Medical Specialties Commons^™

Laryngeal Tuberculosis Mimicking Laryngeal Candidiasis, Claire Walters, Maranda Saigh, Eytan Keidar

Posters

Tuberculosis (TB) from the bacterium Mycobacterium tuberculosis and candidiasis from the fungus Candida albicans are both opportunistic pathogens with the ability to instigate infections within the larynx with similar clinical features, yet vastly different diagnostic parameters and treatment regimens.

Here, we highlight a case of an Indian woman on immune-modulating drugs who presented with severe laryngeal symptoms initially presumed to be laryngeal candidiasis but was later discovered to be laryngeal tuberculosis.

Failed Medial Column Fusion Due To Subtalar Joint Instability, Travis Rich, Randy Semma, Michele Bertelle-Semma

Posters

CNA is a destructive complication affecting the bone and joint structure, most often in diabetics w/ longstanding peripheral neuropathy.

High incidence of major amputation associated with Charcot foot.

Stepping Into Relief: Conquering Rheumatoid Arthritic Foot Pain With Podiatric Management, Natalie Diaz, Marshall Solomon, Inocencio Cuesta

Posters

Rheumatoid arthritis (RA) is a chronic multifactorial autoimmune disease that causes progressive joint destruction along with causing cutaneous manifestations such as nodules. RA negatively impacts life by producing pain, impairing quality of life and biomechanical function of the lower extremities.

Kaposi Sarcoma Case Study, Mohamed Elshebiny, Marshall G. Solomon

Posters

No abstract provided.

Jamestown Canyon Virus Meningoencephalitis: A Case Report, Amy Ishbia, Hannah Guide, Matthew Sierra, Jonathan Doty

Posters

Jamestown Canyon virus is a rare mosquito-borne orthobunyavirus that typically is asymptomatic or causes mild symptoms. However, it can rarely cause severe neuroinvasive disease [2,5]. The primary hosts include white-tailed deer, although moose, elk, and bison can also be hosts [2].

Typically, cases are seen between April and September, with a bimodal distribution peaking in spring and late summer [2].

Number of cases in the U.S. in 2024: 16 total cases, 11 neuroinvasive [1]. Number of cases in the U.S. between 2011-2023: 308, with 10 deaths, 206 neuroinvasive. One case was reported from Alpena, MI, where our patient resided [1].

Cd21 Stains Dendritic Networks In Tertiary Lymphoid Structure Of Transplant Renal Biopsies To Avoid Misdiagnosis Of Borderline Changes, Brandon D. Metcalf, Wei Li, Hassan Kanaan, Ping L. Zhang

Posters

Tertiary Lymphoid Structures (TLS) have been described as germinal center-like lymphoid structures composed dendritic network, mixed lymphocytes and high endothelial venules in internal organs following primary lymphoid organs (thymus and spleen) and secondary lymphoid structures (lymph nodes and native lymphoid structures along GI tract).

The TLS is mainly located at peri-glomeruli, peri-vascular areas or renal pelvis following inflammatory insults. A recent study indicates that TLS can been seen up to 19 % of protocol transplant renal biopsies (TRB) (JASN, 2022;33:186-200).

We hypothesize that CD21 staining can identify dendritic cells of TLS so that borderline changes are not over-diagnosed.

Pyogenic Tenosynovitis Of Tibialis Anterior Tendon After Cat Bite, Daniel Blascak, David Sosnoski, Aaron Seidman

Posters

Pyogenic tenosynovitis is a bacterial infection of the synovial sheath that surrounds a tendon.

Commonly occurs within flexor tendons of the hand; theoretically can occur within any sheathed tendon.

Delayed diagnosis may lead to spread of infection to surrounding tissues and tendon rupture.

Tibialis anterior tendon is encased in a synovial sheath that runs from above the superior extensor retinaculum to the talonavicular joint.

Only five cases of pyogenic tenosynovitis of the tibialis anterior tendon have been reported in the literature.

None of the reported cases were due to animal bite injury.

Provider Perceptions Of Pediatric Obesity Management In The Primary Care Setting, Rina Edelson

Conference Presentation Abstracts

Background: Childhood obesity is a critical public health issue. The primary care setting provides an accessible avenue for management. However, primary care physicians report significant barriers to success in treating this condition.

Objective: The purpose of this study was to compare clinician perception of pediatric overweight and obesity management before and after implementation of a standardized treatment protocol based on the clinical practice guidelines released by the American Academy of Pediatrics in January 2023.

