Tag Archives: Infectious disease
After the patient completed antibiotic therapy for ecthyma gangrenosum, the characteristic eschar remained a while longer.

One Thing after Another: Ecthyma Gangrenosum

Chronic high-dosage steroid therapy can pose a significant risk factor for infection due to its immunosuppressive effect. A 70-year-old African American man presented with acute bilateral painless vision loss. An investigative work-up produced a positive antinuclear antibody titer of 1:1280 with a speckled pattern, a positive test for anti-Ro/anti-Sjögren’s-syndrome-related antigen A antibody, and an erythrocyte […]

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Top left: High-power (oil immersion lens ×1000) peripheral smear showing atypical lymphocytes and no platelets. Top right: Low-power (×200) peripheral smear showing no platelets. Bottom: Computed tomography of the abdomen without contrast showing absence of splenomegaly or other abnormalities.

Platelet Count of Zero: A Curious Case of Thrombocytopenia

To read this article in its entirety please visit our website. -Patrick Twohig, MD, MPH, Jaclyn Rivington, MD This article originally appeared in the November 2017 issue of The American Journal of Medicine.

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Segmental muscle atrophy and fatty change. (A) Significant muscular atrophy in the right iliopsoas (green arrow). (B) Both biceps femoris (red arrow) are preserved, but other muscles are obviously atrophic with fatty change (yellow arrow).

Post-Polio-Like Syndrome

  Post-polio syndrome is a motor neuron disease that occurs in 15%-80% of patients with a history of polio.1 The diagnostic criteria for post-polio syndrome include a confirmed history of polio, partial or complete neurologic and functional recovery after acute polio, a period of more than 15 years with neurologic and functional stability, new symptoms that […]

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Chest x-ray film revealing marked cardiomegaly.

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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(A) Twelve-lead electrocardiogram with first-degree heart block. (B) Transthoracic echocardiogram stills depicting moderate mitral and tricuspid regurgitation. (C) T1-weighted, gadolinium-enhanced brain magnetic resonance imaging with abnormal enhancement of the right facial nerve (arrow). LA = left atrium; LV = left ventricle; RA = right atrium; RV = right ventricle.

Hints of Lyme: Disseminated Borreliosis Involving the Mitral and Tricuspid Valves

A 33-year-old man with cystic fibrosis 220 days removed from bilateral lung transplantation presented with 1 week of intermittent fevers (maximum 102°F), malaise, bilateral lower extremity edema, unintentional weight gain (8 pounds), and 2 days of dyspnea on exertion. His posttransplant course was complicated by persistent leukopenia with intermittent neutropenia attributed to his antirejection regimen of […]

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Esophagogastroduodenoscopy demonstrated white plaque lesions that extended from the gastroesophageal junction to the midesophagus.

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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