The American Journal of Medicine Blog

A 55-year-old man with poorly controlled type 2 diabetes was admitted with 8 days of lower urinary tract symptoms, including burning micturition and frequency, and 2 days of fever and rigors. Examination was normal, except for fever (38.5°C) and tachycardia. No loin tenderness or penile discharge was found, and digital rectal examination showed +1 elastic, nontender […]

The patient’s presentation suggested a number of serious dermatologic or infectious diseases, but in fact, a drug reaction was to blame for her symptoms. A 69-year-old woman with a history of chronic obstructive pulmonary disease was admitted to our hospital with a worsening rash. Four days earlier she presented to a different facility with a […]

A healthy 70-year-old woman was admitted with a 3-day history of a pus-emitting wound on her left shin, in the absence of trauma. She was afebrile, and examination was normal excepting a warm, erythematous and tender area over her left distal tibia with a central swollen area discharging pus. Hemoglobin was 11.7 g/dL, white blood […]

Skin biopsy provided an elusive diagnosis and evidence that the patient had likely omitted important information during medical interviews. A 43-year-old man with a history of alcohol and opioid use was admitted to the inpatient ward from the infectious disease clinic. For 2 weeks, he had experienced recurrent, painful skin nodules that expressed bloody, purulent […]

Upon presentation, the patient was afebrile and hypertensive to 199/81 mm Hg. Physical examination revealed prominent tender left-sided preauricular and submandibular lymphadenopathy and a linear crusted ulcer with jagged edges extending from the inferior aspect of the medial left eyebrow to the left nasolabial fold (Figure 1). Neurologic examination was notable for left-sided ptosis and miosis, […]

A 34-year-old Hispanic man with a history of alcoholic cirrhosis and type 2 diabetes mellitus presented with 2 weeks of diarrhea, nausea, vomiting, abdominal pain, rash, and syncope. Five days before presentation he developed an erythematous petechial rash on his right hand that spread sequentially to his left hand, forearms, feet, legs, and flanks. The […]