Search Results for: ""

Superior mesenteric vein thrombosis (SMVT) is a rare but serious complication associated with COVID-19 infection that can lead to bowel ischemia or infarction. We discuss a case of SMVT presenting with septic shock due to polymicrobial bacteremia, including Bacteroides fragilis and Streptococcus anginosus, that preceded the identification of extensive thrombus involving the superior mesenteric vein. This case underscores the importance of considering SMVT as a differential diagnosis in patients post–COVID-19 presenting with polymicrobial bacteremia and highlights the need for prompt diagnosis and management to prevent further complications.

Lokelma's Interaction With Computed Tomography Angiography | Annals of Internal Medicine: Clinical Cases

A hospitalized 58-year-old man with hyperkalemia received oral Lokelma. Computed tomography angiography was performed due to concern for gastrointestinal (GI) bleeding, which demonstrated radiopaque material throughout the GI tract, even though no oral contrast had been administered. We present the second case, to our knowledge, describing Lokelma's radiopaque properties and the first, we believe, in the setting of GI bleed.

Posterior Reversible Encephalopathy Syndrome in an Older Patient in the COVID-19 and Paxlovid Era | Annals of Internal Medicine: Clinical Cases

Nirmatrelvir/ritonavir (Paxlovid) has been prescribed increasingly for treatment of COVID-19. Due to ritonavir's inhibition of CYP3A4, there are many medication interactions to consider. In this case, a 63-year-old woman recently treated with Paxlovid presented with symptoms mimicking previous episodes of lupus cerebritis. Imaging, however, revealed a pattern more consistent with posterior reversible encephalopathy syndrome. When Paxlovid therapy was initiated in the ambulatory setting, her amlodipine dose was decreased due to concern for interactions. Since Paxlovid is recommended for patients with high risk for progression to severe illness, this poses a unique challenge, especially in older patients with multiple comorbid conditions.

Unusual Extra-intestinal Manifestations of Crohn Disease Complicated by Incidentally Diagnosed Pancreatic Neuroendocrine Tumor | Annals of Internal Medicine: Clinical Cases

Crohn disease is associated with nonnecrotizing epithelioid granulomas, which rarely involve extra-intestinal solid organs. Management of moderate-to-severe Crohn disease, especially with extra-intestinal manifestations, relies on biologic therapies and small molecules which suppress the immune system and potentially increase cancer risk. We present the diagnosis and management of a rare case of Crohn disease with nonnecrotizing epithelioid granulomas in the sacral spine, pancreas, and peripancreatic soft tissue, complicated by an incidentally diagnosed pancreatic neuroendocrine tumor.

Recognition and Treatment of a Right Ventricular Air Embolism | Annals of Internal Medicine: Clinical Cases

Right ventricular air embolism is a rare and dangerous condition that frequently presents with nonspecific symptoms, making diagnosis difficult. We present a case involving a young woman with concerning symptoms following routine injection of contrast. Computed tomography scan visualizing the heart confirmed the finding of a large air embolism. We describe the immediate actions taken and the subsequent treatment provided.

Lipoprotein X in the Setting of COVID-19–Induced Cholangiopathy: An Unforeseen Event | Annals of Internal Medicine: Clinical Cases

Elevated low-density lipoprotein cholesterol (LDL-C) is a well-known culprit for atherosclerosis; however, elevated lipoprotein X (LpX), an abnormal lipoprotein as dense as LDL-C, may confound differentiation between true hyperlipidemia and cholestasis-induced hyperlipidemia. We present the case of a 34-year-old man diagnosed with COVID-19–induced cholangiopathy with LpX. Despite treatment with evolocumab and plasmapheresis, the patient had persistent cholestasis and ultimately received a liver transplant, resulting in the resolution of hyperlipidemia. This case highlights the potential association between LpX and COVID-19–induced cholangiopathy, emphasizing the need for further research to better understand the underlying mechanisms and treatment options for this complex disease.

The Search for Diagnosis: Pericardial Tamponade in a Patient With Autoimmune Polyglandular Syndrome Type 1 | Annals of Internal Medicine: Clinical Cases

This case report describes a 28-year-old man with autoimmune polyglandular syndrome (APS) type 1 who presented with pericardial tamponade complicated by pulseless electric activity cardiac arrest. After 59 minutes of cardiopulmonary resuscitation and pericardiocentesis, spontaneous circulation returned. Although pericardial tamponade has been rarely associated with APS type 2, to the best of our knowledge, it has never been reported in APS-1. This unique case highlights the importance of recognizing autoimmune pathology as a potential cause of pericardial effusion in patients with APS.

Obstructive Nephropathy Associated With Disseminated Herpes Zoster in a Patient With a Kidney Transplant | Annals of Internal Medicine: Clinical Cases

Varicella–zoster virus is a double-stranded, DNA herpesvirus responsible for causing both chickenpox (varicella) during a primary infection, and shingles (herpes zoster) on reactivation of the virus that remains dormant in neurons of dorsal root ganglia. Bladder dysfunction is a rare complication of shingles that may lead to devastating complications if not recognized. We describe the case of a 48-year-old woman with a kidney transplant who presented with skin lesions consistent with herpes zoster and also was found to have acute kidney injury in the setting of acute urinary retention and likely zoster-associated bladder dysfunction.