Design/Methods: This study was deemed exempt by the Institutional Review Board. A survey was created by the study team to assess 5 domains: disease knowledge, current …

Examining The Rate Of Failed Hearing Tests In Children >15 Months Of Age Who Are Referred To Speech Therapy: A Retrospective Analysis, Malika Goel, Kerry Mychaliska

Conference Presentation Abstracts

No abstract provided.

Nsaids Role In Triggering Ibd Exacerbations; Reality Or Misunderstanding? A Systematic Review, Alec Swartz, Malitha Hettiarachchi

Conference Presentation Abstracts

Introduction: Initial studies seemed to show that NSAID use was associated with increased risk of IBD exacerbation. Supported by known role of COX-1/2 isoenzymes (specifically their prostaglandin [PG] products) in maintaining GI mucosal barrier and mediating inflammation Combination of early research findings and COX prostaglandin knowledge resulted in NSAID avoidance in IBD patients. Recent data seemingly contradicts prior research, and NSAID use is predicted to not play a role in IBD exacerbation Methods: We conducted a systematic review of the literature using PubMed and American Journal of Gastroenterology. Of the thousands of results, we narrowed our results to 4 recent …

Moonlighting: A Pilot Project To Assess Impact Of Extracurricular Activities On Career Satisfaction And Quality-Of-Life In Graduate Medical Education, Charlotte O'Sullivan, David Lee, Karen Childers, Justine Nasr

Conference Presentation Abstracts

Background: Moonlighting is the delivery of healthcare outside of training programs in exchange for compensation. The Accreditation Council on Graduate Medical Education allows individual training programs to permit or restrict moonlighting, which leads to variation in prevalence and practice. Guidelines and regulations for moonlighting vary greatly across graduate medical education programs. Yet, limited research has been done to determine resident and fellow physician attitudes towards moonlighting and its impact on quality-of-life. Objective: This pilot study investigates how participating in moonlighting and extracurricular activities may impact resident and fellow physicians’ self-perceptions of quality-of-life and career satisfaction. Methods: 442 residents and fellow …

Amniotic Bladder Therapy For Treating Interstitial Cystitis/Bladder Pain Syndrome: A 6 Month Follow Up, Jack Considine, Codrut Radoiu, Sophie Wittenberg, Nivedita Dhar, Raghav Madan, Jack Vercnocke, Aron Liaw, Alaa Hamada

Conference Presentation Abstracts

Introduction: Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) is a debilitating condition marked by chronic pelvic pain and concurrent lower urinary tract symptoms. Our prior research established the efficacy of Amniotic Bladder Therapy (ABT) in offering symptomatic relief to refractory IC/BPS patients for a duration of up to 3 months. This study aims to delve into the durability of ABT, examining its effects over a more extended period, specifically up to 6 months. Materials and Methods: Consecutive IC/BPS patients participated in the study, receiving intra-detrusor injections of 100mg micronized amniotic membrane. Comprehensive clinical evaluations were complemented by patient reported outcome measures, encompassing …

Navigating Clinical Uncertainty: A Convergence Of Hiv, Positive Ana, And Genetic Cardiomyopathy, Ioannis Karageorgiou, Nicolaas Schimmel, Phillip Marchese, Tawhida Khatoon

Conference Presentation Abstracts

We present a case involving a 36-year-old male with a complex medical history, including hypertension, hyperlipidemia, cerebrovascular accident (CVA), and Hypertrophic Obstructive Cardiomyopathy (HOCM). The patient presented with a week-long history of chest, lower extremity, and back pain, tingling, and a history of recurrent falls. The initial presentation, combined with his history of ICD placement in 2019, led to investigations for Acute Coronary Syndrome (ACS) and ICD malfunction. The patient's initial laboratory workup, which included a comprehensive drug screen, was unremarkable except for mild normocytic anemia and elevated protein levels. CT scans of the head and spine and X-rays of …

Has Colon Cancer Screening Guidelines Reduced Mortality Associated With Colon Cancer?, Sumit Gami, Rakesh Shah, Malitha Hettiarachchi

Conference Presentation Abstracts

Introduction Colorectal cancer (CRC) is a major public health concern worldwide, with high incidence and mortality rates. Globally, CRC is the third most commonly diagnosed cancer in males and the second in females, according to the World Health Organization GLOBOCAN database. The primary goal of CRC screening is to prevent mortality and morbidity from the disease. USPSTF screening recommendations for colorectal cancer, May 18, 2021: Screen all adults 45 to 75 years of age. Recommended screening strategies include: High-sensitivity guaiac fecal occult blood test (HSgFOBT) or fecal immunochemical test (FIT) every year or Stool DNA-FIT every 1 to 3 years …

