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Fiber-optic bronchoscopic image showing multiple submucosal nodules characteristically sparing posterior membranous (A). Narrow-band imaging not showing the intraepithelial capillary loop pattern with dark brown dots (B). Axial and coronal scan depicting calcifications within the tracheal lumen (C and D).

Polypoidal Trachea: A Clinician’s Predicament

A 44-year-old asymptomatic female patient with no known comorbidities was scheduled for donor kidney harvesting for her husband. During intubation, the anesthetist found multiple polypoidal lesions just below the vocal cords, studding the tracheal wall. A diagnosis of multiple tracheal papillomatosis was made, and the patient was referred to the Otorhinolaryngology Department for further evaluation. […]

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Chest computed tomography showing consolidation in lower lobe of right lung.

Connecting the Dots—Acute Abdomen, ST Elevation, and a Consolidating Lung Mass

Community-acquired pneumonia (CAP) is a commonly treated disease and yet may present in unfamiliar ways that if missed may result in unnecessary testing, procedures, and potential harm. Case We present a 38-year-old male with no prior medical history who presented with 3 days of severe, cramping lower abdominal pain. This was intermittent, non-radiating, and exacerbated […]

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A Bad Sign: Dermatomyositis with Interstitial Lung Disease

The presence of an autoantibody explained why a patient with dermatomyositis had respiratory symptoms. A 52-year-old man presented with a 1-month history of fever and rash, and a 2-week history of muscle pain and muscle weakness, which made it difficult for him to rise from a sitting position. The patient denied being a smoker or […]

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Chest radiograph demonstrating 2 bilateral cavitating pulmonary infiltrates (A) and chest radiograph 9 months later demonstrating complete resolution of the infiltrates after immunosuppressive therapy (B).

Granulomatosis with Polyangiitis Presenting as Hypophysitis

A 20-year-old healthy woman presented to a local hospital with 3 months of headaches and fatigue and 3 weeks of intermittent fevers to 40°C. Physical examination was normal. White blood cell count was 6.1 × 109/L, hemoglobin 10 g/dL, sodium 153 mmol/L, and creatinine 0.80 mg/dL. Magnetic resonance imaging demonstrated a 2.1 × 1.8 × 0.9-cm cystic sellar lesion. Hormone testing […]

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The patient's posterior trunk was marked with pink urticarial papules and plaques.

Down the Rabbit Hole: Cutaneous Tuberculosis

The term “going down the rabbit hole,” based on Lewis Carroll’s Alice’s Adventures in Wonderland, is a metaphor for an entry into the unknown, the disorienting, or the mentally deranging. Although the case of a patient with a nonhealing ulcer did not set us on a path with these exact qualities, it did remind us that […]

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doctor gives a physical examination of a patient

Inferior Vena Cava Filters in Patients with Recurrent Pulmonary Embolism

There are sparse data to support the recommendation for inferior vena cava (IVC) filters in patients with recurrent pulmonary embolism while on anticoagulant therapy. Methods This was a retrospective cohort study of administrative data from the Premier Healthcare Database, 2009-2014. All-cause mortality according to the use of IVC filters was evaluated in patients who suffered […]

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