cardiac bypass 1 year prior without pericardiectomy presented with symptoms of acute decompensated congestive heart failure despite Lasix therapy and salt- controlled diet. Following [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on A Heart Too Tightly Hugged: A Case of Pericarditis Presenting As Heart Failure

HM2015 Abstract Number: 541

The Coma You Can’t Mix Up

Case Presentation: An 85-year-old woman presents with worsening somnolence and altered mental status. Symptoms began one week prior with lethargy progressing to unresponsiveness. Her past medical history is significant for diabetes, hypertension and atrial fibrillation. Medications include carvedilol, lisinopril, and amiodarone. Initial vital [...]

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HM2015 Abstract Number: 543

Nephrotic Syndrome After Ranibizumab

Case Presentation: A 78-year-old male was admitted to the hospital with a one week history of shortness of breath and lower extremity edema. His past medical history was significant for atrial fibrillation, chronic obstructive pulmonary [...]

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HM2015 Abstract Number: 516

Beyond Biopsy Results: Post-Infectious Iga Glomerulonephritis

Case Presentation: 50-year-old Hispanic man with uncontrolled diabetes mellitus type 2 who presented initially in DKA was found to have an epidural abscess and transferred to our tertiary center for neurosurgical management with laminectomy and [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Beyond Biopsy Results: Post-Infectious Iga Glomerulonephritis

HM2015 Abstract Number: 546

Disseminated Opportunistic Infection in a Patient with Fulminant Aids

Case Presentation: A 27-year-old man with recently diagnosed human immunodeficiency virus (HIV) not on antiretroviral therapy presents with several months of cough, fever, abdominal pain, weight loss, gait imbalance, and hallucinations. On presentation, he was [...]

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HM2015 Abstract Number: 544

The Tale of the Regurgitant Liver

Case Presentation: An 81 year old female with chronic kidney disease, severe tricuspid regurgitation and a pacemaker presented after a fall with a completely displaced left femoral neck fracture.  She underwent a left hip hemiarthroplasty [...]

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HM2015 Abstract Number: 545

My-Oh-Ma…It Took My Breath Away

Case Presentation: A 49 year-old, previously healthy woman presented with one day of progressively worsening right-sided body pain and shortness of breath.  She noted her pain started while in bed the previous morning, radiating from [...]

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HM2015 Abstract Number: 547

A Challenging Presentation of the Internist’s Tumor

Case Presentation: A 78-year-old Caucasian male presented to the emergency department with complaints of persistent loose stools for the past 2 weeks associated with vague diffuse abdominal pain, loss of appetite and 15 pounds weight [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on A Challenging Presentation of the Internist’s Tumor

HM2015 Abstract Number: 536

Catatonia As a Constituent of Sickle Cell Pain Crisis

Case Presentation: A 27-year-old African American female presented to the hospital with generalized body pain. Her medical history included sickle cell disease (SCD) HbSS type, bipolar disorder type 1 with severe depression, anxiety, post-traumatic stress [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Catatonia As a Constituent of Sickle Cell Pain Crisis

HM2015 Abstract Number: 555

Mind Over Matter – When a Tissue Diagnosis Cannot Be Obtained

Case Presentation: Tissue pathology of a mass is often the gold standard for diagnosis of a malignancy. The dilemma is when the lesion is central and a biopsy cannot be safely obtained. The diagnostic burden [...]

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HM2015 Abstract Number: 505

Beware of Bcg-Osis

Case Presentation: A 78 year male with history of urothelial carcinoma in situ who had undergone bladder resection, presented to the hospital 24 hours after his third weekly intravesicular BCG (Bacillus Calmette-Guerin) therapy due to [...]

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HM2015 Abstract Number: 548

Posterior Reversible Encephalopathy Syndrome–An Insidious Manifestation of Systemic Lupus Erythematosus

Case Presentation: A thirty-five year old African-American female with a history Multiple Sclerosis and uterine fibroids presented with anemia, acute kidney injury (AKI), and lower extremity edema for two weeks. Initially AKI was attributed to [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Posterior Reversible Encephalopathy Syndrome–An Insidious Manifestation of Systemic Lupus Erythematosus

HM2015 Abstract Number: 553

The Drug or the Bug? Diagnostic and Therapeutic Implications of Subclinical Myopericarditis in a Patient Taking Clozapine

Case Presentation: A 33 year old man with treatment refractory bipolar disorder was titrated onto clozapine 200mg daily in an inpatient psychiatric facility. 10 days into his course, he was noted to have fevers, diaphoresis, [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on The Drug or the Bug? Diagnostic and Therapeutic Implications of Subclinical Myopericarditis in a Patient Taking Clozapine

HM2015 Abstract Number: 549

Clear As Mud: A Case of Peripheral Neuropathy and Weakness in an Hiv Patient

Case Presentation: 31 year-old Hispanic male with history of HIV presented to the hospital with a 5-month history of progressive pain and weakness in bilateral upper and lower extremities. Review of systems was also significant [...]

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HM2015 Abstract Number: 508

Mycobacterium Bovis Bacillus Calmette-Guérin (Bcg) Osteomyelitis of the Distal Tibia After Intravesical Bcg Therapy for Bladder Cancer

Case Presentation: An 83-year-old Caucasian man visited an outpatient clinic with a complaint of right ankle pain and swelling for the past 4 months. The patient had a history of bladder cancer with trans-urethral resection [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Mycobacterium Bovis Bacillus Calmette-Guérin (Bcg) Osteomyelitis of the Distal Tibia After Intravesical Bcg Therapy for Bladder Cancer

HM2015 Abstract Number: 554

Seizures and Altered Mental Status in an Organ Transplant Patient

Case Presentation: A 50 year-old man with a history of kidney-pancreas transplant was transferred to our hospital for acute onset right side numbness, twitching and altered mental status. Prior to his presentation, he was hospitalized [...]

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HM2015 Abstract Number: 506

Gastric Perforation in a Patient with Non-Small Cell Lung Cancer Treated with Bevacizumab

Case Presentation: In June a 53-year old female with a history of NSCLC, chronic obstructive lung disease, initially presented with cough, hemoptysis, and weight loss. Bronchoscopy with trans bronchial biopsy confirmed moderate to poorly differentiated [...]

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HM2015 Abstract Number: 509

Catastrophic Antiphospholipid Antibody Syndrome

Case Presentation: A 45 yo African American woman with lupus nephritis and a previous episode of myocarditis presents with 5 days of abdominal pain, headache, decreased appetite and acute shortness of breath. She was found [...]

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HM2015 Abstract Number: 510

Heart of Gold: A Case of Community-Acquired Mrsa Pericarditis with Tamponade

Case Presentation: A 58-year-old man presented with weakness, vomiting, labored breathing, and severe hyperglycemia one week after a previous hospitalization for neck and chest pain. His initial work-up during the prior hospitalization included a neck [...]

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HM2015 Abstract Number: 552

Amiodarone Toxicity Presenting As New Ascites and Weight Loss

Case Presentation: An 83-year old woman with a history of atrial fibrillation on amiodarone and warfarin was admitted with a supratherapeutic INR.  She incidentally noted a two month history of fatigue, anorexia, nausea and increase [...]

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HM2015 Abstract Number: 539

You Broke My Heart Honey When You Took Away My Hooch: Stress-Induced Cardiomyopathy During Acute Alcohol Withdrawal

Case Presentation: A 53-year-old man presented with a new-onset seizure. The patient recently quit drinking because his wife would no longer give him money to pay for alcohol. He was treated for acute alcohol withdrawal [...]

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HM2015 Abstract Number: 562

Pulmonary Strongyloidiasis in Immunocompetent(Ic) Host

Case Presentation: A 75 year old male from Puerto Rico with past medical history of stage Ia lung adenocarcinoma with bronchoalveolar features treated only with lobectomy, otherwise healthy presented to the ER with non-productive  cough, [...]

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HM2015 Abstract Number: 550

One in a Million: A Case of Creutzfeldt-Jakob Disease

Case Presentation: A 63 year-old male was evaluated for rapidly progressive dementia. His illness began with flu-like symptoms.  One month later, the patient presented to the hospital for confusion and dizziness. At that time evaluation [...]

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HM2015 Abstract Number: 563

Acute Pancreatitis Induced by Drug Interaction Between Canagliflozin and Everolimus

Case Presentation: A 52-year-old white female presented to our institution with acute onset of abdominal pain. Physical examination was significant for diffuse tenderness in epigastric region with decreased bowel sounds to auscultation. Pertinent work up [...]

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HM2015 Abstract Number: 565

Recurrent Strokes in Adult Onset Moyamoya Disease with Heterozygous Hemoglobin C and Delta-Beta-Thalassemia: A Case Report and Review

Case Presentation: 35 yo AAF, PMH of HTN, T2DM, TIA, and L internal carotid stenosis (ICA) on daily ASA presented to the ED with acute dysarthria and a stroke workup was initiated.  CT stroke showed [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Recurrent Strokes in Adult Onset Moyamoya Disease with Heterozygous Hemoglobin C and Delta-Beta-Thalassemia: A Case Report and Review

HM2015 Abstract Number: 567

Atypical Chest Pain with Neurological Symptoms

Case Presentation: 85 year-old female with history of depression and osteoarthritis presented with right upper and lower extremity weakness with difficulty ambulating. She also complained of transient substernal non radiating chest tightness which resolved upon [...]

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HM2015 Abstract Number: 564

A Rare Case of Granulomatous Interstitial Nephritis Due to Renal Sarcoidosis

Case Presentation: A 26 year old African-American male with past medical history of pancytopenia and hepatosplenomegaly was transferred to our facility for evaluation of his acute kidney injury. Patient presented with nausea, vomiting, anorexia and [...]

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HM2015 Abstract Number: 566

Streptococcus Strikes Again

Case Presentation: A 46-year-old male with a history of GERD and psoriasis presented with a tender, erythematous right ankle rash.  First noted ten days prior to admission, he did not improve with trimethoprim-sulfamethoxazole and sought [...]

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HM2015 Abstract Number: 568

Cannabinoid Hyperemesis Syndrome- a Classic Case with Compulsive Hot Showering

Case Presentation: A 22 year-old male presented to an academic medical center with complaint of constant, sharp, diffuse abdominal pain with nausea and vomiting of four days duration. Eating worsened symptoms.  He admitted to being [...]

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HM2015 Abstract Number: 499

More Than Just a Viral Hepatitis a Infection

Case Presentation: A 65-year-old healthy man presented with a 4 day history of fatigue and fevers. He denied any cough, chest pain, diarrhea or any recent sick contacts. He did complain of nausea and mild [...]

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HM2015 Abstract Number: 479

More Than Meets the Eye: Metastatic Uveal Melanoma

Case Presentation: A 61-year-old man with no known medical history presented to the Emergency Department with two weeks of increasing abdominal distension. He also reported having progressive left eye pain and vision loss since a [...]

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HM2015 Abstract Number: 473

The Look, the Feel, of Cotton

Case Presentation: A 52 year-old woman presented with two days of chest and back pain. History was significant for treated Cryptococcus fungemia, multi drug resistant urinary tract infection, hepatitis c and intravenous illicit drug use. [...]

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HM2015 Abstract Number: 476

A B-Symptoms Charade

Case Presentation: A 55-year-old man with hepatitis C was admitted for fevers, night sweats, weight loss, and a swollen inguinal lymph node. He first noticed pain in his right groin one month ago, like someone was burning him [...]

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HM2015 Abstract Number: 474

Culture Negative Bartonella Quintana Endocarditis with Mimicking Pauci-Immune Anti-Neutrophil Cytoplasmic Antibody (Anca) Associated Glomerulonephritis in a Homeless Male

Case Presentation: A 55 year-old African American male with a history of homelessness, hepatitis B, and no known history of renal insufficiency presented with complaints of bilateral lower extremity swelling, and hematuria for five days. [...]

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HM2015 Abstract Number: 475

A “Tear”-Ible Culprit

Case Presentation: A 42-year-old man with a history of severe hypertension, chronic kidney disease (stage 3), obesity, and smoking presented with one day of acute onset abdominal pain. The pain awoke him from sleep at 4 AM, starting in [...]

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HM2015 Abstract Number: 472

A Cryptic Case of Cryptococcal Meningitis

Case Presentation: A 50 year old African-American male presented with 2 weeks of headaches, neck pain, and photophobia. Exam revealed positive meningeal signs and a fever of 101oF. CT head and MRI showed small cerebellar [...]

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HM2015 Abstract Number: 470

Nonocclusive Mesenteric Ischemia (Nomi): An Unusual Presentation of an Uncommon Complication

Case Presentation: A 56 year old female presented with intractable pain and a cold right lower extremity. She had End Stage Renal Disease (ESRD) on hemodialysis, hypertension, and severe peripheral vasculature disease (PVD), with bilateral [...]

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HM2015 Abstract Number: 469

Blood, Brain, and Now Bone – Learning More About an Often Overlooked Pathogen

Case Presentation: A 30-year-old Caucasian man with a history of uncontrolled diabetes mellitus complicated by peripheral neuropathy, diabetic foot ulcers, methicillin-resistant S. aureus (MRSA) osteomyelitis and amputation of the left 2nd distal phalanx presented to [...]

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HM2015 Abstract Number: 535

Essential Thrombocythemia Presenting As Acute Ischemic Stroke: A Case Report

Case Presentation: An 81-year-old male with hypertension and diabetes was brought to the ED after 3 days of immobility secondary to left-sided hemiparesis. Initial labs revealed platelet count of 1.3 M/uL, WBC count 22,000 /uL [...]

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HM2015 Abstract Number: 534

Extramedullary Plasmacytoma and Multiple Myeloma Presenting As Chronic Chest Pain: A Rare Case

Case Presentation: A 56 year-old female with no PMH presented to hospital with left sided chest pain of 2 months duration. Chest pain was pleuritic in nature and not associated with exertion. She also had [...]

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HM2015 Abstract Number: 471

It Is Not All in Your Head- an Atypical Presentation of Wilson’s Disease

Case Presentation: An 18 year old male with 1 year of headache, dizziness, mood swings, memory dysfunction, abnormal gait, presented with 2 days of prolonged epistaxis and non-bilious vomiting for few months. He denied use [...]

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HM2015 Abstract Number: 532

It Was Only a Zit

Case Presentation: A 45-year-old woman, with a medical history of IV drug use and chronic hepatitis C virus infection presented to our institution with a complaint of right eye pain and inability to see. She [...]

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HM2015 Abstract Number: 533

Aspergillus Throws a Curve Ball Again!

Case Presentation: A 37-year old man presented to the hospital for hemoptysis of 4 weeks duration.  He has PMH of Granulomatosis with polyangiitis (GPA) with pulmonary and renal involvement; diffuse alveolar hemorrhage and chronic maxillary [...]

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HM2015 Abstract Number: 468

A Near-Fatal Rush to Judgement: A Case of Cocaine-Induced Chest Pain

Case Presentation: A 59 year-old black male with a past medical history significant for tobacco and polysubstance abuse presented to our Emergency Department with severe left-sided chest pain and pressure beginning 45 minutes after using [...]

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HM2015 Abstract Number: 467

The Worst Herpes of My Life: Zoster Ophthalmicus Presenting As Sentinel Headache

Case Presentation: An 84 year-old man presented to hospital one day after the sudden onset of a severe, right-sided headache.  He was on warfarin therapy following mitral valve replacement. The sharp, stabbing pain had worsened [...]

