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Racial Health Disparities, Prejudice and Violence

Racial disparities, discrimination, harassment & violence are public health issues. Learn how ACP is committed to combatting racial disparities in health care.

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Displaying 1 - 10 of 500 in Annals of Internal Medicine: Clinical Cases

Annals of Internal Medicine: Clinical Cases: Archive

Annals of Internal Medicine: Clinical Cases: Vol 5, No 4

Sequential Drug-Induced DRESS Syndrome With Severe Rhabdomyolysis and Probable Myocarditis: A Case Report | Annals of Internal Medicine: Clinical Cases

DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms) is a severe hypersensitivity syndrome with multiorgan involvement. An 81-year-old man with cardiomyopathy and stage IV chronic kidney disease developed DRESS syndrome after sequential exposure to allopurinol and vancomycin. He presented with diffuse rash, eosinophilia, transaminitis, severe rhabdomyolysis (CK 19,228 U/L), and probable myocarditis (troponin 9,712 ng/L). Corticosteroids started late, and a repeat vancomycin dose was temporally associated with rapid multiorgan deterioration and death. This case illustrates a rare presentation of DRESS syndrome with concurrent rhabdomyolysis and myocarditis, emphasizing the lethality of delayed diagnosis and sequential exposure to high-risk agents.

Chronic Pulmonary Aspergillosis: Bronchoscopic Visualization of a Cavitary Aspergilloma | Annals of Internal Medicine: Clinical Cases

Chronic pulmonary aspergillosis is a common condition seen in immunocompetent patients with lung structural damage. Sometimes, a fungal ball-like mass forms inside a lesion, leading to recurrent hemoptysis. Direct visualization of the aspergilloma inside the cavity is rarely possible; however, this case highlights this unusual presentation.

A Case of Crystal-Proven Calcium Pyrophosphate Deposition Disease in the Sternoclavicular Joint | Annals of Internal Medicine: Clinical Cases

Calcium pyrophosphate deposition disease (CPPD) is an important cause of crystalline arthritis commonly involving the knees and wrists, although many joints can be affected. Calcium pyrophosphate deposition disease of the sternoclavicular (SC) joints has been described rarely and historically has either been unconfirmed or reliant on surgical pathology for diagnosis. We describe a patient with episodic pain and swelling of the SC joint with corresponding chondrocalcinosis on computed tomography imaging and subsequent image-guided aspiration that confirmed presence of CPPD crystals. To our knowledge, this is the first reported case of crystal-proven CPPD by arthrocentesis of the SC joint.

What Clinicians Should Know About Kratom and 7-OH Mitragynine | Annals of Internal Medicine: Clinical Cases

An Unrecognized Case of Glanzmann Thrombasthenia Associated With Gastrointestinal Bleeding | Annals of Internal Medicine: Clinical Cases

Glanzmann thrombasthenia (GT) is a rare autosomal-recessive platelet disorder caused by deficiency or dysfunction of glycoprotein IIb/IIIa, resulting in defective aggregation and mucocutaneous bleeding. We report a 22-year-old Egyptian man presenting with gastrointestinal bleeding, severe anemia, and lifelong unexplained bleeding. Endoscopy revealed edematous gastropathy with postbiopsy bleeding exacerbation. Common coagulopathies were excluded and platelet aggregation tests showed absent responses to adenosine diphosphate, collagen, and arachidonic acid, confirming GT by flow cytometry. He was successfully treated with recombinant activated factor VII and tranexamic acid. This case underscores the importance of considering GT in patients with unexplained mucocutaneous bleeding and normal coagulation.

Cardiac Tamponade Due to Entamoeba histolytica in a Patient in a Nonendemic Region | Annals of Internal Medicine: Clinical Cases

Entamoeba histolytica infection is classically associated with intestinal disease and liver abscesses in endemic regions. Pericardial involvement with cardiac tamponade is an exceptionally rare, life-threatening complication. We present a case of a 58-year-old man in the United States with no recent travel who developed pericardial tamponade due to diaphragmatic communication with an E histolytica liver abscess. His case underscores the need to consider parasitic infections in the differential diagnosis of purulent pericardial effusions, even in nonendemic areas, and demonstrates how serologic testing and multidisciplinary collaboration were critical for diagnosis and management of this unexpected condition.

From Risk to Reality: How Pregnancy in Cystic Fibrosis Has Transformed | Annals of Internal Medicine: Clinical Cases

Retatrutide-Induced Intractable Diarrhea | Annals of Internal Medicine: Clinical Cases

Gastrointestinal symptoms accompanying the use of glucagon-like peptide-1 (GLP-1) receptor agonists and glucose-dependent insulinotropic polypeptide receptor-GLP-1 receptor co-agonists have been extensively catalogued. This case report contains a dramatic presentation of unintended consequences from the use of a novel triple-hormone receptor agonist and points toward the need for increased regulatory measures regarding the marketing of these treatments.

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Support the Sandy Shoichet Clinical Vignette Resident Travel Fund We invite you to consider a donation to the Sandy Shoichet Clinical Vignette Resident Travel Fund. Dr. Shoichet was a long-standing member of the Michigan Chapter, a dedicated participant on the Governor’s Council, and a long-time Chair of both the Program Director Committee and the Nominations Committee. His passion for education, steadfast support of the Chapter’s work, and commitment to developing future internists shaped generations of trainees. This fund will provide annual support for the top resident clinical vignette winner to travel to the National ACP Internal Medicine Meeting to present their work Any amount makes a meaningful difference. Thank you for your support.

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