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Displaying 71 - 80 of 241 in ACP Store

Southern California 3 Chapter Fund

Your chapter donation directly impacts physicians in our area by contributing to chapter programming. When you give, you're investing in: Building Tomorrow's Leaders – Supporting programs and educational initiatives that guide medical students and residents as they develop into skilled Internal Medicine Physicians. Amplifying Our Professional Voice – Enabling our chapter to advocate effectively for policies that advance internal medicine and benefit the patients we serve. Connecting Our Community – Creating opportunities for physicians to collaborate, share knowledge, and support one another throughout their careers. Every contribution, regardless of size, makes a measurable difference in our chapter. Together, we're building a stronger future for internal medicine.

Southern California 2 Chapter Fund

Your chapter donation directly impacts physicians in our area by contributing to chapter programming. When you give, you're investing in: Building Tomorrow's Leaders – Supporting programs and educational initiatives that guide medical students and residents as they develop into skilled Internal Medicine Physicians. Amplifying Our Professional Voice – Enabling our chapter to advocate effectively for policies that advance internal medicine and benefit the patients we serve. Connecting Our Community – Creating opportunities for physicians to collaborate, share knowledge, and support one another throughout their careers. Every contribution, regardless of size, makes a measurable difference in our chapter. Together, we're building a stronger future for internal medicine.

Southern California 1 Chapter Fund

Your chapter donation directly impacts physicians in our area by contributing to chapter programming. When you give, you're investing in: Building Tomorrow's Leaders – Supporting programs and educational initiatives that guide medical students and residents as they develop into skilled Internal Medicine Physicians. Amplifying Our Professional Voice – Enabling our chapter to advocate effectively for policies that advance internal medicine and benefit the patients we serve. Connecting Our Community – Creating opportunities for physicians to collaborate, share knowledge, and support one another throughout their careers. Every contribution, regardless of size, makes a measurable difference in our chapter. Together, we're building a stronger future for internal medicine.

Northern California Chapter Fund

Your chapter donation directly impacts physicians in our area by contributing to chapter programming. When you give, you're investing in: Building Tomorrow's Leaders – Supporting programs and educational initiatives that guide medical students and residents as they develop into skilled Internal Medicine Physicians. Amplifying Our Professional Voice – Enabling our chapter to advocate effectively for policies that advance internal medicine and benefit the patients we serve. Connecting Our Community – Creating opportunities for physicians to collaborate, share knowledge, and support one another throughout their careers. Every contribution, regardless of size, makes a measurable difference in our chapter. Together, we're building a stronger future for internal medicine.

Massachusetts Chapter Fund

Your chapter donation directly impacts physicians in our area by contributing to chapter programming. When you give, you're investing in: Building Tomorrow's Leaders – Supporting programs and educational initiatives that guide medical students and residents as they develop into skilled Internal Medicine Physicians. Amplifying Our Professional Voice – Enabling our chapter to advocate effectively for policies that advance internal medicine and benefit the patients we serve. Connecting Our Community – Creating opportunities for physicians to collaborate, share knowledge, and support one another throughout their careers. Every contribution, regardless of size, makes a measurable difference in our chapter. Together, we're building a stronger future for internal medicine.

Wisconsin Chaper Fund

Your chapter donation directly impacts physicians in our area by contributing to chapter programming. When you give, you're investing in: Building Tomorrow's Leaders – Supporting programs and educational initiatives that guide medical students and residents as they develop into skilled Internal Medicine Physicians. Amplifying Our Professional Voice – Enabling our chapter to advocate effectively for policies that advance internal medicine and benefit the patients we serve. Connecting Our Community – Creating opportunities for physicians to collaborate, share knowledge, and support one another throughout their careers. Every contribution, regardless of size, makes a measurable difference in our chapter. Together, we're building a stronger future for internal medicine.

Washington Chapter Fund

Your chapter donation directly impacts physicians in our area by contributing to chapter programming. When you give, you're investing in: Building Tomorrow's Leaders – Supporting programs and educational initiatives that guide medical students and residents as they develop into skilled Internal Medicine Physicians. Amplifying Our Professional Voice – Enabling our chapter to advocate effectively for policies that advance internal medicine and benefit the patients we serve. Connecting Our Community – Creating opportunities for physicians to collaborate, share knowledge, and support one another throughout their careers. Every contribution, regardless of size, makes a measurable difference in our chapter. Together, we're building a stronger future for internal medicine.

Arkansas Chapter Fund

Your chapter donation directly impacts physicians in our area by contributing to chapter programming. When you give, you're investing in: Building Tomorrow's Leaders – Supporting programs and educational initiatives that guide medical students and residents as they develop into skilled Internal Medicine Physicians. Amplifying Our Professional Voice – Enabling our chapter to advocate effectively for policies that advance internal medicine and benefit the patients we serve. Connecting Our Community – Creating opportunities for physicians to collaborate, share knowledge, and support one another throughout their careers. Every contribution, regardless of size, makes a measurable difference in our chapter. Together, we're building a stronger future for internal medicine.

