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Articles 331 - 360 of 14489

Full-Text Articles in Medical Education

Capturing Patient-Centered Quality Of Life: Usability And Initial Validation Of The Pediatric Patient-Generated Index Following Esophageal Atresia Repair, Zanib Nafees, Julia Ferreira, Elena Guadagno, Nikki Ow, Nancy Mayo, Jean-Martin Laberge, Dan Poenaru Apr 2026

Capturing Patient-Centered Quality Of Life: Usability And Initial Validation Of The Pediatric Patient-Generated Index Following Esophageal Atresia Repair, Zanib Nafees, Julia Ferreira, Elena Guadagno, Nikki Ow, Nancy Mayo, Jean-Martin Laberge, Dan Poenaru

Patient Experience Journal

The Patient-Generated Index (PGI) is an individualized measure that allows patients to define the domains most important to their quality of life (QoL). This study evaluates the usability and preliminary validity of the pediatric Patient-Generated Index (pPGI) in children who previously underwent esophageal atresia (EA) repair. We conducted a mixed-methods study including the pPGI, EuroQol-5D-Youth (EQ-5D-Y), and PROMIS Life Satisfaction Short Form-8a. Children aged 7–17 years completed self-reports, while parents served as proxies for younger children. Cognitive interviews explored how children understood and completed the pPGI, and clinician interviews assessed clinical usability. Among 25 participants, the pPGI generated 104 text …

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Preventing Delirium After Surgery: A Qualitative Study Of Patients, Caregivers, And Providers, Jennifer O'Brien, Maria Cruz, Heather Dyck, Hassan Yassin, Una Goncin, Lei Xia, Huma Aftab, Lilian Thorpe, Peter Hedlin Apr 2026

Preventing Delirium After Surgery: A Qualitative Study Of Patients, Caregivers, And Providers, Jennifer O'Brien, Maria Cruz, Heather Dyck, Hassan Yassin, Una Goncin, Lei Xia, Huma Aftab, Lilian Thorpe, Peter Hedlin

Patient Experience Journal

Post-operative delirium is the most common complication in older adults following surgery. Symptoms include agitation, difficulty focusing, sluggishness, hallucinations, slurred speech, restlessness, rapid mood swings, and uncooperative or aggressive behaviour. It can result in longer hospital stays, increased mortality, loss of functional independence, increased need for a higher level of care post-surgery, and an increased risk of readmission to hospital. We aimed to understand and describe the experiences of patients, families, and healthcare providers with postoperative delirium, and to identify targeted initiatives to support patient and family centered care for high-risk patients. We conducted a qualitative descriptive study using interviews …

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Beliefs Regarding Patient Experience In The Emergency Department Among Individuals With Sickle Cell Disease, Elizabeth A. Ibiloye, Gloria N. Odonkor, Ayobami A. Aiyeolemi, Jamie C. Barner, Carolyn M. Brown, Hyeun Ah Kang, Benita A. Bamgbade Apr 2026

Beliefs Regarding Patient Experience In The Emergency Department Among Individuals With Sickle Cell Disease, Elizabeth A. Ibiloye, Gloria N. Odonkor, Ayobami A. Aiyeolemi, Jamie C. Barner, Carolyn M. Brown, Hyeun Ah Kang, Benita A. Bamgbade

Patient Experience Journal

Individuals with sickle cell disease (SCD) frequently experience intense, unanticipated pain episodes known as vaso-occlusive events (VOEs), which often require emergency department (ED) treatment. However, they often report suboptimal experiences in the ED. Using the Theory of Planned Behavior (TPB), this study aimed to elicit salient beliefs regarding SCD patient experience in the ED. Three virtual focus group sessions were conducted with individuals with SCD recruited through a Texas SCD Association and Rare Patient Voice. Nine open-ended questions were used to elicit participants' behavioral, normative, and control beliefs regarding ED use when experiencing VOEs. Qualitative analysis was performed using a …

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The Voices I Never Heard: Reflections From A Public Health Advocate On Representation, Silence, And Struggle, Araya Gautam Apr 2026

The Voices I Never Heard: Reflections From A Public Health Advocate On Representation, Silence, And Struggle, Araya Gautam