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HM2015 Abstract Number: 531

An Atypical Presentation of Upper Gastrointestinal Bleeding in the Setting of an Acute Pulmonary Embolism: Lessons in Acute Care Gastroenterology, Anticoagulation, and Overuse of Diagnostic Testing

Case Presentation: A 75 year old woman with past medical history of hypertension, diabetes mellitus, Barrett’s esophagus, and chronic constipation presented to the hospital complaining of one week of dyspnea after an international flight. CT [...]

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HM2015 Abstract Number: 530

Neurosyphilis: Keep in Mind for Patients with Strokes

Case Presentation: An 80 year-old man with history of hypertension, remote cerebrovascular accidents (CVA), and multiple admissions for syncope and orthostatic hypotension presented with sudden syncope, hypotension, and acute respiratory failure requiring intubation. Vital signs [...]

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HM2015 Abstract Number: 529

Rheum for One More on the Differential Diagnosis: Fibromuscular Dysplasia in the Context of Renal Infarct

Case Presentation: 45 year old quadriplegic female with history of hypertension, SLE (APLS negative) with vasculitis on chronic steroids, CAD status post bare metal stents on chronic anti-platelet therapy, and suprapubic catheter presented with two [...]

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HM2015 Abstract Number: 466

The Monster in My Room: Acyclovir Neurotoxicity in a Hemodialysis Patient

Case Presentation: A 70 year-old woman presented to the hospital via her son after she told him someone had “cut my body in half.”  For the past week, the son had noted her to be [...]

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HM2015 Abstract Number: 465

The Bite of Death: Case of Ehrlichiosis

Case Presentation:  An 89-year-old man was transferred to our facility for altered mental status, fever, acute renal failure, and thrombocytopenia. He was in his usual state of health until a week prior when his children [...]

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HM2015 Abstract Number: 463

Pancreatitis-Oh Schistocytes!

Case Presentation: A 66 year -old woman presented with three days of worsening abdominal pain.  She described the pain as severe sharp epigastric pain which radiated to her back and both lower abdominal quadrants.  She [...]

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HM2015 Abstract Number: 464

Pheochromocytoma in Pregnancy: Evaluation and Management

Case Presentation: A 25-year-old female at 29 weeks gestation presented to the inpatient obstetrics service with hypertension, gestational diabetes and concerns for preeclampsia.  Physical exam was significant for a blood pressure of 151/93 and a [...]

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HM2015 Abstract Number: 461

Direct Thrombin Inhibitor Resistance

Case Presentation: A nineteen year old male with a history of hypertrophic obstructive cardiomyopathy, and status post implantable cardioverter defibrillator for non-sustained ventricular tachycardia, presented to the hospital after cardiac arrest. Prior to transfer to [...]

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HM2015 Abstract Number: 462

Complements to Your Presentation

Case Presentation: A 40 year-old female with no significant past medical history presented with nausea, vomiting, easy bruising, dyspnea on exertion, and presyncope. She had been treated with Levofloxacin for a urinary tract infection one week [...]

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HM2015 Abstract Number: 528

One Million Platelets and Transient Ischemic Attack: How Do You Manage?

Case Presentation: We report a case of 48 year old male with no significant past medical history, presented to hospital with complaint of left arm weakness and dysarthria that started 2-3 hours before. He had [...]

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HM2015 Abstract Number: 460

I Did Not See That Coming! an Unexpected Cause of Eye Pain

Case Presentation: A 34 year old man presented with five days of severe right eye pain. Hours after popping a pimple on the supraorbital ridge of his right eye, he developed fevers, chills, headache, blurry [...]

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HM2015 Abstract Number: 527

Wake Me Up: Thalamic Stroke with Hypersomnolence

Case Presentation: A 62-year-old right-handed female with a past medical history significant for hypertension, hyperlipidemia, and diabetes mellitus presented to the emergency department with a one week history of perioral numbness, gait imbalance and increased [...]

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HM2015 Abstract Number: 493

Recognizing Xanthogranulomatous Pyelonephritis: A Rare Condition Associated with Urinary Tract Obstruction

Case Presentation: A 76 year old male presented to the Emergency Department with weakness 2 days after discharge from a hospitalization in which he was treated for pyelonephritis. His urine culture from that admission revealed [...]

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HM2015 Abstract Number: 496

Case Report on Amiodarone Hepatotoxicity: One More Cause of “Failure to Thrive”

Case Presentation: An 81-year-old white male with history of hypertension, coronary artery disease, atrial fibrillation, ulcerative colitis and cryptogenic cirrhosis was readmitted with generalized weakness, persistent leukocytosis and weight loss.  He was recently discharged with [...]

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HM2015 Abstract Number: 494

Don’t Go Viral! a Rare Cause of Pericardial Pathology

Case Presentation: A 50 year old woman was admitted with generalized fatigue, exertional dyspnea, epigastric discomfort and night sweats. Two months prior she had been to the Pacific coast of Mexico with family. A CT [...]

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HM2015 Abstract Number: 526

Cystic Bone Lesions; Not Always Malignancy

Case Presentation: A 74 year-old male with end-stage renal disease (ESRD) on hemodialysis (HD) for the past 10 years due to autosomal-dominant polycystic kidney disease (ADPKD) presented with progressive left leg pain and sudden inability [...]

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HM2015 Abstract Number: 459

The Clue Is in the Tattoo: A Case of Cutaneous Sarcoidosis

Case Presentation: A 45-year-old male with a history of asthma and diabetes presented to a New York hospital complaining of fevers, night sweats, dyspnea with non-productive cough and bilateral joint pains for two days.  The [...]

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HM2015 Abstract Number: 524

A Not so Common Cause of Abdominal Pain

Case Presentation: A 38-year-old Caucasian male presented to our emergency room (ER) with left-sided abdominal pain that has been progressively worsening for 2 days. He reported that the pain started gradually in the left lower [...]

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HM2015 Abstract Number: 525

Big Heads, Bigger Problems; from Goiter to Genetic Disorder

Case Presentation: A 32 year-old Caucasian female with history of asthma, hypothyroidism, and renal cell carcinoma (RCC) status-post right nephrectomy, presented with a progressively enlarging goiter causing solid food dysphagia. She had been diagnosed with [...]

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HM2015 Abstract Number: 495

Cysts Not Just Cirrhosis

Case Presentation: A 37 year old man presented with complaints of abdominal pain and lower extremity edema. His past medical history was remarkable for an “enlarged liver.” Physical examination revealed muscle wasting, palmar erythema, spider [...]

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HM2015 Abstract Number: 489

Very High Ferritin in an Hiv-Positive Patient with Fever of Unknown Origin

Case Presentation: A 33 year old male with a very recent diagnosis of HIV presented with a 3 week history of fevers and profuse diarrhea, and a 2 day history of a diffuse rash.  His [...]

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HM2015 Abstract Number: 492

Everolimus Effective in Treating Psoriasis in Patient with Renal Clear Cell Carcinoma

Case Presentation: A 60 year-old Asian man with a five year history of psoriasis presented to the ER with painless hematuria. Subsequent imaging and biopsy confirmed renal cell carcinoma with metastasis to the lungs. In [...]

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HM2015 Abstract Number: 490

Always Work Up a Significant Globulin Gap

Case Presentation: A 58 year old male with a history of NASH cirrhosis, diabetes mellitus, and obstructive sleep apnea presented due to multiple symptoms that had been present for the past 3 months, including severe [...]

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HM2015 Abstract Number: 523

When the Coventional Regimen Fails – Romiplostim for the Treatment of Severe Hiv-Associated-Thrombocytopenia

Case Presentation: A 22-year-old African American male presented to our hospital with a 2-day history of bleeding gums while brushing and “swollen glands” on the neck.  He denied any fevers, chills, night sweats, weight loss [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on When the Coventional Regimen Fails – Romiplostim for the Treatment of Severe Hiv-Associated-Thrombocytopenia

HM2015 Abstract Number: 520

Quickly Reversible Cushing’s Reflex in a Rare Case of Elevated Intracranial Pressure: A Case Report

Case Presentation: A 50 year old African American male presented to the Emergency Room with headache, nausea, vomiting, and three seizures in the past 24 hours.  The patient was recently discharged from a hospitalization for [...]

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HM2015 Abstract Number: 522

Expecting the Expected at an Unexpected Time

Case Presentation: A 51 year-old man with untreated HCV (HCV-RNA 460978 IU/ML, Genotype 3a), prior heroin abuse on methadone maintenance presented with hematuria and right upper quadrant pain for 2 days. The exam was significant for [...]

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HM2015 Abstract Number: 521

‘Double Hit’ Anemia in a Patient with Hiv

Case Presentation: A 59-year-old woman with HIV (CD4 1064 cells/mm3), chronic HCV, hypertension and peripheral vascular disease presented with progressive dyspnea on exertion over the past month. Her medication regimen was stable and included Lamivudine/zidovudine, [...]

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HM2015 Abstract Number: 519

A Deep-Seated Time Bomb

Case Presentation: A 38 year-old man presented with left upper quadrant (LUQ) pain radiating to the shoulder. Two weeks prior, he was evaluated for arthralgias, malaise, and intermittent “black spots” in his vision. Physical exam [...]

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HM2015 Abstract Number: 518

A Case of Headache, Neck Pain and Rash:”What’s in Your Differential”

Case Presentation: A 63 year old gentleman with a history of throat cancer and hypertension was transferred from a community hospital with a diagnosis of meningitis. Ten days prior, the patient awakened with a severe [...]

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HM2015 Abstract Number: 517

A Peculiar Cause of Encephalopathy

Case Presentation: A 31 year old male was admitted to the critical care unit following status epilepticus (precipitated by recent antiepileptic dose reduction) requiring intubation and mechanical ventilatory support. He was a known epileptic since [...]

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HM2015 Abstract Number: 457

Hemophagocytic Lymphohistiocytosis Induced by Epstein-Barr Virus: A Potentially Deadly Case of Mono?

Case Presentation: A 39 year-old Ecuadorian man with no past medical history presented with one month of fevers and nausea. Two weeks prior to admission, the patient presented to the emergency department with these symptoms. [...]

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HM2015 Abstract Number: 455

Poetry in Diagnosis: A Case of Poems Syndrome

Case Presentation: A 77-year-old male with systolic heart failure (EF 28%), hypothyroidism, and CKD stage 3 presented with dyspnea on exertion and paresthesias in all four extremities. Physical exam revealed anasarca. CT scan of chest/abdomen/pelvis [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Poetry in Diagnosis: A Case of Poems Syndrome

HM2015 Abstract Number: 458

Early Diagnosis in Cardiac Amyloidosis Matters

Case Presentation: A 50 year old man with a past medical history of coronary artery disease and COPD presented with complaints of recurrent syncope.  These episodes occurred about 5 to 7 times weekly.  Additional symptoms [...]

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HM2015 Abstract Number: 454

What’s That Eating My Liver?

Case Presentation: A 33 year-old woman with no known medical history presented with one week of sharp, stabbing right upper quadrant abdominal pain along with fever to 103 degrees Fahrenheit. She had also noticed a [...]

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HM2015 Abstract Number: 491

Ptx in the Setting of Pcp: An Unusual Chronology

Case Presentation: A 36 year-old woman presented with three days of progressive shortness of breath and chest pain.  Her symptoms began while walking in the mall.  She had a history of HIV/AIDS (CD4 count 34) [...]

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HM2015 Abstract Number: 488

When Lung Meets Thyroid: An Unusual Site for Metastasis

Case Presentation: A 73-year-old male with a history of small cell lung cancer with metastases to the brain and left adrenal gland was admitted for progressive fatigue and dysphagia. Physical examination disclosed a non-tender thyroid [...]

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HM2015 Abstract Number: 486

Getting to the Heart of the Matter

Case Presentation: A 62 year old Chinese male was admitted for 2-month history of left sided hemiparesis. Brain imaging showed multiple lesions suspicious of brain metastases. Otherwise asymptomatic, he was noted to be febrile at [...]

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HM2015 Abstract Number: 487

Spindled Out of Control: A Rare, Aggressive Form of Lung Cancer

Case Presentation: A 79-year-old man with a 40 pack-year smoking history presented with progressive right hip pain. During the two months prior to his admission, he noted generalized fatigue, poor appetite, and an unintentional weight [...]

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HM2015 Abstract Number: 481

Gastro-Bronchial Fistula in Recurrent Pneumonia

Case Presentation: A 50-year-old Caucasian male presented with complaints of worsening shortness of breath, cough productive of thick, yellow colored phlegm and fever for three days. His past history was significant for adenocarcinoma esophagus requiring [...]

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HM2015 Abstract Number: 484

Squamous Cell Carcinoma of De Novo Kidney Allograft: An Extremely Rare Tumor

Case Presentation: A 68 year old Egyptian male came with complaints of nausea, non-bilious, non-bloody vomiting, mild right lower quadrant abdominal pain and generalized weakness for one week associated with decreased appetite and 15 pounds [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Squamous Cell Carcinoma of De Novo Kidney Allograft: An Extremely Rare Tumor

HM2015 Abstract Number: 482

Bullous Pemphigoid and Endocarditis: A Case of Mrsa Gone Awry

Case Presentation: A 78 year old female with pulmonary hypertension and diastolic congestive heart failure presented to the emergency room secondary to shortness of breath and a rash. The shortness of breath began three days [...]

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HM2015 Abstract Number: 483

Splenic Infarct As the Primary Presentation of Lymphoma

Case Presentation: A 79 year old Hispanic male with a past medical history of prostate cancer in remission, hypertension and hyperlipidemia presented with fever and left upper quadrant pain. The left upper quadrant pain began [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Splenic Infarct As the Primary Presentation of Lymphoma

HM2015 Abstract Number: 477

A Case of Diabetic Ketoacidosis in Acromegaly

Case Presentation: A 31-year-old Hispanic male, presented to Emergency Department with nausea and vomiting associated with intermittent blurry vision for 4 days. He also noted malaise, epigastric pain, polyuria, polydipsia and about 40lb unintentional weight [...]

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HM2015 Abstract Number: 480

Nonspecific Symptoms Due to Rapid Weight Loss: Sma Syndrome

Case Presentation: A 31 year old Caucasian female, with a history of cyclical vomiting presented with abdominal pain and intractable nausea and vomiting for 4 days. Abdominal pain was 10/10 in severity, diffuse, pressure type, [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Nonspecific Symptoms Due to Rapid Weight Loss: Sma Syndrome

HM2015 Abstract Number: 478

Thyrotoxic Periodic Paralysis in a Hispanic Woman

Case Presentation: A 23-year-old Hispanic woman, presented to the Emergency Department with periodic bilateral lower extremities flaccid weakness and numbness for 3 months. She reported her symptoms had worsened in severity over the last 2 [...]

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HM2015 Abstract Number: 452

Where Two Channels Meet

Case Presentation: A 32-year-old male patient, Jehovah’s Witness, of no known medical history presented with a 3-month duration of intermittent bloody diarrhea, fatigue and progressive 14 kg weight loss. He denied any fever, chills, night sweats, [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Where Two Channels Meet

HM2015 Abstract Number: 456

A Challenging Diagnosis of Granulomatosis with Polyangiitis (Gpa, Wegner’s Granulomatosis)

Granulomatosis with Polyangiitis (GPA) is a multi-system, immune-mediated disorder characterized by necrotizing vasculitis. Diagnosis can be difficult since symptoms are nonspecific and often hard to distinguish from non-vasculitic processes. We present a diagnostic dilemma for [...]

