Gonococcus typically affects the mucosal surfaces but in rare cases can spread to bloodstream causing disseminated gonococcal infection (DGI). The usual presentation of DGI is rash, polyarthralgia, and tenosynovitis. We present case a 23-year-old female who presented our hospital with pustular rash tenosynovitis hand was sent home on Augmentin. Her symptoms worsened despite treatment she back ED. On investigation, found have appropriately treated. should be kept mind sexually active...

We report a case of 37-year-old woman who presented to our hospital with retrosternal chest pain following intramuscular administration epinephrine due presumed anaphylaxis. On arrival, she was found have ST segment depression in the anterolateral leads on ECG and elevated cardiac troponins. She diagnosed stress cardiomyopathy based left ventricle dysfunction angiographically normal coronary arteries catheterisation. To best knowledge, this is third reported takotsubo appropriately dosed for...

Introduction: Transcatheter mitral valve-in-valve (ViV) & valve-in-ring (ViR) are relatively novel therapeutic alternatives for patients with degenerated bioprostheses or failed annuloplasty rings whose reoperative risk is too high. The predominant procedural access both procedures transapical transseptal. However, whether there differences in outcomes of this procedure using transseptal versus has not yet been defined. Methods: We conducted a systematic review all published articles from...

Strongyloidiasis is a parasitic infestation caused by Strongyloides stercoralis. Most cases are asymptomatic; however, symptomatic patients may present with wide range of non-specific cutaneous, pulmonary, or gastrointestinal symptoms posing diagnostic dilemma and delay in diagnosis. We report case 58-year-old female who presented months generalized pruritus abdominal discomfort along persistent eosinophilia due to strongyloidiasis, which completely resolved treatment.

Thyrotoxic periodic paralysis is a potentially life-threatening condition associated with recurrent episodes of muscle weakness and hypokalaemia due to hyperthyroidism. Diagnosis often delayed or misdiagnosed its rarity in the western world subtle features hyperthyroidism on initial presentation. Here we present case 25-year-old man who presented emergency department (ED) sudden onset bilateral upper lower extremities. His labs revealed elevated T4 suppressed thyroid-stimulating hormone he...

A 20 year old male with past medical history of Type 1 Diabetes and Hypothyroidism presented to our hospital severe hypocalcemia. His calcium was 5.8 mg/dl (normal range 8.6-10.3 mg/dl). He had been complaining generalized weakness for weeks. Vital signs were within normal limits. Physical exam significant positive Chvostek sign. Other labs revealed low magnesium, potassium, vitamin D, albumin, metabolic acidosis ferritin. started on supplements. Tissue transglutaminase antibody IgG...

We describe a case of 40-year-old woman who presented to our hospital with symptoms non-radiating epigastric pain for 4–5 days associated nausea and vomiting. Her history was significant asthma recurrent exacerbations, polyneuropathy sinus infections. Liver function tests revealed cholestasis. Antinuclear antibody antismooth muscle cell were positive. biopsy active chronic hepatitis A diagnosis autoimmune made. All other causes cholestatic jaundice ruled out. eosinophilia, infections...

Vertebral osteomyelitis due to Streptococcus viridans following a dental procedure is rarely reported phenomenon. We discuss the case of 67-year-old immunocompetent woman who presented with low back pain 3 weeks duration associated subjective fever and chills. On admission, MRI lumbar spine showed L5-S1 vertebral paravertebral epidural abscesses. Subsequently, detailed history was retaken patient having had maxillary tooth extraction followed by implant 2 months prior onset her symptoms....

No abstract available. (Published: 6 July 2016) Citation: Journal of Community Hospital Internal Medicine Perspectives 2016, : 31544 - http://dx.doi.org/10.3402/jchimp.v6.31544

Isolated pulmonary valve endocarditis in intravenous drug users is a rarely reported phenomenon. We present the case of 25-year-old male with history use who presented respiratory symptoms after failing outpatient treatment for community-acquired pneumonia. Further investigations identified multiple lung lesions early cavitation, concerning septic embolism on computerized tomography scan, positive blood cultures methicillin-susceptible staphylococcus aureus, and isolated vegetation pulmonic...

Pylephlebitis or infective suppurative thrombosis of the portal mesenteric venous system is an uncommon condition that can potentially be deadly if not recognized and treated early. Although most commonly associated with pancreatitis diverticulitis, any intra-abdominal pelvic infection occurring in region drained by cause this rare entity. We report a case 75-year-old woman who developed post polypectomy pylephlebitis following colonoscopy, rarely reported literature.

Thrombosis is a frequent cause of morbidity and mortality in patients with nephrotic syndrome (NS). Though venous thromboses are common NS, arterial relatively rare. Commonly involved arteries include coronary, iliac, femoral, renal, cerebral, pulmonary, mesenteric, axillary arteries, the aorta. Arterial associated poor prognosis; treatment options limited may not always be amenable to treatment. We present case 39-year-old female NS who presented thigh pain was found have sub-acute...

Glioblastoma is a highly aggressive and generally lethal brain tumor despite treatment. Treatment to ensure prolonged survival while maintaining quality of life has always been challenging, as glioblastoma occurs mostly in elderly population who already have multiple comorbidities. We present the case 75-year-old male was evaluated for complaints recurrent falls due gait abnormalities weakness, found multifocal glioblastoma. Despite rapid initiation chemo radiation, he did not respond...

Generalized pruritic rash in Hodgkin's disease is most commonly due to paraneoplastic manifestation. It can sometimes precede other manifestations of by weeks or months. Hence, if possible causes have been ruled out, should be considered a cause generalized rash. Consideration as help early identification disease. We present case 71-year-old female who presented the hospital with for 4 days. Further workup revealed Stage IV The completely disappeared after receiving chemotherapy, which...

Disseminated mucormycosis endocarditis is extremely rare, and only a few cases have actually been reported in the literature. It almost universally fatal despite aggressive surgical medical management. In this article, we present case of 48-year-old immunocompromised male with endocarditis, who presented acute bilateral lower extremity ischemia passed away due to subsequent multi-organ failure. To our knowledge, first report disseminated native valve presenting as ischemia.

Learning points► Spontaneous carpopedal spasm may occur in bulimic patients if severe acid-base and electrolyte disturbance occurs.► Bulimia nervosa should always be considered otherwise healthy women with unexplained hypokalaemia metabolic alkalosis.

A 41-year-old female presented to the hospital with sore throat and shortness of breath. She was hypoxic an oxygen saturation 87% in room air. Physical examination revealed swollen uvula exudates. had been started on topiramate for treatment migraine few months ago. The dose increased 100 mg twice daily 2 weeks Complete blood count absolute neutrophil (ANC) 8 c/mm 3 . intubated broad-spectrum antibiotics. transferred our fifth day hospitalization. On arrival, her 10 Her agranulocytosis...

Epiploic appendagitis (EA) is an uncommon cause of abdominal pain. It a benign condition but may mimic other serious causes acute abdomen such as appendicitis, diverticulitis, and gynecological emergency in severe cases. Knowledge this the differential diagnosis pain can save unnecessary hospital admission, antibiotics, surgery. In article, we present case 43-year-old female who presented to our with 2-day history right lower quadrant diarrhea. She was diagnosed EA computed tomography...