Patient Experience Journal

Representation of ethnic minorities among trial participants in the UK is poor. It is true that the need for diversity and inclusive language is important in research, but the practicality of making this a reality for patients from under-represented groups has not generally been the case. As a patient advocate, I have been a participant in clinical trial reviews and advisory boards during the past three years and have engaged in a national-level conversation about patient voice and equity. I draw connections between structured frameworks for patient and public involvement (PPI) in the UK and the more informal, community-based caregiving …

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The Quiet End Of The Visit, Avinav Biswas Apr 2026

The Quiet End Of The Visit, Avinav Biswas

Patient Experience Journal

Reassuring language is a common and often well-intentioned feature of clinical encounters, frequently used to convey clinical confidence and bring visits to a close. This personal narrative reflects on an observed outpatient encounter during a physician shadowing experience in which reassurance appeared to function not only as comfort, but also as an implicit signal of conversational closure. From the perspective of a student observer, the piece describes a moment of patient hesitation that arose after reassurance was offered, then quietly disappeared as the visit concluded. Although the encounter was clinically appropriate and efficient, the unspoken pause highlighted how uncertainty can …

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Navigating Medical Ambiguity: A Patient's Perspective On Communication, Timing, And Risk, J. Hansen Apr 2026

Navigating Medical Ambiguity: A Patient's Perspective On Communication, Timing, And Risk, J. Hansen

Patient Experience Journal

This essay recounts the experience of navigating re-vaccination decisions after an initial diagnosis of vaccine-associated myocarditis. A diagnosis later contested by other specialists. It is not a tale of medical error, but of diagnostic ambiguity and divergent clinical reasoning. My intent is to show how, in the absence of consensus, a patient was compelled to assume a central role in adjudicating between competing medical narratives. Recommendations are offered to make medical advice more available to patients and bridge a growing gap between medicine and the public.

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Human Experience, The Boarding Crisis, And Moral Injury-A Call To Action, Thom Mayer, Wendy Dean Apr 2026

Human Experience, The Boarding Crisis, And Moral Injury-A Call To Action, Thom Mayer, Wendy Dean

Patient Experience Journal

Patient experience has evolved to a broader definition of human experience, including workforce experience, and community experience. Hospital boarding is a common, pervasive problem facing healthcare, which threatens all levels of human experience, from patient experience, to workforce experience (moral injury and burnout in healthcare professionals), and community experience (delayed and denied access to care for patients, Emergency Medical Services, and even interhospital transfers. Effective system leadership across the systems and processes of healthcare, as well as stakeholder and boundary management, will be essential to deliver acceptable human experience, in addition to solutions to smooth surgical flow, improve discharge systems, …

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Human Experience: A Catalyst For Global Connection, Jason A. Wolf Apr 2026

Human Experience: A Catalyst For Global Connection, Jason A. Wolf

Patient Experience Journal

As I think about the state of play in our world today, I find we have two choices in how we react. One is with a sense of despair driven by the intentional efforts to disconnect humanity being perpetuated by some. The other, with a sense of hope, that even in the face of these forces, there are those that strive relentlessly to foster connection and opportunity. I find the path forward in holding the tension of pragmatic idealism – that we can dream, with big and noble goals, while recognizing our path forward must be grounded in practical and …

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Diagnostic Overlap In Hus: An Atypical Case, Ryan Daily, Med, Do, Andrea Roast, Md Apr 2026

Diagnostic Overlap In Hus: An Atypical Case, Ryan Daily, Med, Do, Andrea Roast, Md

Books, Presentations, Posters, Etc.

Introduction: Atypical HUS (aHUS) is a rare type of Thrombotic Microangiopathy distinguished by complement dysregulation and overall clinical progression. We present a diagnostically ambiguous case with early intervention that preserved end-organ function with discussion of future pregnancy implications. Case Presentation: A 36yo F (G2P1) with hypothyroidism, Small Intestinal Bacterial Overgrowth (SIBO), and intermittent urticarial rashes presented with fever, abdominal pain, and 3 days of bloody diarrhea. Discussion: This case highlights an atypical presentation of aHUS with diarrheal prodrome and normal complement function, features that typically suggest Shiga toxin–mediated HUS. We saw clinical change after admission, allowing real-time monitoring. Maintaining a …