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HM2015 Abstract Number: 450

Pernicious Anemia: A Rare Cause of Pancytopenia and Hemolysis

Case Presentation: A 48 year-old woman with past medical history of Graves’ disease and vitiligo was referred to the emergency department after she presented to clinic with worsening dizziness and generalized malaise over several weeks. [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Pernicious Anemia: A Rare Cause of Pancytopenia and Hemolysis

HM2015 Abstract Number: 449

Bee Aware…And Your Heart Will Thank You

Case Presentation: A 73-year-old female, with a history of hypertension, dyslipidemia, diabetes, and peripheral arterial disease presented with generalized weakness, nausea and vomiting after an Africanized Bee attack receiving more than 50 bee stings. Vital [...]

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HM2015 Abstract Number: 453

Off the Beaten Path: Cardiac Involvement in an Aids Patient with Burkitt’s Lymphoma

Case Presentation: A 55 year-old Hispanic female with a history of human immunodeficiency virus (HIV) (recently started on highly active antiretroviral therapy, CD4 count of 213 cells/mm3, viral load of 69,835 copies/mL), and non-pulmonary tuberculosis [...]

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HM2015 Abstract Number: 451

Picc Line Can Pick the Heart!

Case Presentation: A 59 year old white male was transferred from an outside hospital with back pain, fever and neurological deficits and found to have an epidural abscess with MRSA positive blood cultures. Emergent debridement [...]

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HM2015 Abstract Number: 448

Calciphylaxis Secondary to Alcoholic Cirrhosis

Case Presentation: A 45-year-old female presented with a two-week history of painful skin lesions on both inner thighs. Her medical history was significant for alcoholic cirrhosis and hypothyroidism. On physical exam, several tender violaceous plaques [...]

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HM2015 Abstract Number: 447

Conns Syndrome Presenting As Hemorrhagic Stroke: A Clinical Conundrum

Case Presentation: A 43 year-old man presented to emergency room with 3 days of altered mental status and aphasia. A friend checked on him and called 911 after 3 consecutive days of non response to [...]

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HM2015 Abstract Number: 446

Hepatic Artery Aneurysm: A Diagnostic Enigma for Upper GI Bleed

Case Presentation:  76 year-old man presented with multiple episodes of vomiting and melena for 1 day. He was postop day 11 after laparoscopic cholecystectomy. His PMH included gall stone pancreatitis, partial gastrectomy in remote past, [...]

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HM2015 Abstract Number: 444

Hemolytic Uremic Syndrome, a Rare Manisfestation of Clostridium Difficile Colitis

Case Presentation: A 32 year old Hispanic female with a history of IV drug use presented with a 3 day history of fever, bloody diarrhea and abdominal pain. She denied recent antibiotic use, sick contacts, [...]

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HM2015 Abstract Number: 445

Doctor, I’m Coughing Up a Lung

Case Presentation: A 25 year old man was recently diagnosed with HIV/AIDS and had a CD4 count of 29 and a viral load of 85 thousand. At the time of his initial presentation, he was [...]

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HM2015 Abstract Number: 443

Presumed Metformin Associated Lactic Acidosis with Normal Kidney Function

Case Presentation: A 76–year-old white male, with type 2 diabetes mellitus (DM), presented with three days history of confusion and difficulty finding words which started after aggressive vomiting of two days duration. His medications list [...]

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HM2015 Abstract Number: 442

Sympathetic Paraganglioma As an Uncommon Cause of Secondary Hypertension

Case Presentation: A 28-year-old female with a history of hypertension presented with difficult to control hypertension after sustaining a motor vehicle accident. She initially developed asymptomatic hypertension at age 21 denying paroxysms of headache, sweating, [...]

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HM2015 Abstract Number: 441

Sepsis Due to Listeria Bacteremia As Initial Presentation of Hodgkin Lymphoma

Case Presentation: A 53-year-old man with past medical history of alcohol use presented to the emergency room with a 1-month history of fatigue, night sweats, high fevers, and 20-pound weight loss over 3 months. Physical [...]

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HM2015 Abstract Number: 440

Pseudomonas Osteomyelitis of Skull Base Presenting As Intractable Headache and Nasopharyngeal Abscess:

Case Presentation: A 71 Year old Hispanic female with significant history of coronary artery disease status post coronary artery bypass grafting, chronic mastoditis with mastoidectomy few years ago, type 2 diabetes mellitus, hypertension and hyperlipidemia [...]

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HM2015 Abstract Number: 439

Aspergillosis Carries High Mortality in Heart Transplant Patients

Case Presentation: A 49 year old Caucasian female presented to the emergency department (ED) with increasing shortness of breath of one week. She had an initial orthotopic heart transplantation for giant cell myocarditis followed by [...]

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HM2015 Abstract Number: 438

Rare Bug, Rare Infection: P. Multocida Endopthalmitis and Endocarditis in an Immunocompromised Patient

Case Presentation: A case of Pasturella multocida infection, which manifested as sepsis, endopthalmitis, and native mitral-valve endocarditis, in an older patient on imatinib for a recently diagnosed gastrointestinal stromal tumor (GIST). Discussion: The patient is [...]

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HM2015 Abstract Number: 435

The Use of Subcutaneoous Icd for Unusual Clinical Presentation

Introduction: The use of an entirely subcutaneous implantable Cardioverter defibrillator (S-ICD) is a better alternative for patients who have limitations to placing pacemaker leads intravenously. We report a case of S-ICD use because of presence [...]

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HM2015 Abstract Number: 436

Cutaneous Lupus Erythematosus Induced by Rheumatoid Arthritis Medication (Abatacept)

Case Presentation: 80-year-old male with Rheumatoid Arthritis (RA). He was confirmed seropositive with Rheumatoid factor positive, Anti- Citrullinated protein positive as well as a high titer ANA positive. He was started on Abatacept for symptom [...]

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HM2015 Abstract Number: 433

An Unusual Case of Recurrent Nausea and Vomiting in a Patient with Mesenteric Vascular Disease

Case Presentation: A 66-year-old woman with multiple comorbidities including chronic mesenteric ischemia, chronic respiratory failure status post tracheostomy, and end-stage renal disease on dialysis presented with intermittent nausea and large-volume emesis. For several weeks prior [...]

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HM2015 Abstract Number: 434

Pituitary Origin of Cirrhosis – a Surprising Link

Case Presentation:  A 19 year old African American male presented with progressive shortness of breath over one month. Associated symptoms were dry cough and forty pound weight loss. Past medical history was pertinent for meningitis [...]

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HM2015 Abstract Number: 432

A Case of Septic Arthritis in a Patient with Colon Cancer

Case Presentation: An 88 year-old female initially presented to an outside hospital five days ago with concern for nausea, dizziness, and lightheadedness of one day duration. At the time, the patient was found to have hemoglobin [...]

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HM2015 Abstract Number: 431

Cef ‘lysing’ Triaxone, an Uncommon Act of a Common Drug

Case Presentation: A 61 year old male with a history of multiple knee replacements for osteoarthritis and septic arthritis presented to the hospital with symptoms of fevers, chills, and generalized malaise. He had recently been [...]

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HM2015 Abstract Number: 429

General Paralysis of the Insane

Case Presentation: A 53 year-old man with HIV (CD4 51/10%) presents with progressive confusion and weakness over two months. He had previously been employed and able to perform all activities of daily living. He is [...]

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HM2015 Abstract Number: 427

A Rare Case of Mitochondrial Myopathy: A Challenging Diagnosis!

Case Presentation: 32-year-old woman with a past medical history of Hashimoto's thyroiditis and fibromyalgia was admitted to the hospital with frequent episodes of muscular weakness and pain. The patient noted to have a life long [...]

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HM2015 Abstract Number: 430

Cam: This Kind Is Not Complementary

Case Presentation: 52 year old male with no past medical history presents to the emergency department with 3 months of increasing fatigue, upper extremity weakness, and oropharyngeal dysphagia. Review of systems was notable for fevers, [...]

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HM2015 Abstract Number: 426

An Atypical Case of West Nile Virus

Case Presentation: 69-year-old male with past medical history of hyperlipidemia, gout and eczema brought in to the emergency department in early fall for altered mental status. Patient was found unresponsive on the floor with non-bloody [...]

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HM2015 Abstract Number: 424

“Wheezing from the Gut! Gerd: A Forgotten Diagnosis”

Case Presentation: A 58-year-old woman with PMH significant for asthma, COPD, history of breast cancer s/p mastectomy on Tamoxifen, OSA, RA and a recent admission 3 weeks ago for asthma exacerbation; presented to the Emergency [...]

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HM2015 Abstract Number: 428

Goldmark?

Case Presentation: A 67 year-old man presented with shortness of breath that began three days prior to presentation. He reported an acute onset of dyspnea with no change in exertion. His past medical history included [...]

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HM2015 Abstract Number: 425

Cocaine – Another Nocuous Effect

Case Presentation: A 51-year-old female with past medical history of chronic renal insufficiency, insulin dependent diabetes mellitus, asthma and active nicotine dependence presented to the hospital with nausea, vomiting and abdominal pain for five days. [...]

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HM2015 Abstract Number: 423

Trimethoprim -Sulfamethoxazole Induced Sepsis Like Syndrome

Case Presentation: 85 year old woman with history of bio-prosthetic mitral valve presented with fever and rigors few days after dental work for which she took trimethoprim-sulfamethoxazole (TMP-SMZ). On physical examination, she had maculopapular rash [...]

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HM2015 Abstract Number: 627

The Answer Is Skin Deep

Case Presentation: A 79-year-old man presented with 4 months of progressive muscle weakness, shortness of breath, and anorexia associated with a 25 lb weight loss.  His exam was notable for hypoxemia requiring 4 liters of [...]

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HM2015 Abstract Number: 625

23-Year-Old with Lymphadenopathy and “B Symptoms”

Case Presentation: A 23-year-old previously healthy African-American female presented with one month history of progressive symptoms: first fever, night sweats, sore throat, malaise and body aches; then poor oral intake, severe fatigue, lower abdominal pain [...]

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HM2015 Abstract Number: 626

Gastric Heterotopic Pancreas Presenting As Acute Pancreatitis

Case Presentation: A 22-year-old man with a history of a Meckel’s diverticulum resected 10 years prior presented with diffuse abdominal pain and nausea for five days. The pain was sharp and stabbing in nature with [...]

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HM2015 Abstract Number: 628

Paraganglioma Causing Resistant Hypertension in a Twenty One Year Old Female

Case Presentation: A 21 year old woman had recently delivered a healthy male infant. This was her first pregnancy, it was complicated in the third trimester by pre eclampsia due to which she underwent a [...]

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HM2015 Abstract Number: 629

Bortezomib Associated Ttp

Case Presentation: A 73 y/o F was admitted with new onset seizure and altered mental status. PMH was significant for HTN and recently diagnosed multiple myeloma (MM). She had received bortezomib 4 days prior to [...]

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HM2015 Abstract Number: 631

Sarcoidosis: The Other Great Mimicker

Case Presentation: A 76-year-old female with past medical history of Paroxysmal Atrial Fibrillation, HTN, CAD, and cholangiocarcinoma (in remission since 2002) presented after a mechanical fall and also complained of increasing abdominal distention. Initial labs [...]

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HM2015 Abstract Number: 630

“Crossfit: Not Just Forging Elite Fitness”

Case Presentation: A 29 year old male with a history of Crigler–Najjar syndrome and working out with CrossFit, a high intensity core strength and conditioning exercise program, presented with two days of bilateral arm swelling.  [...]

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HM2015 Abstract Number: 632

Isolated Left Ventricular Non-Compaction Cardiomyopathy in Adults

Case Presentation: A 55-year-old male admitted with a diagnosis of pulmonary embolism and complaints of several episodes of intermittent palpitations was referred for cardiac evaluation for supraventricular tachycardia. Family history was significant for heart failure [...]

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HM2015 Abstract Number: 633

Spontaneous Coronary Artery Dissection: A Rare Cause of Myocardial Infarction

Case Presentation: A 45-year-old Caucasian female with insignificant medical history presented to a community medical center with typical 8/10 left-sided chest pain radiating to left arm. It resolved with sublingual nitroglycerin, only to present with [...]

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HM2015 Abstract Number: 635

Hodgkin’s Lymphoma Presenting As Gastrointestinal Hemorrhage

Case Presentation: A 61-year-old Caucasian male presented with melena, dizziness and anemia with hemoglobin of 6.0 gm/dL. He received appropriate hemodynamic resuscitation including six units of packed red blood cells. Urgent gastrointestinal tract evaluation was [...]

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HM2015 Abstract Number: 634

Intrapartum Inverted Takotsubo’s Cardiomyopathy Associated with Spinal Anesthesia During Cesarean Section

Case Presentation: A 31-year-old Caucasian female presented in active labor during her second pregnancy. She was planned for a cesarean section under spinal anesthesia with bupivacaine, morphine and fentanyl. Immediately, post-delivery she reported severe headache [...]

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HM2015 Abstract Number: 636

Probable Hydrochlorothiazide-Induced Myopericarditis: First Case Reported

Case Presentation: A 71-year-old African American woman with history of coronary artery disease, hypertension and sulfa allergy, presented with indolent onset retrosternal chest discomfort which was positional, pleuritic, and unresponsive to sublingual nitroglycerin. Her medications [...]

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HM2015 Abstract Number: 637

Skeletal Sarcoidosis and Hypercalcemia

Case Presentation: : A 70-year-old woman presented to the emergency department with general malaise and fatigue.  She has a history of diabetes mellitus type 2, hypertension and dyslipidemia for which she takes Metformin, Nifedipine and [...]

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HM2015 Abstract Number: 638

A Catastrophic Presentation of Thrombotic Thrombocytopenic Purpura (Ttp): Large Vessel Infarction of the Right Middle Cerebral Artery

Case Presentation: 67 year old right-handed female with past medical history of morbid obesity, hirsutism and pre diabetes mellitus presented to the Emergency Department with a chief complaint of acute onset of slurred speech. Notably [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on A Catastrophic Presentation of Thrombotic Thrombocytopenic Purpura (Ttp): Large Vessel Infarction of the Right Middle Cerebral Artery

HM2015 Abstract Number: 640

Pulmonary Mycobacterium Kansasii Infection –A Tale of a Right Upper Lobe Cavitary Lesion

Case Presentation: A 57 year old male with past medical history of COPD and schizophrenia presented with complaints of shortness of breath. The patient was discharged from a different hospital a day prior to the [...]

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HM2015 Abstract Number: 641

Be Still Thy Beating Heart

Case Presentation: A 36 year-old-male with a history of seizure disorder presented to the hospital with high-grade fevers, chest pain, and sore throat. At the time of presentation, he had a fever of 38.3°C, a [...]

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HM2015 Abstract Number: 643

A Wolf in Sheep’s Clothing: A Case of Sepsis Caused by Coagulase-Negative Staphylococci

Case Presentation: A 62  year old man with a history of end stage liver disease secondary to Hepatitis C and alcohol,  chronic obstructive pulmonary disease,  and benign prostate hyperplasia  presented to the hospital with a [...]