Not-So-Typical Neurologic Effects: Unraveling Lithium Toxicity, Alexsandra Biel, Vickie Xin, Mujtaba Moazzam, Ramona Berghea

Conference Presentation Abstracts

Introduction: Lithium is one of the mainstay treatments for bipolar disorder. Given its narrow therapeutic window, acute and chronic toxicity can develop. Acute toxicity includes gastrointestinal and cardiac manifestations whereas chronic toxicity manifests as neurologic, thyroid, and renal dysfunction. The therapeutic range of lithium is 0.6 to 1.2 mmol/L. With chronic use, lithium may be toxic at 1.2 mmol/L or greater (1). Neurological toxicity includes tremors, hyperreflexia, nystagmus, ataxia, confusion, and even seizures, however, rare reports have shown peripheral neuropathy as a manifestation. Case: A 40-year-old male with a history of bipolar disorder complicated by lithium induced chronic kidney disease …

Aids Associated Cryptosporidial And Cmv Cholangiopathy, Nada Alsharif, Luxhman Gunaseelan, Mamoun Souleiman, Cecilia Big

Conference Presentation Abstracts

Introduction AIDS-associated cholangiopathy is a biliary tract condition seen in AIDS patients who are severely immunosuppressed, contributing to significant mortality in this population even in developed countries with access to HAART therapy. Case Description We discuss a thirty-six-year-old HIV positive male, non-compliant with HAART therapy, who presented with a one year history of weight loss, persistent fatigue and chronic diarrhea, which had worsened significantly in the past few weeks. Routine laboratory studies on presentation indicated elevated liver enzymes and alkaline phosphatase, a CD4 count of two, and a high HIV RNA count of 8.8 million. Imaging via CT abdomen and …

Streptococcus Pneumoniae Neck Abscess In A Patient With Waldenstrom's Macroglobulnemia, Tanya Amal, Paul Johnson, Ayesha Sharif

Conference Presentation Abstracts

Patients with Waldenstrom's macroglobulinemia/lymphoplasmacytic lymphoma are at increased risk of sinopulmonary infections, pyelonephritis, and septicemia. The underlying etiology is assumed to be immune dysregulation. Patient's with Waldenstrom's macroglobulinemia have been shown to have somatic mutations in the "V". "D" and "J/H' segments of immunoglobulin gene. These mutations can affect affinity maturation and formation of memory B cells. Subsequently patient's with Waldenstrom's macroglobulinemia also have a suboptimal response to vaccination against Staphylococcus aureus, Streptococcus pneumoniae and Varicella, similar to those with multiple myeloma. Severe infections with gram positive organisms causing multifocal osteomyelitis, pleural effusion and sepsis have also been reported with …

Double Trouble Unmasked: Femoral Pseudoaneurysm And Deep Venous Thromboses Following Coronary Angiography, Mariam Jamil, Antoine Egbe, Khurram Arshad, Yazan Alamro, Essa Kadiri

Conference Presentation Abstracts

Iatrogenic pseudoaneurysms, while infrequent, represent a formidable complication of interventional cardiac catheterization, particularly in cases involving femoral artery access. This report details a unique case involving a 73-year-old male, receiving warfarin for a mechanical aortic valve, who developed a substantial right groin hematoma attributed to an iatrogenic pseudoaneurysm post-cardiac catheterization, subsequently resulting in concomitant deep venous thromboses (DVTs) in the right leg. The pathophysiology of DVTs following left heart catheterization typically involves the formation of a sizable pseudoaneurysm, exerting pressure on adjacent veins, leading to blood pooling and subsequent clot formation. Alternatively, the development of large hematomas in the thigh …

Effect Of Iv Iron-Carbohydrate Supplement On Morbidity And Mortality In Patients With Heart Failure, Yousef Alsmairat, Malitha Hettiarachchi