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Optimizing Behavioral Health Integration In Primary Care Through A Targeted Didactic, Ravneet Dhaliwal, M.A., Behavioral Health Intern, Joshua Morris Apr 2026

Optimizing Behavioral Health Integration In Primary Care Through A Targeted Didactic, Ravneet Dhaliwal, M.A., Behavioral Health Intern, Joshua Morris

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Background: The integration of behavioral health into primary care settings is an essential strategy for improving patient outcomes, increasing access to mental health services, and achieving the Triple Aim of healthcare.1, 2 To maximize this integration and bridge the gap for primary care providers (PCPs), targeted didactic training and continued education are pivotal. National surveys indicate that PCPs often report low comfort levels in managing psychological concerns due to a lack of formal training, despite the high prevalence of these issues in primary care. 3, 4 Brief didactics facilitated by embedded behavioral health psychologists offer an accessible, adaptable method for …

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Raising The Barb: Evaluation Of Phenobarbital Use For Alcohol Withdrawal In Patients On General Medicine Floors, Seth Arakawa, Jason Frederick, Anthony Le Apr 2026

Raising The Barb: Evaluation Of Phenobarbital Use For Alcohol Withdrawal In Patients On General Medicine Floors, Seth Arakawa, Jason Frederick, Anthony Le

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Abstract: Alcohol withdrawal syndrome (AWS) can present as a spectrum of symptoms such as a mild headache, gastrointestinal issues, and diaphoresis. However, if not treated properly, it can progress to severe hallucinations, seizures, or delirium tremens. Current guidelines from the American Society of Addiction Medicine (ASAM) recommend benzodiazepines as first line agents for alcohol withdrawal with phenobarbital recommended as an adjunct agent or replacement to benzodiazepines by providers who are familiar with its use. Although most evidence supporting phenobarbital in AWS comes from critical care settings, emerging data suggest it may also be safe and effective in general ward patients. …

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A Rare And Fatal Complication Of Herpes Simplex Virus (Hsv) Infection, Natalie Bolton, Jeffrey Youker Apr 2026

A Rare And Fatal Complication Of Herpes Simplex Virus (Hsv) Infection, Natalie Bolton, Jeffrey Youker

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Introduction: Hemophagocytic Lymphohistiocytosis (HLH) is a rare syndrome characterized by overactive immune activation, cytokine storm, and uncontrolled hemophagocytosis. Primary HLH is familial and most often seen in infants, whereas secondary HLH occurs more frequently in adults and is triggered by infections, malignancies, or autoimmune disorders. Clinically, secondary HLH often mimics sepsis but fails to respond to standard therapies, contributing to delayed diagnosis and treatment. Without timely intervention, HLH can result in extensive tissue damage, multiorgan failure, and death. In rare cases, central nervous system (CNS) involvement may occur, manifesting as histiocytic infiltration that can be misinterpreted as malignancy or infection. …

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Behavior Change In A Young Woman: The Secret Lies In The Ovarian Tumor, Matthew Moritz, Md, Linh Tang Taylor, Md, Olivia L Snir, Stephanie Griffith, Md Apr 2026

Behavior Change In A Young Woman: The Secret Lies In The Ovarian Tumor, Matthew Moritz, Md, Linh Tang Taylor, Md, Olivia L Snir, Stephanie Griffith, Md

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Introduction: Autoimmune encephalitis is a rare immune-mediated disorder characterized by neuropsychiatric symptoms. Anti-NMDA receptor (NMDA-R) encephalitis, the most common subtype, affects approximately 1 in 1.5 million people annually. We present a case of a young female with new-onset hallucinations, behavioral changes, and personality disturbance. Case Presentation: A 32-year-old female with remote methamphetamine use and recent trauma presented with acute mental status changes, aggression, emotional lability, and hallucinations. Vitals were normal; on exam she appeared confused, agitated, and displayed unusual behavior, including hallucinations. Initial evaluation revealed mild leukocytosis, but otherwise normal urine drug screen, chest radiograph, TSH, ANA, VDRL, heavy metal …

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Cloudy Consequences: Exploring Vaping-Induced Pulmonary Alveolar Proteinosis, Jennifer Wong, Do, Omar Pandhair, Abby Lindseth, Md, Cameron Miles Long, Md Apr 2026