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HM2015 Abstract Number: 642

2, 2, 82? A Late Presentation of Meckel’s Diverticulum

Case Presentation: An 82 year old female with history of perforated appendicitis with open appendectomy at age 15, presented with 3 years of episodic abdominal pain and distention associated with nausea and vomiting. Prior episodes [...]

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HM2015 Abstract Number: 644

A Rare Case Report on Simultaneous Occurrence of Mpo-Vasculitis and Rheumatoid Arthritis

Case Presentation: A 58 year-old male guitarist presented to the hospital with worsening generalized weakness for a week. He also had sore throat and generalized malaise with diarrhea and decreased oral intake. Past medical history [...]

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HM2015 Abstract Number: 645

Acute Liver and Renal Failure : A Rare Adverse Effect Exclusive to Intravenous Form of Amiodarone

Case Presentation: 65 years old male with past medical history of ischemic cardiomyopathy with Automatic Implantable Cardioverter Difibrillator (AICD) presented with complaints of multiple AICD shocks. Lab works at presentation were within normal limits. AICD [...]

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HM2015 Abstract Number: 647

Collapsing Fsgs Caused by Acute Epstein- Barr Virus Infection: A Case Report

Case Presentation: A 20 year old African American Male presented with 1 day history of bilateral throbbing headache , nausea , vomiting .On further questioning, he reported experiencing flu like symptoms 2-3 weeks ago with [...]

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HM2015 Abstract Number: 646

A Hematological Menace : Multiple Venous Thrombosis Complicated by Acquired Factor Viii Deficiency

Case Presentation: A 21 year old African-American male with no medical history presented with multiple organ injuries secondary to gunshot . He had exploratory laparotomy with repair of abdominal wall , colonic resection, splenectomy, and [...]

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HM2015 Abstract Number: 648

This Is Not Vasculitis, Do You C?

Case Presentation: A 25 year-old man presented with one month of progressively painful, bruised, and swollen bilateral calves. Symptoms started as bilateral feet and ankle pain followed by the development of bruising over the posterior [...]

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HM2015 Abstract Number: 649

Acquired Hemophagocytic Lymphohistiocytosis : It’s Not Just in the Genes

Case Presentation: A 71 year old woman with a history of transformed diffuse large B-cell Non-Hodgkin’s Lymphoma, currently in remission, was transferred to our hospital for several days of malaise and persistent fevers. She was [...]

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HM2015 Abstract Number: 651

He Probably Had Dinner at Mary’s

Case Presentation: 85-year-old man with hypertension and prostate cancer presents with five days of fever, chills, poor oral intake, constipation and a non-productive cough. Patient had just completed a course of Azithromycin provided by his primary [...]

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HM2015 Abstract Number: 650

An Underperforming Basketball Player

Case Presentation: A 37 year old African-American man presented with numbness in the hands and weakness of both the upper and lower extremities for a month's duration. Patient stated that the proximal muscle weakness has [...]

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HM2015 Abstract Number: 652

“Heart” to Stomach the Headaches

Case Presentation: 39 year old man with a PMH of testicular seminoma s/p orchiectomy presents with intermittent, sharp, left-sided abdominal pain in the subcostal region with radiation to the left flank and back of 2 [...]

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HM2015 Abstract Number: 653

Rhabdomyolysis with Kidney Injury in a Patient with Uncontrolled Hypothyroidism

Case Presentation: A 40-year-old woman with postablative hypothyroidism from Graves Disease presented with 3 weeks of fatigue and myalgias. She reported severe constipation and worsening bilateral anterior thigh pain exacerbated by movement. Physical examination revealed [...]

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HM2015 Abstract Number: 655

Dying from Sunshine

Case Presentation: A 77 year-old Caucasian male with a history of recently diagnosed myelodysplastic syndrome (MDS), hypertension, hyperlipidemia, atrial fibrillation, lung cancer treated with resection, and amyloidosis of the kidneys, presented to the ED with [...]

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HM2015 Abstract Number: 654

Dic from Spider Bite Mimicking Hemophagocytic Lymphohistiocytosis

Case Presentation: 23 y.o. female with no significant PMH presented to OSH ED 1 week post brown recluse spider bite. She had fever of 102.4 and was started on abx. Over the next several days, [...]

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HM2015 Abstract Number: 656

Perplexing Apoplexy

Case Presentation: 85 year old female presented to the ED with the worst headache of her life for four days. Past medical history was significant for migraines, diabetes mellitus, and recent zoster involving CN VII. [...]

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HM2015 Abstract Number: 657

Stuck in the Heart: Embolized Strut Fracture of Ivc Filter

Case Presentation: A 38-year-old male admitted for gastroenteritis was found to have an incidental finding of linear density in right ventricle (RV) on abdominal x-ray. He had a history of lower extremity deep venous thrombosis [...]

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HM2015 Abstract Number: 659

A Presentation of Paranoia

Case Presentation: A 61 year old woman was brought into the emergency department by her brother for evaluation of confusion, hallucinations, and paranoia.  Her medical comorbidities included anxiety, hypertension, and stage III chronic kidney disease.  [...]

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HM2015 Abstract Number: 658

Sweet’n Low: Fever, Diffuse Rash, Anemia, and Thrombocytopenia

Case Presentation:  A 39-year-old man with no past medical history presented to an outside hospital with several weeks of fevers, chills, night sweats, vomiting, diffuse abdominal pain and a 7 kg weight loss. Vital signs [...]

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HM2015 Abstract Number: 660

An Unusual Case of Sloughing Esophagitis Due to Histoplasmosis in an Immune Competent Patient

Introduction:Esophagitis dissecans superficialis (EDS) is a rare although likely underreported endoscopic finding characterized by sloughing of large fragments of esophageal mucosal lining.   It is commonly seen in immune suppressed patients and those with multiple comorbidities. [...]

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HM2015 Abstract Number: 661

Use of Anti-Il6 Receptor Antibody (Tocilizumab) for Induction Therapy in Secondary Hemophagocytic Lymphohistiocytosis/macrophage Activation Syndrome (Hlh/mas)

Case Presentation: A 61-y.o. woman with pulmonary sarcoid presented with 3 weeks of fever, malaise, and 15-lb weight loss. Social, travel, and family history was unremarkable. Initial exam noted diffuse lymphadenopathy. Labs revealed leukopenia, anemia, [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Use of Anti-Il6 Receptor Antibody (Tocilizumab) for Induction Therapy in Secondary Hemophagocytic Lymphohistiocytosis/macrophage Activation Syndrome (Hlh/mas)

HM2015 Abstract Number: 663

Recurrent Hemosuccus Pancreaticus Requiring Coil Embolization

Case Presentation: A 34 year old African American male with history of alcoholism, chronic pancreatitis, recurrent upper GI bleeding with unknown etiology presented with acute onset of epigastric and LUQ abdominal pain, hematemesis and melena. [...]

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HM2015 Abstract Number: 662

Kounis Syndrome, Acute Myocardial Infarction in the Setting of Anaphylacitc Reaction

Case Presentation: A 62 years old male presented to the emergency department with soft tissue swelling, urticarial skin rash and acute respiratory failure. He was diagnosed with acute anaphylactic reaction with angioedema. He was given [...]

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HM2015 Abstract Number: 664

Fibrolamellar Hepatocellular Carcinoma; a Rare Cause of Liver Mass

Case Presentation: A 26 year old male with past medical history significant for gastroesophageal reflux disease, presented with complaints of ongoing right upper quadrant and epigastric abdominal pain over the previous 6 months. He reported [...]

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HM2015 Abstract Number: 665

A Case of Co-Infection with Hiv and Chagas Disease with Improvement of Chagoma After Treatment with Benznidazole

Case Presentation: A 22 year-old man presented to the emergency department in Cochabamba, Bolivia, with headache and left-sided weakness.  Both were present for three weeks, both progressively worsening.  The patient was from Aiquile, a rural [...]

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HM2015 Abstract Number: 667

A Case of Lower Extremity Paralysis

Introduction:  Thyrotoxic Periodic Paralysis (TPP) is complication of hyperthyroidism, characterized by recurrent episodes of flaccid paralysis associated with hypokalemia. This unusual but serious complication of hyperthyroidism can lead to paralysis, cardiac arrhythmias and respiratory failure. [...]

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HM2015 Abstract Number: 666

Pylephlebitis: A Rare but Serious Complication of Crohn’s Disease

Case Presentation: A 27 yo female with biopsy-proven Crohn’s disease presented with fever, chills, abdominal pain and diarrhea occurring intermittently for the past year. Previously, she had been maintained on TNF inhibitor alone with antibiotics [...]

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HM2015 Abstract Number: 668

A Case of Invasive Klebsiella Pneumoniae Liver Abscess Syndrome

Introduction: Invasive Klebsiella Pneumoniae Liver Abscess Syndrome (IKPLAS) consists of liver abscess findings on imaging with blood cultures or aspirate positive for Klebsiella Pneumoniae, in the absence of hepatobiliary disease.  This entity is ominous from [...]

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HM2015 Abstract Number: 669

An Evolving Diagnosis: Altered Mental Status to Henoch-Schlonein Purpura in an Adult

Case Presentation: A 58 year old male is sent from a behavioral health unit for altered mental status, lethargy, and vomiting for one day. He has a history of hypertension and schizoaffecive disorder, for which [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on An Evolving Diagnosis: Altered Mental Status to Henoch-Schlonein Purpura in an Adult

HM2015 Abstract Number: 671

Back Reconstruction Leading to Cement Embolism

Case Presentation: A 79 year old female with history of osteoporosis, remote breast cancer s/p mastectomy and radiation therapy, and history of multiple vertebral compression fractures presented to the hospital three days after kyphoplasty of [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Back Reconstruction Leading to Cement Embolism

HM2015 Abstract Number: 670

Don’t Always Trust Your Heart

Case Presentation: A 39 year-old woman presented with 4 months of progressive dyspnea on exertion and chest tightness.  Her symptoms first began near the end of her usual 2 mile walk, resolving with rest after [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Don’t Always Trust Your Heart

HM2015 Abstract Number: 672

Radiation-Induced Organizing Pneumonia: A Rare Case of Recurrent Cough and Shortness of Breath

Case Presentation: A 50 year old woman with history of left breast cancer, treated with lumpectomy and eight weeks of radiation therapy completed four months ago, presented with one month of dyspnea, dry cough, and low grade [...]

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HM2015 Abstract Number: 673

Pained Prostate Spreading the Blues

Case Presentation: An 82-year old male presented to emergency department with complaints of severe “prostate” pain with movement, defecation, and micturition for several months, with increase in pain severity 2 weeks prior to presentation. He [...]

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HM2015 Abstract Number: 675

Did Asplenia Lead Astray?

Case Presentation: A 43-year-old Caucasian man with a history of asplenia, nephrolithiasis, and prior mesenteric lymphadenitis presented with fevers, headache, and rash in areas of prior tattoos and scars. Review of systems revealed two months [...]

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HM2015 Abstract Number: 674

Recurrent Aseptic Meningitis in Herpes Simplex Virus-2 (Hsv-2) Uncovers Behcet’s Disease

Case Presentation: A 42-year-old African American female presented to the emergency room complaining of dizziness, headache, nausea, fever and chills for 3 days. The patient reported at least 3 similar episodes in the past 5 [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Recurrent Aseptic Meningitis in Herpes Simplex Virus-2 (Hsv-2) Uncovers Behcet’s Disease

HM2015 Abstract Number: 676

Laparoscopic Surgery for Patient with Severe Chronic Obstructive Lung Disease

Case Presentation: A 56 year old African American man with a past medical history of HIV, TB (treated), and very severe stage IV COPD (FEV1 25%) with a thirty pack years smoking history presented for [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Laparoscopic Surgery for Patient with Severe Chronic Obstructive Lung Disease

HM2015 Abstract Number: 677

Vasoplegic Syndrome in a Postoperative Patient

Case Presentation: A 63 year-old Caucasian male with a history of severe symptomatic aortic insufficiency and coronary artery disease was seen in the intensive care unit status-post aortic valve replacement and single vessel coronary artery bypass graft (CABG). The patient tolerated the [...]

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HM2015 Abstract Number: 679

Chyloperitoneum and Chylothorax Due to Lymphoma

Case Presentation: A 78-year-old woman presented to an outside facility with dyspnea and abdominal distension. Abdominal examination revealed distension and a fluid wave. Pulmonary examination revealed decreased breath sounds and dullness to percussion in the [...]

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HM2015 Abstract Number: 678

Got Platelets? A Clumping Conundrum with an Unexpected Outcome

Case Presentation: A 21 year-old woman with acquired immune deficiency syndrome (CD4 count 22) and chronic platelet clumping was admitted with a sore throat of 24 hours duration. She had enlarged, erythematous tonsils bilaterally; no [...]

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HM2015 Abstract Number: 680

Recurrent Cardioinhibitory Reflex Cardiac Arrest Due to Infection of the Neck and Spine

Case Presentation: A 51 year old male patient with a history of injection drug use was admitted with MRSA bacteremia and lumbar epidural abscesses.  He reported developing new neck pain on hospital day two.  Urgent cervical MRI [...]

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HM2015 Abstract Number: 681

Incidental Diagnosis of Cholangiocarcinoma

Case Presentation:  A 40 year old man with history of hyperlipidemia and elevated transaminases and alkaline phosphatase for the last 10 years, which he attributed to statin use, presented with dark urine, pruritus, scleral icterus, and [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Incidental Diagnosis of Cholangiocarcinoma

HM2015 Abstract Number: 683

“Ring Around the Heart”: A Case of Metastatic Primary Gastric Signet Ring Cell Carcinoma Presenting As Cardiac Tamponade

Case Presentation: 55-year-old Hispanic female with no significant past medical history who was in her usual state of health presented with complaints of multiple syncopal episodes that were preceded by nausea and vomiting for three [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on “Ring Around the Heart”: A Case of Metastatic Primary Gastric Signet Ring Cell Carcinoma Presenting As Cardiac Tamponade

HM2015 Abstract Number: 682

Getting to the Heart of It: An Unexpected Metastasis of a Common Malignancy

Case Presentation: A 51 year old woman presented with one month of progressive dyspnea on exertion, increasing abdominal girth and 20 lbs weight gain. She denied fevers, night sweats, nausea, vomiting, chest pain, orthopnea, paroxysmal [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Getting to the Heart of It: An Unexpected Metastasis of a Common Malignancy

HM2015 Abstract Number: 684

A Rare Case of Abdominal Pain Due to Spontaneous Celiac Artery Dissection

Case Presentation: A 46-year-old gentleman presented to the ED with one day history of acute onset epigastric pain. He is a nonsmoker and nonalcoholic, with past medical history of hypertension. His abdominal pain was sharp [...]

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HM2015 Abstract Number: 685

Abdominal Cocoon As a Rare Presentation of Adenocarcinoma of Colon

Case Presentation: A 58 year old gentleman  with no known past medical or surgical history, or history of smoking or alcohol intake, presented to the ED with abdominal pain, nausea, vomiting ,constipation with generalized weakness [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Abdominal Cocoon As a Rare Presentation of Adenocarcinoma of Colon

HM2015 Abstract Number: 687

Sle or Not Sle? That Is the Question!