A Rare Case of GATA2 Deficiency Presenting as Recurrent Fever in an Adult Man | Annals of Internal Medicine: Clinical Cases

A 36-year-old man with GATA2 immunodeficiency syndrome who had fever, weight loss, and pancytopenia was diagnosed with disseminated Mycobacterium xenopi infection. He was treated for infection and later diagnosed with myelodysplastic syndrome due to GATA2 deficiency. He recovered well after allogeneic hematopoietic stem cell transplant.

An Extremely Rare Cause of Restrictive Lung Disease: Intrapulmonary Mature Teratoma | Annals of Internal Medicine: Clinical Cases

Intrapulmonary mature teratomas are extremely rare, benign neoplasms that arise from the lung. In this case, we present a 40-year-old man with a 1.5-year history of mild exertional dyspnea during physical exercise. Pulmonary function tests revealed restrictive lung disease and computed tomography (CT) of the chest showed a left mediastinal mass consistent with a mature teratoma obstructing the left ventricle and right ventricular outflow tract. Surgical resection revealed that the mass originated from the left upper lobe of the lung, while surgical pathology confirmed the diagnosis of intrapulmonary mature teratoma. Although commonly asymptomatic, intrapulmonary mature teratomas are a rare cause of mildly symptomatic restrictive lung disease.

Previous See more results in Annals of Internal Medicine: Clinical Cases

Displaying 91 - 100 of 225 in ACP Store

Teaching Medicine Series - 7 Book Boxed Set

Teaching and Coaching in the Hospital

ACP POCUS 13: PEARLS - An Ultrasound Physical Examination

This module introduces the internal medicine physician to a method for examining patients with ultrasound based on well-recognized acoustic windows. When combined, these windows provide a framework for a multisystem ultrasound physical examination that integrates cardiac, pulmonary, and abdominal views. This resource is part of the Advanced Point-of-Care Ultrasound (POCUS) series and will prepare you to participate in the American College of Physicians (ACP) live Practical POCUS Skills for Internal Medicine Physicians course. Completion of assigned online learning activities is required prior to arrival at ACP training courses. Visit the website for further information about ACP’s POCUS Pathway, a comprehensive collection of live, hands-on training options.

ACP POCUS 12: Upper Extremity Musculoskeletal

Learn how to use POCUS to scan hand, wrist, and shoulder abnormalities that you may encounter in practice. This resource is part of the Advanced Point-of-Care Ultrasound (POCUS) series and will prepare you to participate in the American College of Physicians (ACP) live Practical POCUS Skills for Internal Medicine Physicians course. Completion of assigned online learning activities is required prior to arrival at ACP training courses. Visit the website for further information about ACP’s POCUS Pathway, a comprehensive collection of live, hands-on training options.

ACP POCUS 11: Lower Extremity Musculoskeletal

Learn how to use POCUS to scan for knee and ankle abnormalities that you may encounter in practice. This resource is part of the Advanced Point-of-Care Ultrasound (POCUS) series and will prepare you to participate in the American College of Physicians (ACP) live Practical POCUS Skills for Internal Medicine Physicians course. Completion of assigned online learning activities is required prior to arrival at ACP training courses. Visit the website for further information about ACP’s POCUS Pathway, a comprehensive collection of live, hands-on training options.

ACP POCUS 10: Gallbladder

Learn about the indications, anatomic landmarks, transducer considerations and techniques, and other POCUS skills associated with scanning the gallbladder and analyze examples of pathologic findings that you may encounter during such work. This resource is part of the Advanced Point-of-Care Ultrasound (POCUS) series and will prepare you to participate in the American College of Physicians (ACP) live Practical POCUS Skills for Internal Medicine Physicians course. Completion of assigned online learning activities is required prior to arrival at ACP training courses. Visit the website for further information about ACP’s POCUS Pathway, a comprehensive collection of live, hands-on training options.

ACP POCUS 9: Abdominal Aortic Aneurysm

Work through using POCUS to scan for abdominal aortic aneurysms and abnormalities that you may encounter during scanning. This resource is part of the Advanced Point-of-Care Ultrasound (POCUS) series and will prepare you to participate in the American College of Physicians (ACP) live Practical POCUS Skills for Internal Medicine Physicians course. Completion of assigned online learning activities is required prior to arrival at ACP training courses. Visit the website for further information about ACP’s POCUS Pathway, a comprehensive collection of live, hands-on training options.

ACP POCUS 8: Skin/Soft Tissue and Musculoskeletal

Learn the principles of ultrasound imaging of skin, soft tissue, and the musculoskeletal system. Review probe settings and techniques; echogenicity in ultrasound images; and abnormalities related to skin, soft tissue, and the musculoskeletal system. This resource is part of the Advanced Point-of-Care Ultrasound (POCUS) series and will prepare you to participate in the American College of Physicians (ACP) live Practical POCUS Skills for Internal Medicine Physicians course. Completion of assigned online learning activities is required prior to arrival at ACP training courses. Visit the website for further information about ACP’s POCUS Pathway, a comprehensive collection of live, hands-on training options.

Soft Shell Jacket - Unisex

Soft Shell Women Jacket

Previous See more results in ACP Store