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A Worm Hole: Liver Abscess in Ascariasis

A patient with an infection that is often asymptomatic developed an uncommon complication. The 60-year-old woman presented with fever and pain in the epigastrium and right hypochondrium, symptoms that had existed for the previous 5 days. On touch, she was clearly febrile. Her temperature was 38.6°C (101.5°F). Her blood pressure and pulse rate were within […]

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close up of gloved hands filling a syringe

Emerging Trends in Pain Medication Management: Back to the Future: A Focus on Ketamine

  Providers face many challenges when faced with pain management. Pain is complex, difficult to understand and diagnose, and especially enigmatic to manage. The discovery of nonopioid agents for pain management has become particularly important considering the ongoing opioid epidemic. This review is focused on revisiting ketamine, an agent that has historically been used for […]

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Hypertriglyceridemia-Induced Acute Pancreatitis with Normal Pancreatic Enzymes

To the Editor: The diagnosis of acute pancreatitis requires 2 of the following 3 features: 1) abdominal pain consistent with acute pancreatitis; 2) serum lipase activity (or amylase activity) at least 3 times greater than the upper limit of normal; and 3) characteristic imaging findings of acute pancreatitis.1 Although normal serum amylase levels have been reported […]

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Polymyalgia Rheumatica with Normal Inflammatory Markers

A 70-year-old man presented with pain in his shoulders, low back, and thighs for 1 year. He had difficulties when changing clothes, taking a bath, and getting out of bed because all these body movements aggravated the pain. He also experienced morning stiffness for 1 hour. Although his weight decreased by 5 kg because of loss […]

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doctor gives a physical examination of a patient

Gas Within the Bladder

To the Editor: An 83-year-old woman with a medical history of hypertension, chronic renal failure, and diabetes mellitus came to the emergency department of our clinic after 2 days of fever, asthenia, adynamia, and hypogastric abdominal pain associated with dysuria, polyuria, and bladder tenesmus. Her family reported that she had been increasingly fatigued in the […]

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