Case Presentation: A 32 year-old African American man with a history of asthma was admitted to the ICU with acute respiratory failure due to diffuse alveolar hemorrhage (DAH), diagnosed by bronchoscopy, requiring intubation and blood [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Sle or Not Sle? That Is the Question!

HM2015 Abstract Number: 686

Superior Vena Cava Syndrome Caused by Aspergillus

Case Presentation: A 66-year-old man with a history of Small Lymphocytic Lymphoma/Chronic Lymphocytic Leukemia(SLL/CLL) in remission, hypogammaglobulinemia and atrial fibrillation presented to an outside hospital with shortness of breath, facial swelling and bilateral upper extremity edema.Computed tomography scanning done prior to [...]

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HM2015 Abstract Number: 688

An Example of the Swiss Cheese Model of Error Leading to Hypoglycemia

Case Presentation: A 54y man with history of DM2 on insulin and ESRD on HD presented to the ER with worsening bilateral foot pain. The patient was admitted 1 month prior for osteomyelitis of the [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on An Example of the Swiss Cheese Model of Error Leading to Hypoglycemia

HM2015 Abstract Number: 689

Myxedema Madness: An Unusual Manifestation of Hypothyroidism

Case Presentation: An 85 year old man with a history of HCV, hypothyroidism on levothyroxine, and anemia presented with a 1 day history of total body pain. He stated that he was in his usual [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Myxedema Madness: An Unusual Manifestation of Hypothyroidism

HM2015 Abstract Number: 691

Sepsis with Transaminitis: More Than Shock Liver

Case Presentation: A 57 year old female with a past medical history of Lyme  disease was admitted to the hematology service with DIC. Acute promyelocytic leukemia was diagnosed and a PICC line was placed for [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Sepsis with Transaminitis: More Than Shock Liver

HM2015 Abstract Number: 690

Severe Refractory Hypoglycemia Following Sulfonylurea Overdose

Case Presentation: A 48 year-old Chinese man with background history of major depression, presented 7 hours after ingestion of unknown amount of multiple drugs including immediate-release gliclazide, simvastatin, fluvoxamine and pacofen (paracetamol, codeine and caffeine). [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Severe Refractory Hypoglycemia Following Sulfonylurea Overdose

HM2015 Abstract Number: 570

An Uncommon Cause of Weakness: Acute Intermittent Porphyria Presenting As Quadriparesis

Case Presentation: A 59 year old man with a history of acute intermittent porphyria was admitted with weakness and subjective chills. Exam revealed severe proximal muscle weakness and areflexia.  Blood cultures grew E. coli, treated [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on An Uncommon Cause of Weakness: Acute Intermittent Porphyria Presenting As Quadriparesis

HM2015 Abstract Number: 572

Syndrome of Irreversible Lithium-Effectuated Neurotoxicity (Silent): Break the Silence

Case Presentation: A 60 y/o African American Female with history of Manic-depressive disorder was brought to emergency room for altered mental status of three day duration. Her home medications included Lithium, Trazadone, Paliperidone. She had [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Syndrome of Irreversible Lithium-Effectuated Neurotoxicity (Silent): Break the Silence

HM2015 Abstract Number: 573

The Hunter’s Trap: A Fatal Case of Tularemia

Case Presentation: A 49 year old man with a medical history significant for hypertension and hyperlipidemia presented to the ER with worsening shortness of breath, cough and malaise. His initial work-up revealed normal lab values [...]

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HM2015 Abstract Number: 575

A Rare Neoplasm with a Large Impact-Cmml Case Report

Case Presentation: 64-year-old man with a history of remote IV drug abuse, untreated hepatitis C, and poor medical follow-up presented with two months of increasing weakness. One week prior to presentation, he reported a flu-like illness with neck swelling, presumed lymphadenopathy, after which his weakness acutely [...]

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HM2015 Abstract Number: 574

A Case of Chronic Flecainide Toxicity

Case Presentation: A 78 year old lady with recent pacemaker placement for sick sinus syndrome, and paroxysmal atrial fibrillation on flecainide (150 mg bid) for the past one year, presented to the ER with nausea [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on A Case of Chronic Flecainide Toxicity

HM2015 Abstract Number: 576

A Breathtaking Defect

Case Presentation:  A 63 year-old female presented with a fall and presyncope. A year ago, the patient had transient dysarthria with progressive confusion, cognitive decline, and several falls. The patient denied recent headache, SOB, palpitations, [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on A Breathtaking Defect

HM2015 Abstract Number: 577

Serotonin Syndrome Induced by Lamotrigine, Aripiprazole and Cocaine Use: A Case Report

Case Presentation: A 24 year old female with a history of bipolar disorder was admitted for nausea, dizziness and jitteriness that started after intentional ingestion of 4 gm of lamotrigine and 80 mg of aripiprazole, [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Serotonin Syndrome Induced by Lamotrigine, Aripiprazole and Cocaine Use: A Case Report

HM2015 Abstract Number: 579

An Uncommon Case of Genital Ulcer

Case Presentation: A 25 year old Ethiopian female presented with a four week history of painful genital ulcer, oral lesions and intermittent back pain with dysuria. Ulcer initially started as painless bumps that progressively became [...]

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HM2015 Abstract Number: 578

A “Pain in the Neck” Diagnosis: Retropharyngeal Calcific Tendonitis with Bacteremia

Case Presentation: A 54-year-old male with type 2 diabetes mellitus presented to the emergency department with occipital headache, neck pain, fevers, and dysuria for three days. He was diagnosed with a urinary tract infection and [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on A “Pain in the Neck” Diagnosis: Retropharyngeal Calcific Tendonitis with Bacteremia

HM2015 Abstract Number: 580

Afferent Limb Syndrome Presenting As Pancreatitis Due to Obstructing Gastric Stump Carcinoma

Case Presentation: A 69 year old male with history of Gastro esophageal reflux disease and Billroth type II procedure for peptic ulcer disease, presented to the hospital with sudden onset of abdominal pain, nausea and [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Afferent Limb Syndrome Presenting As Pancreatitis Due to Obstructing Gastric Stump Carcinoma

HM2015 Abstract Number: 581

The Hidden Bleeder

Case Presentation: 66 years old male with past medical history of Hypertension, chronic kidney disease, active smoker and alcohol abuse, presented with two episodes of hemoptysis. Patient was admitted initially with working diagnosis of possible [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on The Hidden Bleeder

HM2015 Abstract Number: 582

Microscopic Carcinoid

Case Presentation: 51 year old Caucasian male with history of hyperlipidemia presented with complain of melena. Patient had noticed one episode of bright red blood per rectum. On questioning patient also complained of feeling tired [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Microscopic Carcinoid

HM2015 Abstract Number: 584

Sorry to Burst Your Bubble: It’s an Emergency!

Case Presentation: A 63 year old man with poorly controlled diabetes presented to his primary care physician with fevers, chills, urinary frequency, and back pain. He was referred to the Emergency Room (ER) for presumed [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Sorry to Burst Your Bubble: It’s an Emergency!

HM2015 Abstract Number: 585

Total Eclipse of the Heart: A Case of Unexplained Chest Pain Syndrome in a Diabetic Patient

Case Presentation: A 46 year old male with hypertension and uncontrolled type 2 diabetes mellitus presented with sharp, non-radiating sub sternal chest pain.  EKG showed diffuse ST elevations, transthoracic echocardiogram (TTE) showed no abnormalities and [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Total Eclipse of the Heart: A Case of Unexplained Chest Pain Syndrome in a Diabetic Patient

HM2015 Abstract Number: 587

Is It a Lyme Neuroborreliosis, Neurosarcoidosis or Neuroepithelial Tumor? – a Case Report

Case Presentation: A 50 year-old male with no past medical history presents with 3 months of worsening headache (HA), neck stiffness, photophobia, nausea and vomiting. Patient was evaluated by neurology 2 weeks prior to admission. [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Is It a Lyme Neuroborreliosis, Neurosarcoidosis or Neuroepithelial Tumor? – a Case Report

HM2015 Abstract Number: 586

This Headache Is Killing Me!

Case Presentation: A 41 year old Hispanic female with history of methylenetetrahydrofolate reductase deficiency and migraines presented with worsening right sided retro-orbital headache, new onset diplopia, right facial numbness and right facial droop. She presented [...]

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HM2015 Abstract Number: 588

Laxative-Induced Magnesium Toxicity

Case Presentation: A 59-year-old man with end-stage renal disease (ESRD) on hemodialysis presented to the hospital with six days of progressive, symmetric, bilateral, lower extremity weakness and paresthesias, and imbalance. At baseline he could ambulate [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Laxative-Induced Magnesium Toxicity

HM2015 Abstract Number: 589

Beware of Wild C-Ards: Blastomycosis

Case Presentation: A previously healthy 58 year old male presented with increasing dyspnea for three days. On admission, his heart rate was 110, respiratory rate was 19, and his oxygen saturation was 85% on room [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Beware of Wild C-Ards: Blastomycosis

HM2015 Abstract Number: 591

Difficult Diagnosis: Mycobacterium Marinum

Case Presentation: A 60 year-old Chinese man with a seven-month history of two ulcerative lesions in the dorsal surfaces of the right forearm and the right fourth proximal interphalangeal (PIP) joint presented with diffuse pruritic [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Difficult Diagnosis: Mycobacterium Marinum

HM2015 Abstract Number: 590

A Rare and Forgotten Cause of Hypermagnesemia

Case Presentation: A 58-year-old African-American woman with multiple sclerosis and history of recent left thalamic stroke presented with six days of generalized weakness and fatigue.  One week prior, she was hospitalized for a transient episode [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on A Rare and Forgotten Cause of Hypermagnesemia

HM2015 Abstract Number: 592

Tramadol: A Rare Cause of Acute Interstitial Nephritis

Case Presentation: A 44 year old man with history of obesity and hyperlipidemia presents to the ER with two week history of right ankle pain, found to have acute kidney injury warranting admission. He presented [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Tramadol: A Rare Cause of Acute Interstitial Nephritis

HM2015 Abstract Number: 593

A Case of Invasive Pulmonary Aspergillosis in a Patient on Crizotinib for Alk Mutation-Positive Non-Small Cell Lung Cancer

Case Presentation: A 60 year-old Polish woman with stage IV adenocarcinoma of the lung (ALK fusion oncogene positive) on crizotinib, with a recent history of steroid use, presented with one week of malaise.  In the [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on A Case of Invasive Pulmonary Aspergillosis in a Patient on Crizotinib for Alk Mutation-Positive Non-Small Cell Lung Cancer

HM2015 Abstract Number: 595

Looking Beyond the Lone Peak

Case Presentation: A 66 year-old man presented with six months of migratory body aches, slowed walking and twenty-pound weight loss. He had no neurological deficits. Labs showed hemoglobin 10.5 g/dL, creatinine 1.2 mg/dL, and normal [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Looking Beyond the Lone Peak

HM2015 Abstract Number: 594

Uncommon Cause of Bilateral Lower Limb Weakness

Case Presentation: A 64 years old Chinese female, with background of hypertension and diabetes mellitus, presented with progressive bilateral lower limb weakness over 3 weeks. Examination revealed normal upper limbs, bilateral foot drop and absent [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Uncommon Cause of Bilateral Lower Limb Weakness

HM2015 Abstract Number: 596

An Extremely Rare Case of Spontaneous Tumor Lysis Syndrome

Case Presentation: A 43 year-old gentleman with a history of obesity, hypertension, obstructive sleep apnea, and recently diagnosed stage IV gastric adenocarcinoma treated only with 2000 centigrays of radiotherapy to his stomach one week prior [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on An Extremely Rare Case of Spontaneous Tumor Lysis Syndrome

HM2015 Abstract Number: 597

Borrelia Cervicalgia: A Case of Non-Compressive Cervical Radiculopathy

Case Presentation: A 63 year-old woman presented with one-week history of severe neck pain radiating to the left arm, along with two days of weakness and numbness of both upper limbs, left greater than right. [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Borrelia Cervicalgia: A Case of Non-Compressive Cervical Radiculopathy

HM2015 Abstract Number: 599

Hashimoto’s Encephalopathy Presents with Psychosis

Case Presentation: A 48 year-old man presented with disorientation, mumbling speech, aggressive behavior, and visual hallucinations.  He was healthy until two months prior when he developed hallucinations.  He had been given a diagnosis of schizophrenia [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Hashimoto’s Encephalopathy Presents with Psychosis

HM2015 Abstract Number: 598

Straining to Diagnose

Case Presentation: A 50-year-old physician presented to the emergency department with waxing and waning fevers, chills, and sweats. Nine days prior to presentation he developed a sore throat, fevers, night sweats, and chills, which resolved [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Straining to Diagnose

HM2015 Abstract Number: 600

Making Wrong Connections: The ‘Tale’ of an Angry Organ

Case Presentation: A 23 year old male presented to the emergency department with left sided pleuritic chest pain radiating to the back, mild cough, clear sputum and shortness of breath for 2 days. He had [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Making Wrong Connections: The ‘Tale’ of an Angry Organ

HM2015 Abstract Number: 603

A Mysterious Cause of Aseptic Meningitis

Case Presentation:    A 32 year old woman presented to the emergency department with a 2 day history of headache, fever, stiff neck, and photophobia. Her past medical history was significant for 5 episodes of [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on A Mysterious Cause of Aseptic Meningitis

HM2015 Abstract Number: 602

Ralstonia: Crossing the Line

Case Presentation: A 49 year old man with stage IIIB colon cancer currently undergoing chemotherapy with 5-fluorouracil and oxaliplatin was referred to the emergency department (ED) for gram negative rod bacteremia. The day prior to [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Ralstonia: Crossing the Line

HM2015 Abstract Number: 604

Rapidly Progressive Diffuse Large B-Cell Lymphoma Presenting As Innumerable Pulmonary Nodules in an Aids Patient: A Fatal Case Report

Case Presentation: A 52 yo AA female presented with SOB, cough productive of green sputum and a 12lb weight loss over 3 months.  PMH: AIDS (CD4 180), hx pulm TB (treated, yrs ago), DM2, ex-IVDU [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Rapidly Progressive Diffuse Large B-Cell Lymphoma Presenting As Innumerable Pulmonary Nodules in an Aids Patient: A Fatal Case Report

HM2015 Abstract Number: 607

Nephrotic-Range Proteinuria in a Patient with Multiple Sclerosis, What Is the Connection?

Case Presentation: A 47 year-old African American female who presented for routine annual check-up, was found to have abnormal labs; Creatinine(Cr) of 4.7 and Blood urea nitrogen(BUN) of 37. Her creatinine was 0.8, 6 years [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Nephrotic-Range Proteinuria in a Patient with Multiple Sclerosis, What Is the Connection?

HM2015 Abstract Number: 606

Lupus Hiding in the Shadows of Anti-Gbm Disease

Case Presentation: A 21 year old man presented with severe shortness of breath and hypoxia. He had history of Anti-GBM disease (Goodpasture’s syndrome), living related donor renal transplant, failed renal transplant due to medication non-adherence [...]

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HM2015 Abstract Number: 608

The Elusive Palindromic Rheumatism

Case Presentation: A 59 year-old woman with a history of diabetes presented with one day of right shoulder pain. The pain was sudden, severe, and woke her in the night. She denied recent joint trauma. [...]

