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A Red Herring in the Green Grass: Syphilitic Membranous Glomerulonephritis

Physical discomfort attributed to a routine chore was actually an unusual presentation of an insidious infection. A 51-year-old man presented to the emergency department and reported 1 week of persistent, localized lower back pain that began after he had spent the day mowing his lawn. He denied any trauma, rash, dysuria, discoloration of urine, or […]

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Deadly Diarrhea: The Clever Disguise of Aortic Dissection

  Aortic dissection is one of the great imitators that can present in many ways clinically, depending on the portion of the aorta undergoing dissection.1 Therefore, it is of utmost importance to discuss the variety of presentations, including those that are rare, so as not to miss this potentially fatal diagnosis. Our case is important because […]

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A Hard Calculus: Submandibular Sialolithiasis

  Eating worsened the discomfort a 52-year-old woman was experiencing, who presented with a 4-day history of painful swelling on the left side of the neck. The consumption-related symptom is common among those with her diagnosis. Assessment A tender, firm, warm swelling was identified in the patient’s left submandibular region. Intraoral examination revealed a hard […]

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Intermittent Gastric Volvulus Mimicking Acute Coronary Syndrome

Intermittent gastric volvulus plagued a 61-year-old white woman with chest pain for months before it was observed on esophagogastroduodenoscopy (EGD). She presented to the Emergency Department with complaints of progressively worsening localized, burning, left-sided and substernal chest pain that was identical to her previous myocardial infarction. Her chest pain was associated with nausea, vomiting, and […]

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An Uncommon Cause of Obstructive Jaundice: An Infrequent Neoplasm

A 42-year-old man was admitted to the Johns Hopkins Hospital with right upper quadrant abdominal pain and scleral icterus of 3 weeks duration. The pain was described as aching and cramping in quality that typically occurred after meals. He had no vomiting or diarrhea but did note acholic stools and had more recently developed diffuse […]

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