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Pelvic computed tomography scan showed a heterogeneous mass with central necrosis (star) compressing and invading the urinary bladder. A Foley catheter (arrow) can be seen within the residual portion of the bladder.

Pneumaturia and Nephrotic Syndrome Caused by a HiddenPelvic Malignancy

A 78-year-old female was admitted to the cardiac critical care unit with concerns for acute on chronic heart failure exacerbation. She had a history of nonischemic cardiomyopathy that had previously remained stable over a period of 15 years through standard medical management. Six months prior to admission, she developed dyspnea and lower extremity edema. She […]

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Magnetic resonance imaging brain scan with contrast. (A) Axial view showing (arrow) transverse and sigmoid sinus venous thrombosis. (B) Axial view showing (arrow) left ophthalmic vein thrombosis. (C) Sagittal view showing (arrow) left ophthalmic vein thrombosis. (D) Axial view showing (arrow) focal perichiasmatic enhancement of the left optic nerve.

Lesson Learned Through a Case of Pneumococcal Meningitis: Sometimes Doing Less Is More Harmful

Pneumococcal meningitis is commonly associated with intracranial complications. We present a case of pneumococcal meningitis leading to partial loss of vision in the left eye secondary to vascular complications. A 62-year-old African American female with a past medical history of breast cancer and hypothyroidism presented with complaints of altered mental status, neck pain, headache, and […]

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Computer tomography without contrast of abdomen showing colonic distension with air fluid levels without mechanical obstruction.

Hypokalemia in an End-Stage Renal Disease Patient

Kidneys play an essential role in K+ homeostasis, but the role of the colon in K+ homeostasis is not well recognized. Increased colonic K+ excretion plays a vital role in regulating plasma K+ level in patients with end-stage renal disease.1 We present a case of hypokalemia in a patient with end-stage renal disease with colonic pseudo-obstruction. […]

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(A) Simple pelvic radiology showed a pubic diastasis visualizing ill-defined bone margins without fracture lines. (B) The tomography showed the presence of bone destruction, a consequence of the pubic symphysis osteomyelitis. Also, a retroperitoneal abscess was found, approximately 30 cm long, with muscle involvement of the psoas and ipsilateral ileopsoas.

Psoas Abscess Associated with Pubic Symphysis Osteomyelitis

Infectious osteitis pubis is often diagnosed as sterile osteitis pubis, so this diagnosis requires a high level of suspicion. The following case is about a 56-year-old woman with a personal history of diabetes mellitus and secondary complications related to her illness, due to poor glycemic control. The patient went to the Emergency Department as a […]

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(A) Computed tomography showing an ill-defined and erosive lesion in the L4 facet joint. (B) Magnetic resonance imaging T1-weighted images showing disseminated and extensive hypointense foci on L3-5 facet joints and pedicles. (C) Magnetic resonance imaging T2 fat saturation image showing numerous hyperintense and oval masses within sacrospinal muscle. (D) Homogeneous peripheral enhancement after the intravenous administration of gadolinium for the masses. (E) Plain radiograph of tophaceous enthesopathy of the left foot. (F) Plain radiograph of tophaceous enthesopathy of the bilateral anterior inferior iliac spine, greater trochanter, and lesser trochanter. (The arrows denote the lesions.)

Tophaceous Gout of Lumbar Spine with Fever Mimicking Infection

A 56-year-old man was admitted with complaints of low back pain and fever lasting for about 2 months. He had a 10-year history of intermittent gouty arthritis in his feet, which was being treated with colchicine, with the most recent attack occurring 12 months before. Assessment On physical examination, his body temperature was 38.5°C. His […]

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Computed tomography scan demonstrating drug packets.

Ethico-Legal Challenges of Drug Packing—A Case Report

Body-packing, or the internal concealment of illicit drugs, has been described worldwide and is typically used to smuggle drugs across secure borders. Body-packers who swallow or insert packets of illicit drugs into body cavities are at risk for acute toxicity and gastrointestinal obstruction. We present a case of body-packing that exposed the challenging ethical and […]

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