Tag Archives: hematology
Physical examination revealed a right parietal cephalohematoma as well as crusted vesicles over C4-6 dermatomal distribution.

Hyponatremia: An Unusual Link to a Common Encounter

A 76-year-old Chinese man presented with 2 falls in a day and nonspecific symmetrical lower-limb weakness. This was not associated with anorexia, vomiting, syncope, or seizures. Five days prior, he had consulted his general practitioner for herpes zoster and was prescribed oral acyclovir 800mg 5times a day. His background medical history included ischemic heart disease […]

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Gallium scintigraphy findings. (A) Coronal section and (B, C) axial on gallium scintigraphy show marked uptake (arrows).

Reactive Arthritis Caused by Haemophilus parainfluenzae in a Diabetic Patient

We report the first likely known case of reactive arthritis caused by Haemophilus parainfluenzae. An 84-year-old woman developed polyarthritis of the neck, shoulders, and hips. Two months prior to admission, she had received dental treatment for caries; 1 week later, she noted fever and extremity pain. Physical examination revealed that the range of motion of both […]

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The patient also had hemorrhagic necrosis of the skin and soft tissue of the right thigh.

A Genetic Origin? Purpura Fulminans

Over days, a patient’s relatively small lesion evolved into widespread tissue damage. A previously healthy 49-year-old Arab woman was admitted for a 2-cm painful red lesion on her left breast. She had been well until a few days earlier, when she developed left flank pain and was treated with ofloxacin for a presumed urinary tract […]

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Doppler assessment by transesophageal echocardiogram of severe mitral stenosis.

Diagnostic and Management Dilemma: Massive Hemoptysis from Severe Mitral Stenosis

Severe hemoptysis in a critically ill patient must prompt rapid development of a broad differential. We present an unusual case that presented a diagnostic and management dilemma. A 55-year-old man presented to the Emergency Department with dyspnea and hemoptysis. He was hemodynamically unstable, requiring intubation and pressor support. Assessment On examination, he was afebrile and […]

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Hemoglobin A1c trend before and after proprotein convertase subtilisin/kexin 9 inhibitor (PCSK9I) therapy. Hemoglobin A1c values prior to PCSK9I therapy were in the range of 6.4% to 7.3%. After initiation of therapy, they slowly trended up, eventually doubled, and then improved after discontinuation of the medication.

Doubling of Hemoglobin A1c on PCSK9 Inhibitor Therapy

A 70-year-old man with history of cerebrovascular accident, hyperlipidemia, and type 2 diabetes mellitus presented with polyuria, polydipsia, and weight loss. Severe hyperglycemia (serum glucose, 585 mg/dL) was present on admission. No precipitating factors were identified. Initial laboratory findings were also notable for elevated aspartate aminotransferase (703 IU/L) and alanine aminotransferase (779 IU/L). Diabetes mellitus, […]

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Intra-Abdominal Varix Rupture: A Life-Threatening Cause of Hemoperitoneum

A 54-year-old male with decompensated alcoholic cirrhosis presented after a syncopal event and ground-level fall. Initial examination noted a distended abdomen without overlying bruising. At admission, his hemoglobin was 6.3 g/dL from a baseline of 8-10 g/dL. A computed tomography scan of the abdomen was notable for “complex ascites” adjacent to his liver concerning for […]

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