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HM2015 Abstract Number: 609

Group a Streptococcal Septic Arthritis

Case Presentation: A 44 year-old woman with a history of untreated rheumatoid arthritis (RA) initially presented to an outpatient gynecologist with several days of vaginal discharge and itching, which was diagnosed as bacterial vaginosis. Examination [...]

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HM2015 Abstract Number: 611

Pernicious Anemia Presenting As Pancytopenia

Case Presentation: A 50-year-old man with no prior history presented with one month of progressively worsening shortness of breath, now occurring with minimal exertion. He endorsed nausea and bilious vomiting, but denied hemoptysis, hematemesis, hematochezia, [...]

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HM2015 Abstract Number: 610

Beta Testing: Checking for Complications

Case Presentation: A 33-year-old man with history of beta thalassemia major and cirrhosis due to multiple blood transfusions presented with two months of increased frequency of urinary incontinence. He sustained a fall four months ago [...]

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HM2015 Abstract Number: 612

Temperate Pyomyositis – a Smoldering Dust Devil

Case Presentation:  A 61 year-old uncontrolled diabetic complicated by bilateral femoral- femoral bypasses due to peripheral vascular disease presented with intractable left leg pain after a fall.  In the Emergency Department, he was noted to [...]

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HM2015 Abstract Number: 613

A Common Diagnosis from an Uncommon Etiology: Traumatic Superior Gluteal Artery Rupture Presenting As Anemia and Knee Pain

Case Presentation: A 63 yr old gentleman with a history of ischemic stroke and hypertension presented to the ED from his assisted living center for evaluation of R hip & knee pain. The patient reported [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on A Common Diagnosis from an Uncommon Etiology: Traumatic Superior Gluteal Artery Rupture Presenting As Anemia and Knee Pain

HM2015 Abstract Number: 615

Recurrent Drug-Induced Liver Injury Related to Oral Contraceptive Use

Case Presentation: A 23 year-old woman with history of acute liver injury three years ago with use of an oral contraceptive pill (OCP) presented complaining of severe generalized itching and diffuse yellow discoloration of her [...]

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HM2015 Abstract Number: 614

New Onset Dvt and Chronic Cough: A Subacute Mystery

Case Presentation: A 51-year-old man with no prior history presented with a 2-day complaint of right leg pain and swelling. He was undergoing an outpatient work up for a 6-month history of chronic cough and [...]

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HM2015 Abstract Number: 616

Eczema Herpeticum: A Severe Manifestation of Herpes Simplex Infection

Case Presentation: A 57-year-old African-American man presented with a pruritic rash and fever for two days. Past history was significant for chronic dermatitis for 9 months that initially involved the head and neck, which was [...]

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HM2015 Abstract Number: 617

When a Physical Examination Becomes Unreliable; Complication of Inferior Myocardial Infarction

Case Presentation:  A 74-year-old woman with morbid obesity presented with chest pain for three hours. Chest pain was constant, pressure sensation, located in her left chest and accompanied with shortness of breath. Her blood pressure [...]

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HM2015 Abstract Number: 619

A Common Virus As a Rare Cause of Hepatitis

Case Presentation: A 22-year-old male with a history of pancytopenia and peptic ulcer disease presented with one week of fevers, chills, and night sweats and was found to have elevated transaminases and worsening thrombocytopenia. Over [...]

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HM2015 Abstract Number: 618

Pneumococcal Sepsis Presenting with Acute Aortic Occlusion

Case Presentation: A 52-year-old female with history of hypertension and smoking presented with increasing dyspnea for five days. She also reported numbness in her legs and inability to walk for few days. She was cachectic, [...]

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HM2015 Abstract Number: 620

Eosinophilic Granulomatosis with Polyangiitis (Egpa) Presenting As Chronic Diarrhea, Stroke, Neuropathy and Endomyocarditis – a Case for Hospitalists

Case Presentation: A 56 year-old Hispanic female with a history of asthma, chronic sinusitis, and nasal polyps presents with diarrhea and abdominal pain for 6 months. Patient had previously been admitted twice with a diagnosis [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Eosinophilic Granulomatosis with Polyangiitis (Egpa) Presenting As Chronic Diarrhea, Stroke, Neuropathy and Endomyocarditis – a Case for Hospitalists

HM2015 Abstract Number: 621

Bilateral Renal Infarction Associated with Oxaliplatin-Based Chemotherapy for Colon Carcinoma: A Case Report

Case Presentation: A 62 year old male with colon carcinoma and liver metastasis presented to emergency department after developing right flank pain while undergoing 6th cycle of oxaliplatin infusion. He was on FOLFOX (Folinic acid, [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Bilateral Renal Infarction Associated with Oxaliplatin-Based Chemotherapy for Colon Carcinoma: A Case Report

HM2015 Abstract Number: 623

A Case of Severe Myocarditis and Pericarditis Complicated with Drug Reaction with Eosinophilia and Systemic Symptoms Syndrome

Case Presentation: A 33-year-old Japanese man, with no significant past medical history, presented to our hospital with a two-day history of fever, diarrhoea and diffuse maculopapular rash. Four weeks before, he had taken cefaclor, and [...]

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HM2015 Abstract Number: 622

Functional Vitamin B12 Deficiency: An Unusual Consequence of Recreational Nitrous Oxide Use

Case Presentation: A 42 year old female noticed numbness and a tingling sensation over her feet bilaterally. This sensation progressed to involve the entire lower extremities and was accompanied by unsteady gait and weakness over [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Functional Vitamin B12 Deficiency: An Unusual Consequence of Recreational Nitrous Oxide Use

HM2015 Abstract Number: 624

A Case of Levamisole Induced Vasculitis

Case Presentation: A 53 year-old woman with unspecified arthritis presented with recurrent rash. She reported frequent episodes of skin tenderness that escalated to pruritic, ulcerating blisters containing dark fluid and necrotic ecchymoses throughout her extremities [...]

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HM2015 Abstract Number: 569

Tick…tock? A Rhythm Problem

Case Presentation: A 31-year-old man with no past medical history presented after a pre-syncopal event. He felt increasingly unwell over the four weeks prior to admission with decreased appetite, fatigue, and intermittent night sweats. Several [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Tick…tock? A Rhythm Problem

HM2015 Abstract Number: 571

Levamisole Lesions: The Perils of Tainted Cocaine

Case Presentation: A 48 year old woman presented to the ED with painful skin lesions on thighs, nose, and ears which appeared after smoking cocaine the night prior. The patient reported at least five previous [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Levamisole Lesions: The Perils of Tainted Cocaine

HM2015 Abstract Number: 694

Rifampin Induced Dress

Case Presentation: An 86-year-old male with hypertension, diabetes, and pulmonary tuberculosis on therapy presented to the ED with fever and a rash. He developed an erythematous rash over his body two months prior to admission. [...]

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HM2015 Abstract Number: 695

Unicuspid Aortic Valve – a Classic Presentation

Case Presentation: A 26 year old male with no relevant past medical history, had presented to the hospital after two episodes of syncope with diaphoresis and lightheadedness. On physical examination his blood pressure and pulse [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Unicuspid Aortic Valve – a Classic Presentation

HM2015 Abstract Number: 696

Not Just Another Tick-Borne Illness

Case Presentation: A 69 year-old man presented with pleuritic chest pain for several hours.  Prior to admission he had hiked throughout the northeast United States.  Five days prior to presentation he noticed a small, non-painful, [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Not Just Another Tick-Borne Illness

HM2015 Abstract Number: 697

Extraintestinal Recurrence of Clostridium Difficile Infection Without Diarrhea

Case Presentation: A 61 year-old man with cryptogenic cirrhosis, type 2 diabetes mellitus, hypertension, and chronic kidney disease presented with worsening abdominal pain for 3 weeks. He had discontinued oral vancomycin two months earlier for [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Extraintestinal Recurrence of Clostridium Difficile Infection Without Diarrhea

HM2015 Abstract Number: 698

The Klebsiella Liver Abscess: Recognizing the Patient Profile of an Emerging Domestic Disease

Case Presentation: A 62 year-old native Filipino woman with poorly controlled diabetes mellitus presented with three days of fevers and one day of confusion. Her last visit to the Philippines was 14 years ago. She [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on The Klebsiella Liver Abscess: Recognizing the Patient Profile of an Emerging Domestic Disease

HM2015 Abstract Number: 699

Adult-Onset Still’s Disease: Still a Challenging Diagnosis

Case Presentation: A 28-year-old woman presented with two weeks of fever. She had been healthy until three months prior, when she developed an episodic pink macular rash over her upper arm that gradually spread to [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Adult-Onset Still’s Disease: Still a Challenging Diagnosis

HM2015 Abstract Number: 700

Twisted Cyster

Case Presentation: A 21 year old Spanish-speaking male immigrant from Guatemala with no significant past medical history presented to the emergency department (ED) with nausea, vomiting, neck pain, and vertigo. He was noted to have [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Twisted Cyster

HM2015 Abstract Number: 701

Leave No Stone Unturned

Case Presentation: A 37-year-old man presented with 10 days of right flank pain.  It was of variable intensity, but never completely went away after onset.  He had episodic nausea and vomiting and several episodes of [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Leave No Stone Unturned

HM2015 Abstract Number: 703

Hyperammonemia: Its Not Always Liver

Case Presentation: This is the case of a 68-year-old Hispanic woman with a history of hypertension, non-insulin dependent diabetes mellitus and dyslipidemia who presented to the ED with AMS for 1 day. Collateral history from [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Hyperammonemia: Its Not Always Liver

HM2015 Abstract Number: 704

When the Treatment Becomes the Problem

Case Presentation: A 61-year-old male with traumatic brain injury, paraplegia and HCV cirrhosis presented with hematemesis secondary to esophageal varices. His course was complicated by aspiration pneumonia and Vancomycin, Aztreonam and Metronidazole were started. On [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on When the Treatment Becomes the Problem

HM2015 Abstract Number: 705

Triple Coronary Artery Aneurysms from Incomplete Kawasaki Disease

Case Presentation: Coronary artery aneurysms (CAA) are incidental findings during coronary angiography noted during 0.15-4.9% of patients[1]. These are usually a consequence of atherosclerotic coronary disease, the absence of which should raise the suspicion of [...]

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HM2015 Abstract Number: 707

Diffuse Alveolar Hemorrhage (Dah) Secondary to Amiodarone and Apixaban Use: A Case Report

Research Topic: Diffuse alveolar hemorrhage is a clinical syndrome resulting from pulmonary capillaritis, bland pulmonary hemorrhage, or diffuse alveolar damage.1 DAH has been reported as a rare adverse event with amiodarone therapy, warfarin therapy, and [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Diffuse Alveolar Hemorrhage (Dah) Secondary to Amiodarone and Apixaban Use: A Case Report

HM2015 Abstract Number: 708

An Unusual Presentation of Obstructive Jaundice That Is Steroid Responsive

Case Presentation: A 56-year-old woman presented with jaundice and abdominal bloatedness, associated with poor appetite for the last 2 weeks. She has a past history of chronic sclerosing sialadenitis, with immunoglobulin G4 (IgG4) predominant lymphoplasmacytic inflitrate [...]

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HM2015 Abstract Number: 709

Dengue Related Pancreatitis: An Uncommon Association

Case Presentation: Dengue fever (DF) presents with a myriad of symptoms. Abdominal pain is uncommon in DF. We report a case of DF presenting as pancreatitis. A 44 year old male presented to our hospital [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Dengue Related Pancreatitis: An Uncommon Association

HM2015 Abstract Number: 710

Mind the Gap

Case Presentation: A 49 year old male, diagnosed with Human Immunodeficiency Virus infection 6 months ago, and initiated on anti-retroviral therapy (ART); was admitted with 2-day history of fever and cough productive of green sputum. [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Mind the Gap

HM2015 Abstract Number: 711

Ocular and Mucocutaneous Sequelae in Stevens-Johnson Syndrome/toxic Epidermal Necrolysis Overlap Syndrome Associated with Mycoplasma Pneumoniae Infection

Case Presentation: A 23-year-old female presented with 7-day history of rash and oral ulcers. The blisters started from the face then spread to neck, left arm and rest of her body. She also complained of [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Ocular and Mucocutaneous Sequelae in Stevens-Johnson Syndrome/toxic Epidermal Necrolysis Overlap Syndrome Associated with Mycoplasma Pneumoniae Infection

HM2015 Abstract Number: 712

Ease the Pressure

Case Presentation: A 25-year-old African-American man with history of AIDS CD4 79 and partially treated cryptococcal meningitis presented with headache and blurred vision. Physical exam demonstrated bilateral cranial nerve six palsies. CT head on arrival [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Ease the Pressure

HM2015 Abstract Number: 713

The M.O. of N.M.O

Case Presentation: A 19-year-old African-American woman with history of neonatal meningitis with baseline mental retardation, left hemiparesis and seizure disorder presented with altered mental status, decreased responsiveness, new right hemiparesis and aphasia. Brain and spine [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on The M.O. of N.M.O

HM2015 Abstract Number: 714

Francis Bacon Was Right: An Unusual Cause of Bleeding in Liver Disease

Case Presentation: A 54 year old man with Hepatitis C without cirrhosis, complicated by porphyria cutanea tarda (PCT), presented with painful bruising and swelling of his legs and arms. There was no inciting trauma, he [...]

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HM2015 Abstract Number: 715

A Patient with an Acute Stroke…should We Blame the Indomethacin?

Case Presentation: A 66-year-old Hispanic male with hypertension presented with slurred speech, dizziness and blurred vision. One day prior to admission, he was diagnosed with gout, involving his right toe and started on indomethacin 50 mg [...]

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HM2015 Abstract Number: 716

An Unusual Cause of Hematemesis

Case Presentation: A 70 year old man with lung cancer presented from home to the emergency department after a bout of massive hematemesis. Four months ago, he was diagnosed with lung cancer spreading to mediastinal [...]

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HM2015 Abstract Number: 717

Aseptic Meningitis Secondary to Ehrlichia Chaffeensis

Case Presentation: A 47year old Caucasian man came to the emergency room with of fever, severe headaches, severe body aches and pain for 4days. Headaches worsened and he developed photophobia on day 5. He was taking Bactrim [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Aseptic Meningitis Secondary to Ehrlichia Chaffeensis

HM2015 Abstract Number: 718

Clostridium Difficile Colitis and Reiter’s Syndrome

Case Presentation: A 69year old Caucasian female who presented to the emergency room after 3 weeks of diarrhea preceded by constipation and 1 weeks of abdominal pain. Abdominal pain was severe colicky and generalized, with [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Clostridium Difficile Colitis and Reiter’s Syndrome

HM2015 Abstract Number: 719

Acute Axonal Motor Neuropathy Following Acute Pancreatitis

Case Presentation:      A  26 year old man without significant medical history presented  on October 10, 2014 with 24 hours of severe abdominal pain. He was found to have severe pancreatitis with multiorgan failure requiring [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Acute Axonal Motor Neuropathy Following Acute Pancreatitis

HM2015 Abstract Number: 720

Are We Missing Diagnosis of Large Vessel Vasculitis? Role of 18F-Fluorodeoxyglucose Pet-Ct Scan

Case Presentation: A 69 years old male with past medical history of C5-C6 quadriplegia and atrial fibrillation presented to clinic complaining of left temporal area discomfort for 2 weeks associated with visual alteration. He denied [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Are We Missing Diagnosis of Large Vessel Vasculitis? Role of 18F-Fluorodeoxyglucose Pet-Ct Scan

HM2015 Abstract Number: 721

Something on My Mind: A Rare Case of Worsening Neurological Symptoms and Rapid White Matter Demyelination

Case Presentation: A 53 year old gentleman presented to the emergency department with acute left arm weakness and altered mental status with difficulty with memory and performing activities of daily living. His past medical history [...]

