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Transesophageal echocardiography (TEE) and contrast-enhanced computed tomographic (CT) imaging. (A) TEE short-axis aortic valve view demonstrating prosthetic mechanical aortic valve graft (black arrowhead) with surrounding hypoechoic abscess (white arrowheads) and no vegetations. (B) Coronal and (C) sagittal CT images demonstrating a well-defined mid-density collection (white asterisk) in the anterior mediastinum, immediately adjacent to the aortic root and ascending aorta.

Aortic Root Abscess in a Patient with Marfan’s Syndrome

Aortic root abscess is a recognized complication of both native and prosthetic valve endocarditis. It is uncommon to develop an aortic root abscess secondary to aortic root graft infection (in the absence of prosthetic valve endocarditis), and there is sparse literature on the management of these patients. We present a case of aortic root abscess […]

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Axial T2-weighted image at the level of the C5-C6 intervertebral disc. The thecal sac (between arrowheads) is severely compressed, measuring 3 mm in anteroposterior diameter.

A Fateful Miss: Ground-Level Fall Revealing Occult Cervical Spinal Stenosis

A 67-year-old man was admitted after a fall at home. He intended to sit down, but the chair was not where he thought it was, and he fell on his buttocks in the sitting position. He was brought to the emergency department complaining of inability to walk and difficulty voiding. Medical history included obesity, diabetes, […]

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High-resolution chest computed tomography scan before treatment (A) and after treatment (B) of Pneumocystis jirovecii pneumonia with 21-day course of trimethoprim-sulfamethoxazole and intravenous immunoglobulin.

Pneumocystis Pneumonia Complicated by Extensive Diffuse Pneumatoceles

A 60-year-old male presented to the outpatient clinic with shortness of breath, subjective fevers, and night sweats of 1-month’s duration. Initial chest X-ray revealed new bilateral perihilar consolidations. He was treated with a 5-day course of levofloxacin 750 mg/d without improvement. Therefore, he underwent a chest computed tomography (CT) scan which showed extensive bilateral pneumatoceles […]

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On positron emission tomography/computed tomography, 18F-fludeoxyglucose accumulation was seen in bilateral carotid, iliac, femoral, and popliteal arteries, and thoracic aorta with standardized uptake value maximum of 6.94 in right iliac artery. Arrows (A) and arrowheads (B).

Diffuse Vascular FDG Uptake in Late Onset Takayasu Arteritis

A 75-year-old Japanese woman presented to our hospital with intermittent right neck pain and right-sided headache lasting for 3 weeks. Her erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level were elevated to 100 mm/h and 2.95 mg/dL, respectively. Whole body positron emission tomography (PET) and computed tomography (CT) showed 18F-fludeoxyglucose (FDG) uptake in the bilateral […]

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Contrast-enhanced abdominal computed tomography scan. (A) Diffuse bowel wall thickening of 13 mm showing the “target sign” (arrows). (B) Engorgement of mesenteric vessels or ‘‘comb sign’’ (arrow head) and bladder wall thickening (asterisk).

Recurrent Abdominal Pain in Systemic Lupus Erythematosus: Concurrent Lupus Enteritis and Lupus Cystitis

A 44-year-old woman was admitted to the hospital in March 2017 with a 5-day history of abdominal pain, vomiting, diarrhea, dysuria, and urinary frequency. She was afebrile, normotensive, and in sinus tachycardia. Her abdomen was distended and diffusely tender. Bowel sounds were hyperactive. No abdominal guarding or rebound pain in response to deep palpation was […]

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(A) Twelve-lead electrocardiogram showing ST-segment elevations >2 mm in inferolateral leads caused by dissection of the distal portion of a so-called wraparound left anterior descending artery. (B) Thrombotic occlusion of the proximal left anterior descending artery, which was treated with simple angioplasty and intracoronary administration of abciximab with final Thrombolysis In Myocardial Infarction (TIMI) 1 flow. (C) Intravascular ultrasound with evidence of intramural hematoma (solid arrow), left anterior descending artery dissection (dotted arrow), and (D) control coronary angiography after 48 hours with final TIMI 3 flow.

More Martial than Arts: Coronary Artery Dissection after Chest Kick

A 40-year-old male smoker without relevant medical history reported to the Emergency Department 2 days after a kick to his unprotected chest during a karate training session. The day before, he had presented with severe chest pain and his general practitioner had prescribed ibuprofen. No electrocardiogram (ECG) had been done. At the Emergency Department, the […]

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