Alabama Chapter Fund

Your chapter donation directly impacts physicians in our area by contributing to chapter programming. When you give, you're investing in: Building Tomorrow's Leaders – Supporting programs and educational initiatives that guide medical students and residents as they develop into skilled Internal Medicine Physicians. Amplifying Our Professional Voice – Enabling our chapter to advocate effectively for policies that advance internal medicine and benefit the patients we serve. Connecting Our Community – Creating opportunities for physicians to collaborate, share knowledge, and support one another throughout their careers. Every contribution, regardless of size, makes a measurable difference in our chapter. Together, we're building a stronger future for internal medicine.

Arizona Chapter Fund

Your chapter donation directly impacts physicians in our area by contributing to chapter programming. When you give, you're investing in: Building Tomorrow's Leaders – Supporting programs and educational initiatives that guide medical students and residents as they develop into skilled Internal Medicine Physicians. Amplifying Our Professional Voice – Enabling our chapter to advocate effectively for policies that advance internal medicine and benefit the patients we serve. Connecting Our Community – Creating opportunities for physicians to collaborate, share knowledge, and support one another throughout their careers. Every contribution, regardless of size, makes a measurable difference in our chapter. Together, we're building a stronger future for internal medicine.

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Displaying 71 - 80 of 500 in Annals of Internal Medicine: Clinical Cases

A Combination Regimen of Adalimumab and Methotrexate in a Challenging Case of Recalcitrant Gut and Cutaneous Sweet Syndrome | Annals of Internal Medicine: Clinical Cases

We report a case of a 50-year-old woman with cutaneous Sweet syndrome (SS) presenting with symptomatic iron deficiency anemia. Main clinical findings were cutaneous papules and small bowel ulcers, visualized on enteroscopy. She was eventually diagnosed with gut and cutaneous SS. After not responding to different treatment regimens, she was given subcutaneous adalimumab and oral methotrexate combination therapy, and finally achieved clinical remission. To our knowledge, this is the first reported case of such a treatment combination for recalcitrant gut and cutaneous SS. Although rare, a diagnosis of gut SS should be considered in similar clinical situations. In recalcitrant cases, anti–tumor necrosis factor-α agents may be considered.

Pott Puffy Tumor: A Rare Disorder of Childhood Presenting With New Seizures in an Adult | Annals of Internal Medicine: Clinical Cases

Pott puffy tumor (PPT) is defined as frontal bone osteomyelitis associated with subperiosteal abscess resulting from sinus disease, which occurs most commonly in the pediatric population. This case report details a 62-year-old man who developed fever, seizures, and encephalopathy and was ultimately diagnosed with PPT, making him both the oldest adult documented with this condition, as well as the first adult documented to present with seizures, to the best of our knowledge. Clinicians should include PPT on their differential diagnosis for adults presenting with fevers and seizures, as prompt management of frontal bone osteomyelitis is critical to preventing associated central nervous system complications.

Meningitis Caused by Campylobacter jejuni in a Patient With Immunodeficiency Due to Bispecific Antibody Therapy | Annals of Internal Medicine: Clinical Cases

Bispecific antibodies, such as talquetamab and teclistamab, offer promising treatment options for refractory multiple myeloma but are associated with significant immunosuppression and susceptibility to atypical infections. We report a case of recurrent Campylobacter jejuni meningitis in a 44-year-old man undergoing talquetamab and teclistamab therapy, highlighting the role of hypogammaglobulinemia in disease recurrence. Diagnosis was confirmed using molecular tools, emphasizing their value in detecting pathogens with low bacterial loads. This case underscores the need for vigilance, advanced diagnostics, and tailored prophylaxis to mitigate infection risks in immunocompromised patients receiving novel therapies.

Hydropneumopericardium Due to Esophageal-Pericardial Fistula: A Rare Complication of Esophageal Stenting | Annals of Internal Medicine: Clinical Cases

We present a case of a 53-year-old woman with a history of ulcerative esophagitis and esophageal stricture status post esophageal stenting that was complicated by stent migration. She presented with fatigue, melena, and dark output from her percutaneous endoscopic gastrostomy tube. An echocardiogram showed hydropneumopericardium with cardiac tamponade physiology requiring emergent pericardiocentesis. The aspirated fluid was brown and cloudy; pathology of the fluid showed meat and vegetable matter consistent with food. She ultimately required esophagectomy with esophagostomy. This case highlights the importance of early recognition of esophageal-pericardial fistulas, as delay in the management carries a high risk for morbidity and mortality.

