Medical Sciences Commons^™

Histology Slide, John Farber

The Medicine Forum

A 45 year old Black female without significant past medical history was admitted with insidious cough, dyspnea, nausea, vomiting, and progressive weight loss. She suddenly went into respiratory distress and succumbed to death. Autopsy subsequently showed widespread granulomatous disease. This slide of one of the lung lesions shows a noncaseating granulocyte with a fibrotic center surrounded by palisading histiocytes, consistent with a diagnosis of nodular sarcoma.

Cord Compression By Extramedullary Hematopoiesis In Polycythemia Vera, Lisa Reale, Steve Zrada, Jose Martinez

The Medicine Forum

A 73-year-old male with polycythemia vera and a history of prostate cancer presents to an outside hospital complaining of back pain of two months duration. He denied fevers, chills, night sweats, weight loss, lower extremity weakness and decreased sensation. Other than chronic constipation and urinary hesitancy, his review of systems was unremarkable. A spinal x-ray revealed a T12 vertebral fracture and the patient was transferred to Thomas Jefferson University Hospital for further management.

Nevirapine Hepatotoxicity: Case Report And Discussion, Matt Baichi

The Medicine Forum

Nevirapine (viramune) is a nonnucleoside reverse transcriptase inhibitor commonly used in combination with other antiretroviral medicines in the treatment of HIV/AIDS. The safety profile of nevirapine, as determined by review of prospective clinical trials, reports rash with an incidence of 16% as the most common side effect. Clinical hepatitis is reported to occur with an incidence of 1%. A review of the literature shows many case reports of nevirapine-induced hepatotoxicity in patients receiving both treatment and prophylaxis for HIV. The purpose of this case report is to stress the importance of early recognition and withdrawal of the offending drug.

Nonspecific Interstitial Pneumonitis In Hiv-Infected Patients, Bobbak Vahid

The Medicine Forum

A 24 year old African-American male with a history of AIDS with a recent CD4 count of 57/uL, is admitted to the hospital with substernal chest pain and shortness of breath for the past two weeks. Dyspnea is mostly on exertion, and the patient denied productive cough or hemoptysis, fevers, chills, or night sweats. Three weeks prior to presentation, the patient underwent esophagogastroduodenoscopy, which revealed an esophageal ulcer. Biopsies did not show any specific pathology and cultures were negative. Outpatient medications include prednisone, rabeprazole, fluconazole, clarithromycin, and ethambutol, bactrim.

Vitals on admission were as follows: temperature 97.2, pulse 80/min, and …