Tag Archives: diagnosis
Surgeons team working with Monitoring of patient in surgical ope

Presumed Pancreatitis in the Setting of Renal Impairment

We present a patient misdiagnosed with acute pancreatitis in the setting of acute kidney injury. Misdiagnosis delayed the treatment of his underlying illness and resulted in misuse of resources and prolonged hospital stay. Case Report A 60-year-old nonverbal male with a history of quadriplegia, diabetic nephropathy, and nephrolithiasis with left ureteral stent placement was referred […]

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Diabetic Mastopathy Masquerading as Breast Cancer

A 50-year-old woman with long-standing type 1 diabetes mellitus complicated by diabetic retinopathy, peripheral vascular disease and end-stage renal disease on hemodialysis was referred for screening mammography by her primary care physician. Her hemoglobin A1c was 7.1%, and she was on long-acting insulin along with mealtime coverage. Mammography revealed heterogeneouslydense breast tissue (Figures 1A and […]

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Should Patients Infected with Borrelia burgdorferi No Longer Be Referred to as Having Lyme Disease?

In 1977, a seminal paper described what was subsequently called Lyme arthritis.1 The name ‘Lyme’ originated from the initial investigation of the disease that was conducted in the Connecticut towns of Lyme, Old Lyme, and East Haddam.1 As more of the clinical manifestations of this illness were discovered, the condition became referred to as Lyme disease.2, 3, 4 In 1983, the […]

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(A) Skin impairment. Papulonodular skin lesions on the tip of the nose, from 3 to 10 mm, characteristic of sarcoidosis: firm, nonedematous, noninflammatory, nonpainful, nonpruriginous, with predominant facial involvement. (B) Endoscopic view (right nasal fossa) showing a major mucosae thickening. (C) Numerous uniform circumscribed nests of non-caseating granulomata which are characterized by the paucicity of lymphocytes and absence of necrosis.

Skin and Nasal Involvement: Look for Sarcoidosis!

  Sarcoidosis is a systemic, noncaseating, granulomatous disease affecting young adults between the ages of 25 and 40 years, most often of Black origin (35.5/100,000 vs 10.9 in the White population). Although the lower respiratory tract is affected in 90% of cases, ear, nose, and throat locations are very uncommon, with a prevalence varying between […]

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Photograph of the patient's face shows bilateral periorbital ecchymosis (raccoon eye appearance).

Raccoon Eye Appearance: Amyloidosis

To the Editor: An 82-year-old woman presented to our outpatient clinic with a 6-month history of recurrent internal bleeding near the eyes. The patient had a history of type 2 diabetes mellitus, but had no significant medical history including traumatic injuries. Physical examination revealed bilateral periorbital ecchymosis and large tongue (Figure). Serum protein electrophoresis revealed […]

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A Depressing Diagnostic Error

To the Editor: A 52-year-old woman with diabetes presented to the hospital with acute onset of right flank pain, in the setting of profound lower extremity weakness and cachexia with a 30-lb unintentional weight loss over the past 6 months. She was diagnosed with ascending pyelonephritis and treated with empiric antibiotics. On hospital day 2, […]

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