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HM2015 Abstract Number: 722

A Case of Clozapine-Induced Myocarditis

Case Presentation: A 23-year-old male with schizoaffective disorder was admitted to the psychiatry service with acute psychosis and treated with clozapine.  Low-grade fever developed after 23 days, prompting medical consultation.   He reported chest discomfort [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on A Case of Clozapine-Induced Myocarditis

HM2015 Abstract Number: 723

Stones, Groans, and an Atypical Presentation(E)

Case Presentation: A 61-year-old woman with a 9-month history of an asymptomatic parathyroid nodule presented to the hospital with three weeks of malaise, constipation, unsteady gait, and confusion. Over the three weeks, she described how [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Stones, Groans, and an Atypical Presentation(E)

HM2015 Abstract Number: 724

Hidden Histoplasmosis

Case Presentation: A 78 year old man presented with right upper quadrant abdominal pain to the emergency department. He had no signs of acute abdomen. Labs were significant for low platelet count, elevated alkaline phosphatase. [...]

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HM2015 Abstract Number: 725

The Woman Who Won’t Wake Up: A Case of Hypoactive Delirium

Case Presentation: An 89-year-old woman with history of hypothyroidism, hyponatremia, and hypertension presented with unresponsiveness and myoclonic jerking of the lower extremities.  At baseline, she was alert and oriented to person, place and time,  and [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on The Woman Who Won’t Wake Up: A Case of Hypoactive Delirium

HM2015 Abstract Number: 726

Acute Onset Dystextia

Case Presentation: A 20 year old woman presented with a 5 day history of a right sided abnormal facial sensation and a 1 day history of right hand ataxia. She described the right side of [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Acute Onset Dystextia

HM2015 Abstract Number: 727

Allergic Angina: Capecitabine-Induced Coronary Artery Vasospasm

Case Presentation: The patient is a 63-year-old male with history of colon cancer (status post resection, on adjuvant capecitabine/oxaliplatin chemotherapy) who presented with chest pain and inferolateral ST segment elevations on his EKG. The chest [...]

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HM2015 Abstract Number: 728

Radiation and Osteomyelitis: A Real Pain in the Neck

Case Presentation: A 78 year old man presented with neck pain, fever, and malaise for 3 days. He noted progressively worsening pain and stiffness of the anterior neck bilaterally. He reported right- sided headache and [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Radiation and Osteomyelitis: A Real Pain in the Neck

HM2015 Abstract Number: 729

When Denture Cream Poisons Your Bone Marrow

Case Presentation: A 57 year old female presented to our institution for evaluation of progressive dyspnea.  Symptoms were present for three months prior to presentation. She was seen in the emergency department and initial laboratories [...]

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HM2015 Abstract Number: 730

More Than Meets the Eye: Heuristics Gone Haywire

Case Presentation: An 82-year-old woman with dementia, right eye blindness, prior right retinal surgery, atrial fibrillation, and prior stroke presented to an outside hospital with a six-month history of weakness, confusion, ataxia, and falls.  A [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on More Than Meets the Eye: Heuristics Gone Haywire

HM2015 Abstract Number: 731

It’s Not a Tumor, Redux. an Unexpected Cause of Mesenteric Mass: Al Amyloidosis

Case Presentation: A 53-year-old man presented with nine months of abdominal pain, nausea, constipation, dizziness and syncope with standing, weight loss, and edema.  He had anasarca, persistent orthostatic hypotension, anemia, hypoalbuminemia, and nephrotic-range proteinuria.  BNP [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on It’s Not a Tumor, Redux. an Unexpected Cause of Mesenteric Mass: Al Amyloidosis

HM2015 Abstract Number: 732

Mercury Instead of Insulin

Case Presentation: A 51-year-old man with a past medical history of diabetes mellitus, polysubstance abuse, chronic kidney disease stage 3a and major depressive disorder presented to a Texas hospital after a suicide attempt using liquid [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Mercury Instead of Insulin

HM2015 Abstract Number: 733

Questioning the Surgical Consultation: Who Actually Saw the Patient?

Case Presentation: 65 year-old woman with a history of essential thrombocythemia presents with four months of left upper quadrant abdominal pain. The patient was admitted to an outside hospital two weeks prior to the current [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Questioning the Surgical Consultation: Who Actually Saw the Patient?

HM2015 Abstract Number: 734

A Case of Wegner with C-Anca, Anti Gbm+ with Preserved Kidney Function in a 22 Year Old

A case of wegner with C-ANCA, anti GBM+ with preserved kidney  function in a 22 year old Case Presentation: 22 years old male, Jehovah's witness  with no past medical history. He was in a normal [...]

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HM2015 Abstract Number: 735

Brain Hiccups

Case Presentation: A 67-year-old man with a history of type 2 diabetes and hypertension was referred to our hospital for evaluation of persistent hiccups and fever. The patient developed hiccups seven days before the admission, [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Brain Hiccups

HM2015 Abstract Number: 736

Ultrasonography-Assisted Liposuction (Ual) for a Hiv Patient with Respiratory Failure Associated Severe Cervical Lipodystrophy

Case Presentation: A 57 year old female presented to the ER with complaints of worsening dyspnea for three weeks. Immediate arterial blood gas revealed: pH 7.26 PO2 79.5 PCO2 55 HCO3 30.5 with Sa02 87% on 6L O2. There was [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Ultrasonography-Assisted Liposuction (Ual) for a Hiv Patient with Respiratory Failure Associated Severe Cervical Lipodystrophy

HM2015 Abstract Number: 737

Schwannomatosis (Neurofibromatosis Type 3, Nf3): A Case Report and Literature Review

Case Presentation: A 53 year old female presented to the ER complaining of one month of progressive lower back pain with radiation to her right leg, and associated severe bilateral tight hamstrings. The patient was unable [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Schwannomatosis (Neurofibromatosis Type 3, Nf3): A Case Report and Literature Review

HM2015 Abstract Number: 738

Acquired Acrodermatitis Enteropathica

Case Presentation: A 78 year- old female was admitted with progressive rash. The rash began as a pruritic eruption in between her fingers one month ago. Her primary care physician advised her to use moisturizing [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Acquired Acrodermatitis Enteropathica

HM2015 Abstract Number: 739

Super Morbid Obesity and Vte

Case Presentation: A 41-year-old super morbidly obese man (245.4 kg, BMI= 82 kg/m2) presented to the emergency room 9 days after  laparoscopic sleeve gastrectomy complaining of sudden dyspnea, dry cough, palpitations, and painful left lower [...]

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HM2015 Abstract Number: 348

Unexplained Dyspnea in the Presence of Confounding Hypertrophic Cardiomyopathy

Case Presentation: A 42 year old man with a history significant for hypertension, sleep apnea, and childhood asthma was transferred to University of Miami Hospital from an outside facility. He had presented with atypical chest [...]

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HM2015 Abstract Number: 349

An Inflamed Pancreas and a Broken Heart: Pancreatitis-Induced Takotsubo Cardiomyopathy

Case Presentation: A 47 year-old woman presented to the emergency department with epigastric abdominal pain. She was found to have an elevated lipase level and was admitted for acute pancreatitis. She clinically improved but became [...]

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HM2015 Abstract Number: 350

Hemophagocytic Lymphohistiocytosis in a Patient with Goodpasture’s Syndrome: A Rare Clinical Association

Case Presentation: Hemophagocytic lymphohistiocytosis (HLH) is a life threatening clinical syndrome that occurs in the setting of an autoimmune disease, chronic immunosuppression, malignancy and infection. Goodpasture’s syndrome is a rare auto- antibody mediated disorder that [...]

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HM2015 Abstract Number: 351

Malignant Triton Tumors in Sisters with Clinical Neurofibromatosis Type- 1

Case Presentation: Introduction: Malignant triton tumors (MTTs) are uncommon sarcomas, a subgroup of malignant peripheral nerve sheath tumors (MPNSTs). They arise from Schwann cells of peripheral nerve or existing neurofibromas and have elements of rhabdomyoblastic [...]

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HM2015 Abstract Number: 352

A History of Asthma in a Non-Asthmatic!

Case Presentation: Our patient is a 66 year old female with history of new-onset asthma. Four months before admission, she developed acute onset of bilateral sensorineural hearing loss. She was evaluated by ENT who prescribed [...]

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HM2015 Abstract Number: 353

A Hunt for an Ectopic Source: An Initial Overlooked Case of Cushing’s Syndrome

Case Presentation: 48 year old female with Cushing's syndrome, pituitary microadenoma (3mm), type 2 diabetes mellitus, and hypertension, presents with hypokalemia (lowest K = 1.9 mEq/L), chest pressure, and 10-lb weight gain. Symptoms started during [...]

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HM2015 Abstract Number: 354

An Unexpected Viral Syndrome

Case Presentation: A 32 year-old woman with no past medical history presented to clinic with complaints of sore throat and vaginal discharge for one week. Patient reported an episode of unprotected sex two months prior [...]

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HM2015 Abstract Number: 355

The Diagnosis Is Staring at You

Case Presentation:  A 65 year old female recently discharged from an outside hospital with new onset heart failure presented with 24 hours of worsening dyspnea associated with dizziness. Previous cardiac work up included an echocardiogram [...]

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HM2015 Abstract Number: 356

A Case of Myasthenic Crisis After Exposure to Ciprofloxacin

Case Presentation: An 87 year-old woman on nightly CPAP status post recent left hip fracture presents from rehabilitation with weakness for 2 weeks. At rehabilitation, the patient had not had access to CPAP and had [...]

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HM2015 Abstract Number: 357

Fighting a Losing Battle- a Case of Refractory Pyoderma Gangrenosum

Case Presentation: A 57-year-old man with multiple medical problems including tobacco use, congestive heart failure (CHF), and pyoderma gangrenosum (PG) presented to the hospital for nausea, vomiting and myalgias, thought to be withdrawal symptoms due [...]

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HM2015 Abstract Number: 358

Surreptitious and Suspicious: A Case of Factitious Shock

Case Presentation: A 36 year old female with a medical history of gastroparesis and migraines was admitted with depressive symptoms, nausea, and vomiting with a blood pressure on admission of 69/42.  She had frequent readmissions [...]

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HM2015 Abstract Number: 359

Dramatic Response to Infliximab in Refractory Neurosarcoidosis Complicated by Cryptococcal Meningitis

Case Presentation: A 44 year old African American female presented with two weeks of progressive left sided hearing loss and facial droop associated with gait imbalance. MRI of brain showed extensive heterogenous nodular and leptomeningeal [...]

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HM2015 Abstract Number: 360

Chikungunya: A Case Report Highlighting the Importance of Obtaining Key Elements of Patient History in Order to Aid in Diagnosing a Rare Infection

Case Presentation: A 70 year-old Hispanic female presents with a four-day history of generalized weakness and immobilizing pain in her knees, ankles, and right upper wrist. She endorses fevers that started the day prior to [...]

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HM2015 Abstract Number: 362

Still Febrile? A Case of a Foreign Student in the Us

Case Presentation: A 19 year-old student from China presented with two weeks of pharyngitis, fevers, chills, and night sweats, associated with large joint polyarthralgias, myalgias and evanescent rash.  Prior blood cultures were without growth. She [...]

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HM2015 Abstract Number: 363

After a Night of Heavy Drinking

Case Presentation: A 22 year-old female student with no medical history presented to Ohio State Medical Center complaining of throbbing epigastric pain, increased abdominal girth, and nausea after ingesting two bottles of wine. Patient denied [...]

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HM2015 Abstract Number: 364

From the Head to the Limbs: A Case of Voltage-Gated Potassium Channel Limbic Encephalitis

Introduction: Limbic encephalitis (LE) is a rare but reversible disorder that can result from infectious or autoimmune causes. As an autoimmune disease, it can exist as part of a paraneoplastic or non-paraneoplastic process.   Case [...]

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HM2015 Abstract Number: 365

A 49-Year-Old Man with Weakness, Dysphagia, and Recurrent Syncope

Case Presentation: A 49-year-old previously healthy gentleman presented with progressive weakness, dysphagia and recurrent syncope. Six months ago, he developed dysphagia to solids and watery diarrhea; endoscopic evaluation failed to reveal a cause. He had [...]

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HM2015 Abstract Number: 366

An Apple Might Not Have Kept the Doctor Away, but an Orange Would Have

Case Presentation: A 74 year old man presented to the hospital with tachypnea and dizziness. He reported ecchymosis on his abdomen and flanks 3 days prior. His appearance was disheveled and mood was anxious. An [...]

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HM2015 Abstract Number: 367

A Case of Hereditary Hemorragic Telangectasia with Severe Anemia

Case Presentation:       This is a 59 years old Caucasian female with past medical history of hypothyroidism who came to our hospital after having a syncopal episode. She reported a history of recurrent epistaxis for [...]

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HM2015 Abstract Number: 368

Metastatic Choroidal Melanoma Presenting As Cauda Equina Syndrome

Case Presentation:  A 67 year old male with history of right eye choroidal melanoma with retinal detachment treated with plaque radiotherapy at well-recognized hospital specializing in ocular disease, presented 15 years later with a complaint [...]

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HM2015 Abstract Number: 369

Small Cell Carcinoma of the Bladder – a Rare Aggressive Tumor and a Curse to the Elderly

Case Presentation: An active 78-year-old male with atrial fibrillation, hypertension and diabetes mellitus presented to the hospital with new onset gross hematuria associated with jaundice, periumbilical abdominal discomfort, nausea, malaise, night sweats, and anorexia.  He [...]

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HM2015 Abstract Number: 370

Life Threatening Transaminitis As a Complication from Use of Clozapine

Case Presentation: A 39-year-old female with hepatitis C, polysubstance abuse with Cocaine and Cannabis, hypothyroidism and schizoaffective disorder was initially admitted to the psychiatry unit for management of psychosis. On presentation, patient had normal labs [...]

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HM2015 Abstract Number: 371

Hemangioblastoma: A Hiccup in Holiday Plans

Case Presentation: A 35-year-old man with hypertension and cervical disc herniation presented with five days of persistent hiccups. He had had two recent hospital visits for hiccups, which were not relieved by ranitidine, metoclopramide, and [...]

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HM2015 Abstract Number: 372

Unusual Skin Lesions in Rural Haiti: A Picture Is Worth 1,000 Words

Case Presentation: A 38 year-old woman was referred to the district hospital in Hinche, Haiti due to shortness of breath at rest and epigastric pain. She also complained of lumbar back pain, subjective fevers, and [...]

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HM2015 Abstract Number: 373

A Rare Case of Synchronous Lung Malignancy

Case Presentation: 74 year old male, a chronic smoker, with a past medical history of Chronic Obstructive Pulmonary Disease presented with complaints of cough, wheezing episodes, worsening shortness of breath and episodes of streaky hemoptysis [...]

