Internal Medicine

Blunt thoracic aortic injury in an older person is a critical clinical emergency. Optimal timing and sequence of interventions is crucial in cases co-presenting with pelvic vascular injuries and hemodynamic instability, What is the most appropriate approach?

In pediatric patients with unexplained neurological symptoms and MRI findings of lateral ventricular lesions or brainstem-thalamus-basal ganglia abnormalities, monitor closely for BD signs.

A unique case of bilateral retinal vasculitis as the initial manifestation of systemic lupus erythematosus. Recognizing the possibility of such atypical presentations allows clinicians to maintain a high index of suspicion for SLE.

Although it seems to be a rare complication, there should be a high index of suspicion for colonic ischemia in patients taking a GLP-1 receptor agonist who present with abdominal pain.

Retinal artery occlusion is a rare complication of infective endocarditis. Following the diagnosis of bilateral RAO, TEE revealed the presence of mobile vegetation on the mitral leaflet. Blood culture confirmed E. rhusiopathiae endocarditis.

The patient presented with digital vasculitis, rapidly evolving interstitial lung disease, sub-clinical myositis, and arthritis of the hands with no prior history of Raynaud’s phenomenon. What antibodies would you test to determine the final diagnosis?

As PD progresses, minor perceptual disturbances can evolve into formed hallucinations and delusions. This unique case describes aprosopsia, which is transient perceptual absence of facial features.

Surgical intervention is typically used to treat HCM with severe mitral regurgitation but can be high risk. MitraClip combined with PTSBME was successfully performed in this patient with obstructive HCM and severe MR.

An 18-year-old girl who presented for primary amenorrhea treatment was found to have a 46, XY karyotype. CAIS was diagnosed and treated. Her twin brother had a 46, XY karyotype with male physical and ultrasound features.

A raised eosinophil count and esophageal eosinophilic infiltration were found in a man with refractory hiccups, unremarkable physical and CT examination, and normal upper endoscopy. Hiccups resolved with topical budesonide.

Weil’s disease is a zoonotic infection which may cause arrhythmias. This fatal case of total AV block induced by leptospirosis is a warning of the importance of early, and accurate, diagnosis and treatment of this infection. 

In this unusual case, OCT revealed multiple mural thrombi in a PAVF as the source of embolic strokes and continuing ischemic attacks, indicating a potential emboligenic mechanism in PAVF.

Elbow tuberculosis is a rare manifestation of TB, with symptoms often mimicking diseases such as rheumatoid or septic arthritis. Surgical intervention can greatly benefit diagnosis, but is not always necessary for successful treatment.

A man with a history of prolonged NSAID use suffered progressive fatigue, melena, and intestinal obstruction. Multiple interventions led to laparoscopic subtotal colectomy with ileo-sigmoid colon anastomosis.

A patient diagnosed with aseptic meningitis developed a right temporal headache with scalp tenderness, and imaging results were consistent with giant cell arteritis. Could the GCA have caused the aseptic meningitis?

Blood culture-negative infective endocarditis can be difficult to diagnose. In this case, a woman with Bartonella-induced infective endocarditis required aortic valve replacement surgery, CABG, and targeted antibiotic therapy, 

A rare case of intestinal myiasis, caused by larvae of the drain fly, Clogmia albipunctata. The patient presented with abdominal discomfort, perianal itching, nausea and vomiting, before successful treatment with ivermectin.

Explorative laparoscopy was key to detecting a necrotic gallbladder in an 8-year-old boy who presented with acute abdominal pain but had no evidence of infection and unclear imaging findings.

Gastrointestinal involvement is common in systemic lupus erythematosus but acute pancreatitis as an initial manifestation is extremely rare. The patient's abdominal symptoms resolved after corticosteroid and cyclophosphamide therapy.

Mycobacterium TB can infect any ophthalmic tissue. Most common ocular presentations are granulomatous anterior uveitis and posterior uveitis, but this case shows rare bilateral corneoscleral perforation.