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Abdomen Actin’ Up: A Unique Presentation Of Disseminated Abdominal Actinomycosis, Arpana Parachuri, Md, Brianna Shinn, Md, Rino Sato, Md

The Medicine Forum

INTRODUCTION

Abdominal actinomycosis is a chronic, indolent disease characterized by nonspecific symptoms such as fatigue, weight loss, fever, and abdominal pain. Actinomyces is a genus of fastidious, gram-positive, non-acid-fast, branching filamentous bacilli characterized by sulfur granules that is normally found in oral flora and inhabits the gastrointestinal (GI) tract. Actinomyces infections are relatively rare, however when present, they have the ability to invade multiple organs and disseminate throughout multiple body cavities. Factors that increase the risk of developing actinomycosis include poor oral hygiene, alcoholism, and preexisting dental disease. Intrauterine devices (IUDs) also increase the risk of developing pelvic actinomycosis. Over …

Grand Rounds Panel Discussion: Blood Thinners Peri-Operatively: What To Do?, Jad Al Danaf, Md, Anusha Govind, Md, Loheetha Ragupathi, Md, Shuwei Wang, Md

The Medicine Forum

PANELISTS

Mathew DeCaro, MD: Associate Professor of Cardiology, Director of the Coronary Cardiac Unit, Cardiology fellowship program director

John Doherty, MD: Professor of Cardiology

Gregary Markefka, MD: Associate Professor of Cardiology, Associate Director of the Coronary Cardiac Unit, Cardiology fellowship assistant program director

Geno Merli, MD: Professor of Vascular Medicine, Co-director of Jefferson Vascular Center

Srikanth Nagalla, MD, MS: Associate Professor of Medicine, Director, Clinical Hematology

Eric Schwenk, MD: Assistant Professor of Anesthesiology, Director of orthopedic anesthesia

Barry Ziring, MD: Clinical Associate Professor of Internal Medicine / Primary Care, Director of the division …

65-Year-Old Man With Weight Loss, Anorexia, And Distal Extremity Numbness, Leigh Van Vranken, Ms Iii, William Kim, Ms Iii, Darren N. Seril, Md, Toshimasa Okabe, Md

The Medicine Forum

Case Report

A 65-year-old Caucasian male with no significant pastmedical history presented to the emergency department with an unintentional 44-pound weight loss over a four-month period. The weight loss was preceded by fatigue and anorexia,which had been increasing for approximately eight months.In addition, he noted numbness and tingling of his hands and feet that began over the same time period. The patient was initially treated for depression with sertraline by his primarycare physician. However, his symptoms persisted without significant improvement. An initial workup at outside hospital one month prior to presentation included an abdominal CTscan, which revealed a mass in …

A 30 Year-Old Man Infectious Endocarditis And Cerebrovascular Accident, Neerav G. Sheth, Md, Joseph Desimone, Md

The Medicine Forum

Case Report

A 30 year old male with a remote history of intravenous drugabuse (IVDA) and Hepatitis C was admitted in July 2008 with changes in mental status and a new right sided paresis. According to the family, the patient was in his usual state of health until approximately 2-3 weeks prior to admission when he developed headaches, generalized malaise, and fever to 101 degrees Fahrenheit after swimming in a lake. He was seen in an outside hospital emergency department, diagnosed with otitis media and subsequently discharged on prednisoneand ciprofloxacin. The morning of admission, the patient was found naked, nonverbal, …

Download Entire Issue-The Jefferson Medicine Forum, Volume 6, Winter 2004

The Medicine Forum

Download entire issue-The Jefferson Medicine Forum, Volume 6, Winter 2004.

What's Your Diagnosis? Hematology Slide Review, Jane Choi Md, Pgy-2

The Medicine Forum

A 23 year-old Caucasian female with no past medical

history presents with one week of easy bruising and

increasing “red spots” on her arms and chest. She does

not recall any history of trauma that may have lead to

the bruises. She denies any fever or chills. She has no

history of bleeding problems and underwent dental

procedures last year without any complications. On

review of systems, she had vague left abdominal pain over

the past week and 3 days of right ear pain that was

recently treated with cefuroxamine as directed by her

primary care doctor. Family history is …