Cloudy Consequences: Exploring Vaping-Induced Pulmonary Alveolar Proteinosis, Jennifer Wong, Do, Omar Pandhair, Abby Lindseth, Md, Cameron Miles Long, Md

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Abstract: Pulmonary alveolar proteinosis (PAP) is a rare disease caused by abnormal accumulation of surfactant within alveoli. Vaping of electronic cigarette smoke has recently been described as a cause of pulmonary alveolar proteinosis in two case reports. We add to this rare literature by describing a case of pulmonary alveolar proteinosis induced from vaping in a young woman with confirmed granulocyte/macrophage colony-stimulating factor (GM-CSF) autoantibodies as the proposed mechanism. Introduction: Pulmonary alveolar proteinosis (PAP) results from inappropriate accumulation of pulmonary alveolar surfactant due to dysregulated granulocyte/ macrophage colony-stimulating factor (GM-CSF) signaling.1 Its incidence is approximately 0.2 cases per million with …

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Ecmo As A Bridge To Lung Transplant For Refractory Rapidly Progressive Interstitial Lung Disease, Matthew Moritz, Omar Pandhair Apr 2026

Ecmo As A Bridge To Lung Transplant For Refractory Rapidly Progressive Interstitial Lung Disease, Matthew Moritz, Omar Pandhair

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Anti-melanoma differentiation-associated gene 5 (MDA-5) antibody is most frequently associated with dermatomyositis with various degrees of clinical manifestations including rapidly progressive interstitial lung disease (RP-ILD), inflammatory arthritis, vasculopathy, and other cutaneous findings. Clinically amyopathic dermatomyositis (CADM) is frequently associated with RP-ILD and has high mortality rates. Here we present a case of anti-MDA5 associated RPILD but without other features of dermatomyositis that did not respond to standard immunosuppressive therapy. A 41-year-old woman with recently diagnosed interstitial lung disease and polyarthritis previously on methotrexate presented with progressive dyspnea and worsening hypoxemic respiratory failure. She was previously admitted for respiratory failure two …

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Evaluating Outcomes Of Long-Acting Injectable Antiretrovirals For Hiv Treatment And Pre-Exposure Prophylaxis In A Pharmacist-Managed Clinic Setting, Kaitlin Repass, Pharmd, Melissa Yokoyama, Pharmd, Farnaz Khoshnahad, Pharmd, Bcacp, Char Hunt, Pharmd, Ms, Bcacp Apr 2026

Evaluating Outcomes Of Long-Acting Injectable Antiretrovirals For Hiv Treatment And Pre-Exposure Prophylaxis In A Pharmacist-Managed Clinic Setting, Kaitlin Repass, Pharmd, Melissa Yokoyama, Pharmd, Farnaz Khoshnahad, Pharmd, Bcacp, Char Hunt, Pharmd, Ms, Bcacp

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No abstract provided.

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Hydroxocobalamin In Septic Shock Management – Should It Be Introduced Sooner?, Linh Tang Taylor, Md, Cameron Miles Long, Md, Omar Pandhair Apr 2026

Hydroxocobalamin In Septic Shock Management – Should It Be Introduced Sooner?, Linh Tang Taylor, Md, Cameron Miles Long, Md, Omar Pandhair

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Introduction: Treating sepsis involves timely antibiotics, adequate fluid resuscitation, and vasopressor support if shock develops. Plasma concentrations of nitric oxide and hydrogen sulfides are elevated in early sepsis, contributing to vasoplegia,1 a pathology that isn’t addressed by vasopressors. High-dose hydroxocobalamin (vitamin B12) does, and therefore, has long been explored as a potential adjunct to vasopressors, though no consensus or official guidelines for its use have been published. Case Report: A 26-year-old man who was diagnosed with acute myeloid leukemia a few months prior presented to the emergency room for fever, weakness, and emesis. He was found to be profoundly hypotensive …

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Hypercalcemic Crisis After Open Mitral Valve Replacement, Andrew Sunwood, Do, Jason Heino Apr 2026

Hypercalcemic Crisis After Open Mitral Valve Replacement, Andrew Sunwood, Do, Jason Heino

