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Displaying 11 - 20 of 35 in Annals of Internal Medicine: Clinical Cases
Central Nervous System Nocardiosis Due to Nocardia farcinica | Annals of Internal Medicine: Clinical Cases
Nocardia is an opportunistic aerobic, filamentous, gram-positive branching rod that infects immunocompromised hosts. Infections usually stem from the pulmonary, integumentary, or, rarely, gastrointestinal systems. Nocardia farcinica has a noted predilection for neural tissue, thought to represent secondary dissemination from prior infection.
Periorbital Ecchymosis in a Patient With Nephrotic Syndrome | Annals of Internal Medicine: Clinical Cases
Amyloid light-chain amyloidosis is a rare multiorgan disorder characterized by amyloid deposits in various organs and extracellular tissues. If untreated, it can have progressive and irreversible consequences, ultimately leading to death. When amyloid protein is deposited in the perivascular tissues and the vessels become fragile, the skin shows purpuric changes due to vascular collapse. The “raccoon eyes” appearance can be the first manifestation of amyloid light-chain amyloidosis and should not be overlooked.
Pyoderma Gangrenosum Secondary to Herpes Zoster | Annals of Internal Medicine: Clinical Cases
This is a clinical image demonstrating pyoderma gangrenosum (PG) as a rare but important complication of herpes zoster. The proposed mechanism for why herpes zoster may cause PG is discussed.
A Case of Emphysematous Cholecystitis | Annals of Internal Medicine: Clinical Cases
An 85-year-old man with no history of biliary intervention or cholecystenteric fistulas presented to the emergency department with right hypochondralgia. Imaging revealed pneumobilia and an emphysematous gallbladder wall, consistent with the presentation of emphysematous cholecystitis. Pneumobilia is a rare finding with emphysematous cholecystitis. Gas production by anaerobic bacteria in the biliary tract could be the cause of pneumobilia.
Brownish-Yellow Layering on Skin—an Unusual Manifestation of Cutaneous Aspergillosis in a Heart Transplant Recipient | Annals of Internal Medicine: Clinical Cases
An unusual cutaneous manifestation of aspergillosis in an immunocompromised patient in which Aspergillus terreus grew on the necrotic skin, creating a brownish-yellow layer of fungal growth, is reported.
Hepatic Encephalopathy in Osler-Weber-Rendu Syndrome | Annals of Internal Medicine: Clinical Cases
Hereditary hemorrhagic telangiectasia or Osler-Weber-Rendu syndrome is a rare condition that leads to multiple vascular malformations. We describe the interesting patient case of a woman with recurrent epistaxis secondary to Osler-Weber-Rendu syndrome, who presented with confusion, and was ultimately found to have a hepatic arteriovenous malformation leading to hepatic encephalopathy. Computed tomography angiography images are provided, which highlight the extensive hepatic arterioportal shunting that caused elevated serum ammonia levels in the setting of gastrointestinal breakdown of blood products.
A Young Man With Recurrent Syncope | Annals of Internal Medicine: Clinical Cases
A 35-year-old man presented with recurrent syncope. On examination, wooly hair and palmoplantar hyperkeratosis were seen. Cardiac magnetic resonance imaging showed late gadolinium enhancement, and a genetic test ultimately confirmed the diagnosis of Carvajal syndrome.
Purple Urine Bag Syndrome: “Treated” and Untreated | Annals of Internal Medicine: Clinical Cases
An elderly man with chronic constipation presented with purple urine.
Nyctalopia and Bitot Spots | Annals of Internal Medicine: Clinical Cases
Vitamin A deficiency is endemic in resource-poor areas of low- and middle-income countries in Latin America, sub-Saharan Africa, and South Asia. Although rare in the United States, individuals at risk such as the homeless, those with malabsorptive disorders, or any person with a chronically poor diet may present pathognomonic clinical signs and symptoms.
Idiopathic, Self-limiting Bilateral Bell Palsy | Annals of Internal Medicine: Clinical Cases
Bilateral facial palsy is exceedingly rare, representing only 0.3% to 2.0% of facial palsy cases (1). In contrast to the oft-recognized unilateral facial palsy, bilateral facial palsy is usually related to an underlying systemic disorder with a broad range of differentials including infections, autoimmune disorders, and sarcoidosis.