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HM2015 Abstract Number: 374

Role of Ada As a Pleural Fluid Biomarker – an Illustrative Case of Dyspnea

Case Presentation: A 23 year old Asian female presents with 1 month history of progressively worsening shortness of breath associated with left sided pleuritic chest pain and non-productive cough. She also reported unintentional weight loss [...]

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HM2015 Abstract Number: 375

A Shining Case of Chromium Toxicity

Case Presentation: A 67 year old caucasian woman with a past medical history of seizures, arthritis, transient ischemic attacks, orthostatic hypotension, posttraumatic stress disorder, depression, peptic ulcer disease, and fibromyalgia presented to our university hospital [...]

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HM2015 Abstract Number: 376

Hunger Is Not a Game: Refeeding Syndrome Induced by Ritual Fasting

Case Presentation: A 42-year-old Hispanic female with no significant medical history presented to the ED with chest pain, nausea, vomiting and poor oral intake for 2 days.  She had similar symptoms in the past in [...]

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HM2015 Abstract Number: 377

Routinizing Hiv Diagnosis and Linkage to Care in Urban Populations

Case Presentation: A 54 year old African-American male presented to a Baltimore emergency department with complaints of shortness of breath, chest pain and melena. He was admitted to family medicine for evaluation of acute coronary [...]

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HM2015 Abstract Number: 378

Angiosarcoma of the Chest- Challenges in Making the Diagnosis in Rapidly Progressing Disease: Tumor Burden on the Heart

Case Presentation: A 42-year-old female with no past medical history presented with increased dyspnea on exertion.  She was initially diagnosed with pericarditis and pulmonary nodules at an outside hospital. After continued symptoms, studies revealed a [...]

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HM2015 Abstract Number: 379

Advanced Care Planning: You Just Have to Ask

Case Presentation:  A 70 year old female with a past medical history of diabetes, atrial fibrillation, coronary artery bypass surgery, aortic valve replacement, below the knee amputation, non-hodgkins lymphoma, and end stage renal disease presented [...]

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HM2015 Abstract Number: 380

Discharge Against Medical Advice: A Challenge in Patient-Centered Care

Case Presentation: A 32 year-old woman with a history of IV drug abuse on methadone maintenance presented with dyspnea and chest pain. Exam revealed a systolic murmur and “track marks” on the arms. CT-Angiogram showed [...]

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HM2015 Abstract Number: 381

Case Report on Narcotic Bowel Syndrome: Tip of the Iceberg

Case Presentation: A 41-year-old African American woman presented to our institution for the sixth time within a year with complaints of acute diffuse abdominal pain associated with nausea and vomiting. Abdominal exam was non-focal. Her [...]

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HM2015 Abstract Number: 382

Hypotensive and Hypernatremic: A Rare Case of Pituitary Malfunction in Colon Cancer

Case Presentation: A 57 year-old woman with known stage IV colon cancer presented with hypotension and several months of polydipsia and polyuria. Lab values showed multiple abnormalities: serum sodium 152 mmol/L, urine sodium <10 mmol/L, urine [...]

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HM2015 Abstract Number: 383

Hemosuccus Pancreaticus- an Uncommon Cause of GI Bleed

Case Presentation: A 44 year-old male with a history of alcoholism was admitted to the ICU with hematemesis, maroon stool, hypotension and tachycardia. Abdominal exam was benign, but hemoglobin was 7.4g/dL, hematocrit 28 % and [...]

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HM2015 Abstract Number: 384

More Than Meets the Eye- a Perplexing Case of Confusion

Case Presentation: A 78 year old Hispanic man with DM, ankylosing spondylitis was admitted with one day of progressive word finding difficulties, dysarthria, ataxia and confusion, preceded by one day of nausea and non bloody [...]

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HM2015 Abstract Number: 385

Severe Headache 15 Hours After Iohexol Ct Myelography

Case Presentation: 50 year-old male with a history of cervical disc herniation and spinal stenosis presents with severe headache of sudden onset. One day prior to arrival, the patient underwent a technically successful outpatient CT myelogram [...]

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HM2015 Abstract Number: 386

Painful Rash in the First Trimester

Case Presentation: A 25 year-old primigravida, with past medical history of atopic dermatitis, presented to the Emergency Department with generalized skin eruption worsening over six days. One week prior to the skin rash, the patient [...]

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HM2015 Abstract Number: 387

An 18-Years-Old Haitian Female with Progressive Dementia and Ataxia

Case Presentation: An 18- years-old Haitian female was admitted to a University Hospital for progressive movement disorder and cognitive difficulties. Nine months ago her personality and memory had changed; she was above average student but as [...]

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HM2015 Abstract Number: 388

Favism Causing Methemoglobinemia in G6Pd Deficiency

Case Presentation: A 43 year old Albanian man without any significant past medical history, presented to the hospital with sudden onset intermittent dyspnea, chills and dark urine of 4 days duration. He had started consuming [...]

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HM2015 Abstract Number: 389

Heart of the Matter: An Unusual Cause of Severe Agitation

Case Presentation: A 71-year-old woman with early-onset Alzheimer’s dementia presented after a fall at an inpatient psychiatric facility where she had been admitted for treatment of agitation, yelling and aggressive behavior. Prior to onset of [...]

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HM2015 Abstract Number: 390

A Case of Neuro-Behcet’s Disease Without Recurrent Oral Ulcers

Case Presentation: A previously healthy 25 year-old Spanish woman presented with two days of fever, bilateral erythematous axillary swelling and tender vulvar and labial lesions. She had no known medical problem and was sexually active [...]

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HM2015 Abstract Number: 391

Gabapentin Toxicity Mimicking Rubral Tremor in a Patient with Chronic Kidney Disease

Case Presentation: A 76 year-old man presented with 2 months of episodic face and body tremors with acute worsening over 2 days that interfered with eating and walking. The tremors previously lasted 10 minutes but [...]

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HM2015 Abstract Number: 392

Left Ventricular Thrombus in a Cocaine Abuser Presenting As Thromboembolic Stroke

Case Presentation: A 35-year-old man presented to the emergency department (ED) with sudden onset right-sided weakness and inability to speak. The patient went out with his friends earlier that night and arrived home in his [...]

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HM2015 Abstract Number: 393

Vertebrobasilar Insufficiency from Subclavian Steal Syndrome

Case Presentation: An 80 year old male with a medical history of Diabetes Mellitus Type 2, Hypertension, DVT + Pulmonary Embolism presented to the ED with difficulty walking, muscular weakness, increased frequency of falls associated [...]

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HM2015 Abstract Number: 394

Role of Sphincterotomy in Type Ii Sphincter of Oddi Dysfunction

Case Presentation: 50 years old African American female patient with past medical history of Fibromyalgia, Chronic Back pain, Cholecystectomy in 2011 admitted with with sudden onset of colicky epigastric and right upper quadrant abdominal pain, [...]

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HM2015 Abstract Number: 395

A Delayed Diagnosis: Cardiac Bio-Markers Reapplied

Case Presentation: A 50 year-old man with history of a double lung transplant was transferred to the Medicine service from an outside Emergency Department. He had experienced a brief, witnessed alteration of consciousness in the [...]

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HM2015 Abstract Number: 396

To Cut or Not to Cut: When Physician Determination of Capacity Falls Short

Case Presentation: A 76 year-old woman presents with the progressive inability to use her left arm. She is also found to be confused and unable to care for herself. Ten years prior to presentation the [...]

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HM2015 Abstract Number: 397

Lupus Induced Acute Transverse Myelitis with Permanent Neurological Sequelae and the Associated Grieving Process

Case Presentation:  A 26 year-old previously healthy male presented to an outside hospital complaining of worsening 2-week history of fever, rash, back pain and polyarticular arthralgia.  He had a lumbar puncture in the emergency department [...]

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HM2015 Abstract Number: 398

Swarming in the Ascitic Fluid – Can We Fish Them Out?

Case Presentation: A 64 year old Caucasian male was admitted with confusion and lethargy. He denied  fever, nausea, vomiting, diarrhea, abdominal pain, hematochezia, melena or dyspnea. His past medical history included cirrhosis of liver secondary [...]

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HM2015 Abstract Number: 399

Where Is Kevorkian When We Need Him

Case Presentation: A 72-year-old male was admitted for continued management of his acute on chronic pancreatitis, malnutrition and pain. He sought to get on with his life so with haste, he wanted to proceed with [...]

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HM2015 Abstract Number: 400

A Rare Case of Asthma Presenting with Foot Drop

Case Presentation: A 70 year old female with Asthma ,DM2,and HTN,presented with progressive b/l lower extremity weakness ,numbness and unsteady gait.She had been recently started on mometasone and montelukast for control of her worsening asthma.Her symptoms began within two days [...]

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HM2015 Abstract Number: 401

Gentle Liar Wolf

Case Presentation: A 85-year-old Japanese woman was admitted because of the bilateral lower leg edema for three weeks. She had hypertension and dyslipidemia for 10 years, type 2 diabetes for 7 years, and arteriosclerosis obliterans [...]

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HM2015 Abstract Number: 402

Finding a Rotten Pipe Before It Bursts

Background: Aortic graft infection is a rare complication of abdominal aortic aneurysm (AAA) repairs.  Its incidence is approximately 0.2-0.7%, and can be divided into two separate categories: 1. infections resulting from open AAA repairs and [...]

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HM2015 Abstract Number: 403

The Gene Hit That “Bruised” a Kidney

Case Presentation: A 30-year-old woman presented with right flank and back pain, nausea, and increased urine frequency for one year. One year prior to our evaluation, she was told she had a “bruise” on her [...]

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HM2015 Abstract Number: 404

Neisseria Subflava – a Commensal Organism or Pathogen?

Case Presentation: A 50-year-old African-American male presented with fever and right thigh pain for one week. He had a history of aortic valve replacement secondary to aortic dissection 5 years ago. Patient also gave history [...]

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HM2015 Abstract Number: 405

Vertigo As a Presentation of Stroke

Case Presentation: A 46-year-old man with a history of hypertension presented with headache, vertigo, diaphoresis, nausea and vomiting. Non-contrast head CT was normal. Physical exam did not reveal any focal neurologic deficits or other abnormalities. [...]

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HM2015 Abstract Number: 406

Mycotic Common Iliac Artery Aneurysm in Intravenous Drug User

Case Presentation: A 53-year-old male with past medical history of hypertension and intravenous drug use comes to the Emergency Department (ED) with complaint of the right lower quadrant abdominal pain, right hip, ankle and knee [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Mycotic Common Iliac Artery Aneurysm in Intravenous Drug User

HM2015 Abstract Number: 407

A Bloody Mess: Distal Splenorenal Shunt for the Management of Variceal Bleeding Unamenable to Tips

Case Presentation: A 56 year-old Kenyan woman presented with massive hematemesis, hypotension, and altered mental status. Exam noted ascites with hepatosplenomegaly. Emergent esophagogastroduodenoscopy (EGD) revealed bleeding esophageal varices that were banded at that time. Subsequent [...]

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HM2015 Abstract Number: 408

Peau D’orange: Buzzwords Which Incorrectly Framed a Differential

Case Presentation: A 49-year-old Eritrean woman with RA presented with right arm swelling and was found to have DVTs in multiple vessels. Initial exam also documented peau d’orange changes of the right breast and a [...]

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HM2015 Abstract Number: 409

Mmystery of Pericarditis

Case Presentation: A 67 year old male with a history of hypertension presented to the hospital with sudden onset of worsening, positional chest pain and shortness of breath. Pt was worked up for acute coronary [...]

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HM2015 Abstract Number: 410

Lyme Disease in a Patient Who Presented with Podagra Mimicking Gout

Case Presentation: A 32 year old  immigrant from Egypt , came to the Emergency with sudden onset of pain, swelling and redness of the left great toe. Pain was excruciating, non radiating ,increased on ambulation [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Lyme Disease in a Patient Who Presented with Podagra Mimicking Gout

HM2015 Abstract Number: 411

Its Not Always What You Think It Is..Pull Out Your Antennas

Case Presentation: A 73 year old Chinese male with a medical history of hypertension presents with a 2 week history of fevers, malaise, and confusion. His pulse was 103, temperature of 101 F and he [...]

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HM2015 Abstract Number: 412

Use of the Xpert Mtb/rif Assay for the Rapid Diagnosis of Tuberculosis and Resistance to Rifampin

Case Presentation: A 35 year old Burmese male with a history of human immunodeficiency virus (HIV) not on antiretroviral therapy and tuberculosis (TB) treated in Malaysia presented to our hospital complaining of a two month [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Use of the Xpert Mtb/rif Assay for the Rapid Diagnosis of Tuberculosis and Resistance to Rifampin

HM2015 Abstract Number: 413

You Booze, You Lose: An Unusual Case of Myocardial Injury Caused by Rhabdomyolysis!

Case Presentation: A 52 year-old female with hypertension, alcoholic hepatitis and ongoing alcohol abuse presented to the emergency department with generalized myalgias and mid-sternal chest pressure for 2 days. Last drink was 3 days ago. [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on You Booze, You Lose: An Unusual Case of Myocardial Injury Caused by Rhabdomyolysis!

HM2015 Abstract Number: 414

Fuo in Central Ohio

Case Presentation: 69 year old male with history of COPD, DM, and HTN presented as a hospital transfer with fever of unknown origin for 8 weeks, decreased appetite, 30 pound weight loss, and night sweats. [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Fuo in Central Ohio

HM2015 Abstract Number: 415

Compartment Syndrome and Toxic Leukoencephalopathy As a Complication of Polysubstance Abuse

Compartment syndrome and Toxic Leukoencephalopathy as a complication of polysubstance abuseRitika Vankina MD, Santhi Gokaraju MD, Jonathan Davis MD, Philip Hsu MDCase Presentation: A 37 year-old-male with history of polysubstance abuse, was admitted after being found [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Compartment Syndrome and Toxic Leukoencephalopathy As a Complication of Polysubstance Abuse

HM2015 Abstract Number: 416

An Unheard Case of Recurrent Lyme Carditis

Case Presentation: A 70 years old lady presented to the emergency department with the complaints of dizziness and lightheadedness for 2 weeks. Her vital signs were within normal limits except a heart rate of 48 [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on An Unheard Case of Recurrent Lyme Carditis

HM2015 Abstract Number: 417

P-Anca Positive Vasculitis ,chronic Kidney Disease and Association with Cocaine

Case Presentation: A 28-year old African American male presented with flu-like symptoms and hematuria of one month duration.  Patient finally visited the ER when he developed generalized aching pain. Patient admitted to cocaine and marijuana use for more than 10 years.  On exam he was hypertensive with [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on P-Anca Positive Vasculitis ,chronic Kidney Disease and Association with Cocaine

HM2015 Abstract Number: 418

Small Vessels, Small Nerves, Big Problems

Case Presentation: A 31-year-old female with systemic lupus erythematosus (SLE), presented with a 3-week history of new-onset ascending lower extremity “burning/pinprick sensation” and weakness, as well as new urinary incontinence. Physical exam on admission was [...]

By | 2015-02-27T01:00:14+00:00 February 27th, 2015|Uncategorized|Comments Off on Small Vessels, Small Nerves, Big Problems