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59. Hypercalcemic Crisis After Open Mitral Valve Replacement Andrew Sunwood, DO Background: Hypercalcemic crisis is a rare manifestation of primary hyperparathyroidism characterized by a sudden increase in serum calcium levels to >14 mg/dL with symptoms of hypercalcemia including adverse gastrointestinal symptoms, abdominal pain, and even predisposition to cardiac arrhythmias. There is only one other documented case of hypercalcemic crisis occurring after open heart surgery. Case information: 69-year-old female with a history of primary osteoporosis on alendronate and valvular heart failure presented for mitral valve replacement. Preoperative lab work did not show evidence of electrolyte abnormalities. She under- went open bioprosthetic …

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A Case Of Pembrolizumab Associated Sjs/Ten Spectrum Reaction, Lauryn Orsillo, Do, Alex Zhu, Md, Linh Tang Taylor, Md Apr 2026

A Case Of Pembrolizumab Associated Sjs/Ten Spectrum Reaction, Lauryn Orsillo, Do, Alex Zhu, Md, Linh Tang Taylor, Md

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Introduction: Immune checkpoint inhibitors (ICIs), such as pembrolizumab, are becoming increasingly more common.1 They are associated with a variety of cutaneous immune-related adverse events which can range from drug eruptions to life-threatening Stevens–Johnson syndrome (SJS)/ toxic epidermal necrolysis (TEN) spectrum reactions.2 As use of these ICIs and PD1 inhibitors expands, the incidence of severe dermatologic toxicity can be expected to rise. Early recognition is critical, as SJS/TEN spectrum reactions carry substantial morbidity and mortality compared with drug eruptions. Case report: An 80-year-old female with a history of triple-negative breast cancer on pembrolizumab presented to the ED for evaluation of a …

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Implementation And Impact Of The Transition Series For Senior Residents In Internal Medicine Residency, Abby Lindseth, Md, Jeffrey Youker Apr 2026

Implementation And Impact Of The Transition Series For Senior Residents In Internal Medicine Residency, Abby Lindseth, Md, Jeffrey Youker

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The transition from medical student to intern is widely recognized as a challenging period, and numerous curricula have been developed to support this transition. However, the transition from intern to senior resident receives far less attention despite presenting its own unique challenges. Anecdotal feedback from internal medicine residents and emerging literature suggests that the transition to senior resident is associated with feeling emotionally overwhelmed from simultaneously being a learner, leader and educator.1,2 To address this gap, the Transition Series was developed as a novel curriculum to support internal medicine residents as they advance into their senior roles. Building on the …

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Phenazopyridine-Induced Sulfhemoglobinemia: A Diagnostic And Management Dilemma, Natalie Bolton, Md, Linh Tang Taylor, Md, Kristy Poonyagarlyagorn, Md, Cameron Long, Md Apr 2026

Phenazopyridine-Induced Sulfhemoglobinemia: A Diagnostic And Management Dilemma, Natalie Bolton, Md, Linh Tang Taylor, Md, Kristy Poonyagarlyagorn, Md, Cameron Long, Md

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Introduction: Sulfhemoglobinemia is a rare dyshemoglobinemia which occurs when sulfur irreversibly binds to hemoglobin. Presents similarly to methemoglobinemia. Common offending medications: dapsone, acetanilide, phenacetin, and nitrates. Rarely observed secondary to phenazopyridine, an over-the counter medication used to treat dysuria. Few facilities are capable of testing for sulfhemoglobinemia Case Background: A 67-year-old woman with recurrent urinary tract infections and interstitial cystitis presented with encephalopathy and recurrent falls for three days. PMH: multiple sclerosis, recurrent urinary tract infections, asthma, neurogenic bladder, neuropathic pain, and obstructive sleep apnea. Chronically on multiple centrally acting medications. Not on medications for multiple sclerosis due to cost. …

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A Fatal ‘Sepsis’: Intravascular Large B-Cell Lymphoma In Disguise, Jennifer L. Wong, Do1, Jared A. Shipley, Md2, Christine Johnson, Md3 Apr 2026

A Fatal ‘Sepsis’: Intravascular Large B-Cell Lymphoma In Disguise, Jennifer L. Wong, Do1, Jared A. Shipley, Md2, Christine Johnson, Md3

