Correction: An Atypical Presentation of Progressive Multifocal Leukoencephalopathy With Newly Diagnosed HIV Infection | Annals of Internal Medicine: Clinical Cases

Opsoclonus Associated With Cat Scratch Disease | Annals of Internal Medicine: Clinical Cases

A 49-year-old woman presented with fever, malaise, and enlarged left axillary lymph nodes after a cat bit her left hand, leading to the diagnosis of cat scratch disease. On the fifth day of admission, she had rapid, chaotic, and impulsive eye movements that appeared to be opsoclonus. Opsoclonus is a characteristic and rare ocular manifestation that occurs in association with infections and other diseases, and which will be shown in the accompanying video.

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.

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.

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.

An Interesting Case of Hypercalcemia: Intrathyroidal Parathyroid Adenoma | Annals of Internal Medicine: Clinical Cases

Hyperparathyroidism is the most common cause of hypercalcemia in the general population, with most patients presenting with mild to moderate hypercalcemia on routine bloodwork. Serum parathyroid hormone levels, followed by neck imaging studies, are helpful in diagnosing and localizing parathyroid adenomas. Ectopic parathyroid adenoma causes diagnostic challenges. Here, we present the patient case of a 65-year-old man with severe and symptomatic hypercalcemia who was found to have an intrathyroidal parathyroid adenoma, confirmed only after thyroid resection. Although imaging and laboratory results were helpful in our evaluation, pathology was the key to establishing the final diagnosis.

Culture Negative Endocarditis With Tropheryma whipplei | Annals of Internal Medicine: Clinical Cases

Tropheryma whipplei endocarditis is an increasingly recognized cause of culture negative endocarditis but is challenging to diagnose and often not accompanied by typical symptoms of Whipple disease. In this report, we describe a case of T. whipplei endocarditis and share echocardiographic images from the patient case.

Acute Localized Abdominal Pain From Primary Epiploic Appendagitis | Annals of Internal Medicine: Clinical Cases

This report describes primary epiploic appendagitis in a 40-year-old man. He had the classic physical finding of highly localized abdominal pain and the classic computed tomography findings of a hyperattenuating ring sign and a central dot sign.

Deep Vein Thrombosis in a Patient With an Absent Infrarenal IVC | Annals of Internal Medicine: Clinical Cases

Absence of an infrarenal inferior vena cava is a rare anomaly that can be associated with deep venous thrombosis in young patients with no other provoking factors. Here, we present a patient case of a young man having groin pain and found to have gonadal vein and pampiniform plexus thromboses with an absent infrarenal inferior vena cava.