Metastatic Pancreatic Adenocarcinoma Manifesting as Otomastoiditis and Collet–Sicard Syndrome | Annals of Internal Medicine: Clinical Cases

Otomastoiditis is not prevalent in immunocompetent adults and in some cases can be caused by insidious malignancies of the temporal bone. Collet–Sicard syndrome (CSS) is a constellation of symptoms associated with unilateral lower cranial nerve deficits that can occur in the setting of radiologically elusive temporal bone malignancies. We present a rare case of an adult man with temporal bone biopsy–confirmed pancreatic cancer that initially presented with otomastoiditis and CSS. This case demonstrates how malignancy should remain a top differential diagnosis for clinicians who encounter immunocompetent adults with otomastoiditis, even when unsupported by advanced imaging modalities.

Emerging Threat: A Case of Neuroinvasive Powassan Virus Infection | Annals of Internal Medicine: Clinical Cases

Powassan virus (POWV) infection is a tickborne illness that may cause neuroinvasive disease with high morbidity and mortality. The incidence of this disease is increasing in the United States. We present a confirmed case of neuroinvasive POWV infection acquired in December 2023. This case illustrates the need for increased awareness of neuroinvasive POWV infection owing to severity of illness and rising incidence. Climate change and tick expansion are likely major contributors to the evolving seasonality and increasing incidence of POWV infection. Early testing may minimize unnecessary antimicrobials and diagnostic studies.

Cefepime-Induced Cotard Syndrome in a Patient With End-Stage Renal Disease: A Rare Manifestation of Neurotoxicity | Annals of Internal Medicine: Clinical Cases

Cefepime is a fourth-generation cephalosporin used for severe infections but is associated with neurotoxicity, particularly in patients with renal impairment. We report a rare case of Cotard syndrome, a delusion of being dead, in a 76-year-old woman with end-stage renal disease receiving cefepime. She developed sudden neuropsychiatric symptoms, repeatedly insisting she was dead, stating, “I have no heartbeat” and “I need to be brought back to life.” Laboratory results and imaging were unremarkable, and electroencephalogram showed toxic-metabolic encephalopathy. Symptoms resolved rapidly after cefepime discontinuation and dialysis. This case underscores the importance of monitoring for neuropsychiatric effects in vulnerable patients receiving cefepime.

Mucocutaneous Leishmaniasis Causing Airway Compromise | Annals of Internal Medicine: Clinical Cases

A 37-year-old man presented with dyspnea and erythematous, nodular facial lesions. An examination revealed nasopharyngeal edema, and imaging showed prevertebral swelling. An extensive infectious and autoimmune evaluation was negative. A cheek biopsy was done, and polymerase chain reaction was positive for Leishmania braziliensis, confirming the diagnosis of mucocutaneous leishmaniasis. This is a progressive manifestation of a parasitic infection by Leishmania spp. It may present several years following resolution of an initial cutaneous infection. In this case, 26 years. Negative serology for leishmaniasis does not exclude active disease, and a high index of suspicion leads to early diagnosis and treatment.

Movement Disorder Following Hypoglycemic Encephalopathy in Mitochondrial 3-Hydroxy-3-methylglutaryl-CoA Synthase-2 (mHS) Deficiency | Annals of Internal Medicine: Clinical Cases

Mitochondrial 3-hydroxy-3-methylglutaryl-coenzyme A synthase (mHS) deficiency is an ultra-rare inborn error of ketone body synthesis that is caused by biallelic mutations in HMGCS2. The manifestations of mHS deficiency can include hypoketotic hypoglycemia, metabolic acidosis, lethargy, encephalopathy, hyperammonemia, and hepatomegaly. Here, we report a case of movement disorder following hypoglycemic encephalopathy involving the basal ganglia in a patient with mHS deficiency. Exome sequencing showed novel compound heterozygous variants in HMGCS2, a partial gene deletion (classified as pathogenic) and c.704T>A (p.M235K) variant that was deemed to be likely pathogenic. Our findings suggest that mHS deficiency can result in basal ganglia injury and movement disorder.

A Patient Presenting With Hematochezia Found to Have Geophagia-Induced Electrolyte Derangements | Annals of Internal Medicine: Clinical Cases

Geophagia is the deliberate practice of eating earth or other soil-like substances. Although associated with nutritional deficiency, it may occur as a culturally sanctioned practice outside the context of illness. A patient with kidney failure on home hemodialysis presented with hematochezia, myalgias, and fatigue. She was found to have constipation with radiopacities in the gastrointestinal tract, symptomatic hypokalemia, hypocalcemia, and relative hypophosphatemia in the setting of end-stage kidney disease. History revealed significant geophagia and intake of bentonite clay, which is primarily composed of aluminum, a phosphorus binder, and silica, a potassium binder. Her electrolyte abnormalities resolved with clay discontinuation.

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