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Introduction: Intravascular large B-cell lymphoma (IVLBCL) is a rare, aggressive subtype of non-Hodgkin lymphoma characterized by selective proliferation of neoplastic cells within small vessel lumina. Cases in Western countries more commonly involve the central nervous system or skin, whereas patients in Eastern regions often present with hemophagocytic syndrome or medullary disease. The absence of lymphadenopathy, low circulating tumor burden, and subtlety of morphologic clues contribute to delays in diagnosis. By presentation, most have advanced disease, and a substantial proportion are diagnosed only at autopsy. We report a unique case with mixed features who manifested respiratory involvement and ultimately suffered cardiovascular …

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Pulmonary Pseudomyxoma Peritonei, Hannah Kirk, Do, Omar Pandhair Apr 2026

Pulmonary Pseudomyxoma Peritonei, Hannah Kirk, Do, Omar Pandhair

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Introduction: Pseudomyxoma peritonei (PMP) is an intra -abdominal cancer occurring in one to four out of one million patients. It begins as a mucinous adenocarcinoma of the appendix that implants on other peritoneal surfaces, spreading into gelatinous ascites. Treatment consists of hyperthermic intraperitoneal chemotherapy (HIPEC) and cytoreductive surgery (CRS). Extra -abdominal metastases are rare. We present the case of a patient who underwent treatment for PMP and was found to have lung nodules over a decade later. Case Presentation: A 73 -year -old woman with pseudomyxoma peritonei presented to the emergency department with progressive dyspnea and unintentional weight loss. Twenty …

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Puzzling Papules: Uncovering The Etiology Of A Rash In A Returning Traveler, Lisa Stampke, Md, Shahana Baig-Lewis, Md Apr 2026

Puzzling Papules: Uncovering The Etiology Of A Rash In A Returning Traveler, Lisa Stampke, Md, Shahana Baig-Lewis, Md

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Introduction: There are an estimated 1.8 billion people that travel internationally every year [1]. Approximately 22-64% of those acquire an infectious disease during or after returning home that is not endemic to their home country [1]. This is especially concerning in our current political climate and declining vaccination rates in the United States which places more patients at risk for preventable diseases [2]. These factors present a unique challenge in diagnosing and treating a symptomatic returning traveler. Case Description: A 25-year-old incompletely vaccinated male returned from Kenya after volunteering for 5-weeks in a rural hospital. He was in his usual …

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Efficiency Rx: Emr Training For Resident Wellness, Calder Dorn, Do, Tom Chau, Md, Mba, Facp, Shelley Schoepflin Sanders, Md, Facp Apr 2026

Efficiency Rx: Emr Training For Resident Wellness, Calder Dorn, Do, Tom Chau, Md, Mba, Facp, Shelley Schoepflin Sanders, Md, Facp

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Introduction: Physician burnout affects nearly 60% of physicians during their careers, leading to increased medical errors, reduced care quality, higher turnover, and lower patient satisfaction. ii. The widespread use of Electronic Medical Records (EMRs) has been identified as a key contributor, with poor usability, inbox overload, and documentation burden reducing direct patient interaction among cited factors iii. Institutions like UCHealth, OHSU, CHOP, and Mayo Clinic have implemented strategies that improved EMR confidence and reduced burnout vi. While Providence offers training to all providers, there are no initiatives specifically targeted to internal medicine (IM) residents. Methods: Providence St. Vincent Medical Center …

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Snuggles, Not Struggles: Evaluation Of A Post-Operative Pain Management Protocol In A Level Iii Community Nicu, Maleane Chin, Danielle Megano, Aiyana Ooki-Knutson, Deasy Erin Wilson Apr 2026

Snuggles, Not Struggles: Evaluation Of A Post-Operative Pain Management Protocol In A Level Iii Community Nicu, Maleane Chin, Danielle Megano, Aiyana Ooki-Knutson, Deasy Erin Wilson

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Abstract: Neonates are an extremely sensitive population often subject to painful interventions. This pain can have numerous adverse effects including physiologic instability, altered brain development, and abnormal stress responses, which can persist into childhood. Effective post-operative pain management for neonates is crucial for promoting positive developmental outcomes. No specific post-operative pain protocol for neonatal patients has shown to be most effective, so the American Academy of Pediatrics recommends that healthcare institutions establish a neonatal pain protocol to provide more standardized care. This project is a retrospective, single center observational study determined to be exempt by the institutional review board. Infants …

