Tag Archives: diagnostic dilemma

Case of Tuberculous Pericarditis Mimicking Lupus Carditis

A 48-year-old man presented to the emergency department of our hospital complaining of sharp substernal chest pain, fever, and chills for 3 days. He denied shortness of breath, cough, night sweats, nausea, vomiting, or diarrhea. He also denied dry eyes, dry mouth, oral ulcers, or photosensitivity. He was born in the Dominican Republic but has […]

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Not Your Typical Renal Cyst

A 32-year-old man with no significant past medical or family history presented to his primary care physician with lower back and abdominal pain. Renal function tests and urinalysis were unremarkable. Computed tomography scan demonstrated a mixed cystic solid renal lesion with focal wall thickening and contrast enhancement within the left portion of a horseshoe kidney. […]

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Four Cancers and a Rash: Henoch–Schönlein Purpura

A patient who had a history of 4 primary malignancies developed a rash that is usually seen among children. The 65-year-old man presented with a 2-day history of anasarca, painless skin lesions, and new arthralgias in both hands. He had a previous diagnosis of amyotrophic dermatomyositis, and although he had none of the typical skin […]

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Not so Obvious: Acute Herpes Esophagitis

  The gross examination immediately suggested infection with Candida species, but biopsy results pointed to a different culprit. A 29-year-old woman sought care in the emergency department after experiencing sharp epigastric pain over 2 days. She was initially seen at an urgent care center and empirically treated for gastritis with omeprazole. However, her pain progressively worsened and […]

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More than a Mite Contagious: Crusted Scabies

Although an extensive skin infestation might be expected to cause serious discomfort, this is not always the case. A holiday visit sparked concern among family members when they saw that their relative, a 53-year-old woman who lived alone, was unable to perform routine daily activities. They brought her to the hospital to be evaluated for […]

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