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The Rash After The Remedy, Elaine Chen, Md Apr 2026

The Rash After The Remedy, Elaine Chen, Md

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Introduction: Trimethoprim/sulfamethoxazole (TMP/SMX) is a widely prescribed and generally well-tolerated antibiotic. Cutaneous reactions occur in up to 4% of patients, including morbilliform rash, urticaria, DRESS, Stevens-Johnson syndrome, and toxic epidermal necrolysis. More rarely, TMP/SMX can trigger leukocytoclastic vasculitis (LCV), a small-vessel vasculitis characterized by neutrophilic infiltration, fibrinoid necrosis, and leukocytoclasia. LCV typically manifests as palpable purpura on dependent areas. While often skin-limited, systemic involvement may occur. We present a case of TMP/SMX-induced LCV with multi-organ features. Case description: A 53-year-old healthy male presented to urgent care with dysuria. Urine culture grew pan-sensitive E. coli, and he completed a 7-day course …

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Hepatic Schistosomiasis: An Unexpected Culprit Behind The Hepatic Mass, Jin Yun Do, Udip Dahal Md, Kenneth Flora, Md Apr 2026

Hepatic Schistosomiasis: An Unexpected Culprit Behind The Hepatic Mass, Jin Yun Do, Udip Dahal Md, Kenneth Flora, Md

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Introduction: Schistosomiasis is the second most common parasitic infection worldwide and is associated with significant morbidity and mortality. We present an unusual case of hepatic schistosomiasis presenting as a hepatic mass. Case Description: A 78-year-old male with no prior hepatobiliary disease with an incidental finding of a hepatic lesion on postoperative abdominal CT imaging after an endovascular aneurysm repair. He lived in China until immigrating to the United States over 50 years ago. Previously hospitalized for abdominal pain and diarrhea, at which time he was told he had an infection in his liver. Details of treatment are unknown. He has …

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When Common Isn’T Typical: A Diagnostic Twist In Hyperparathyroidism, Connor Shortt, Do*, Laura Loertscher, Md* Apr 2026

When Common Isn’T Typical: A Diagnostic Twist In Hyperparathyroidism, Connor Shortt, Do*, Laura Loertscher, Md*

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Introduction: Primary hyperparathyroidism is the third most common endocrine disorder, following diabetes and thyroid disease. It is characterized by excess calcium and inappropriately elevated parathyroid (PTH) levels. Severe disease classically presents with a combination of nephrolithiasis, bone pain, osteoporosis, constipation, abdominal pain, anxiety, depression, or confusion. However, due to the availability of routine labs, most cases now present as asymptomatic hypercalcemia. Case Description: A 60-year-old female was evaluated for falls, generalized weakness, constipation, and brain fog. Her admission labs revealed a calcium of 19.6 mg/dL and subsequent PTH of 1,932 pg/mL. She was treated with intravenous fluids, pamidronate, and cinacalcet, …

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Eosinophilic Fasciitis Masquerading As Myositis: A Diagnostic Challenge, Jennifer L. Wong, Do, Elizabeth S. Ballner, Do, Mary Elizabeth Swift-Taylor Apr 2026

Eosinophilic Fasciitis Masquerading As Myositis: A Diagnostic Challenge, Jennifer L. Wong, Do, Elizabeth S. Ballner, Do, Mary Elizabeth Swift-Taylor

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Introduction: Eosinophilic fasciitis (EF), or Shulman’s disease, is a rare disorder of unknown etiology and poorly understood pathogenesis. It is characterized by fibroblast activation and interleukin-driven eosinophilia. Early clinical features include limb or trunk erythema, non-pitting edema, and progressive fascial thickening, often producing an “orange peel” appearance. Eosinophilia is a prominent laboratory finding in the early phase, but diagnosis often requires a full-thickness skin-to-muscle biopsy. Systemic corticosteroids are first-line therapy, with methotrexate as the steroid -sparing agent for refractory disease. We present a unique and diagnostically challenging case of EF confirmed by histopathology. Case Presentation: A 56-year-old man presented with …

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