Conference Presentation Abstracts

Objectives: To study the effect of intravenous iron on morbidity and mortality in hospitalized patients with heart failure with reduced ejection fraction. The current European Society of Cardiology's 2021 heart failure guidelines recommend the consideration of Ferric Carboxymaltose in symptomatic patients with a left ventricular ejection fraction < 45%. Methods and results: We conducted a systematic review using articles published in PubMed and EMBASE databases. The number of records first identified was 263. The study only reviewed Randomized Clinical Trails (RCTs) published in the years 2013-2023 and removed all the duplicates and irrelevant articles using Rayyan.ai tool. The final number of qualified articles that met the study's inclusion criteria was 3, with a total of 2,279 participants. The inclusion criteria for the study included: Age > 18, and heart failure (HF) with left ventricular ejection fraction (LVEF) < 50%. The study showed that intravenous iron supplementation in patients with heart failure and iron deficiency has been proven to reduce the symptoms of heart failure, improve quality of life, increase exercise capacity and skeletal muscle strength. IV iron-carbohydrate therapy significantly reduced hospitalization for worsening heart failure, but did not significantly impact all-cause mortality, compared to control. Conclusion: IV iron-carbohydrate therapy significantly reduced hospitalization for worsening heart failure, but did not significantly impact all-cause mortality, compared to control. Based on the study review, we recommend IV iron therapy for patients with systolic dysfunction heart failure associated with iron deficiency anemia.

How Dry Is Too Dry? Dehydration Management Of Pediatric Patients In The Ed, Shruthi Rethi

Conference Presentation Abstracts

Background: Gastroenteritis and dehydration are some of the leading causes of morbidity within pediatric EDs in the US, with over 1.7 million visits and more than 70,000 hospitalizations. There are many different guidelines/standards on the definition of dehydration. Clinical exam guidance using dehydration scales have been explored (eyes, mucous membranes, and tears). However, use of them in practice is varied.
Electrolyte lab values have not been included in dehydration scales, as a cut off is difficult to determine to guide IV vs oral rehydration, or admission. There can be little overlap between clinical exam and laboratory results. Studies have shown …

The Silent Michigan Epidemic: Unraveling Neurological Changes Posed By Recreational Nitrous Oxide Abuse, Tabssum Chauhan, Mariam Jamil, Nada Alsharif, Antoine Egbe Bessong Tabot, Ammara Aftab, Erin Frankowicz, Rajiv John

Conference Presentation Abstracts

Introduction Nitrous oxide (N2O), traditionally considered a benign, odorless gas with analgesic and anesthetic properties, has seen a rise in abuse among young individuals in the United States. This abuse can lead to clinically significant neurological symptoms, including peripheral neuropathy and subacute combined degeneration of the spinal cord due to functional B12 deficiency induced by N2O. This case series examines four patients with N20 toxicity, and the functional recovery observed during subsequent follow-up visits after appropriate management. We will explore their motivation for abusing N20, their sources of access, and why its use is on the rise. Cases Description: The …

Pituitary Cushing's Disease And Compression Fractures: A Case Presentation, Nora Mcheik, Ajaz Banka

Conference Presentation Abstracts

Introduction: Cushing's disease, arising from a pituitary macroadenoma, is marked by excessive cortisol production. Labs usually signify overproduction of adrenocorticotropic hormone (ACTH), leading to elevated cortisol levels. While cortisol is essential for various physiological functions, its excess can result in various symptoms and complications associated with Cushing's disease. Notably, individuals with this condition may experience an association with compression fractures, particularly in the vertebrae, due to weakened bones. Prolonged exposure to elevated cortisol levels contributes to the development of osteoporosis, characterized by weakened bone density, making fractures more likely. These compression fractures can manifest as localized or radiating back pain, …

A Rare Case Of Primary Sclerosing Pneumocytoma In A Healthy Female, Nitya Batra, Atulya Aman Khosla, Mohammad Muhsin Chisti, Vikash Jaiswal, Ashbita Pokharel

Conference Presentation Abstracts

Introduction: Pulmonary sclerosing pneumocytoma is a rare group of benign pulmonary neoplasms that usually affects older adults over 50 years of age . This neoplasm is more commonly seen in women, with female to male ratio of 5:1 and is predominantly seen in Asian ethnicities. These tumors originate from type II alveolar pneumocytes and are hence classified as adenoma under the 2021 World Health Organization (WHO) classification of tumors . They account for 3-5 percent of total benign lung tumors. One of the striking aspects of PSP is its clinical presentation, or rather the lack thereof in many cases. It …

Myxedema Coma-Induced Heart Failure With Reduced Ejection Fraction: Unraveling The Complex Interplay, Mohammad Ali Mozaffari, Batool Shukr, Hafsa Hassan, Khurram Arshad, Antoine Egbe Bessong Tabot, Mariam Jamil, Rajiv John, Adam Hafeez

Conference Presentation Abstracts

Introduction Myxedema coma is a rare condition with a high mortality rate. It poses the risk of cardiovascular complications, typically affects elderly females, and is often triggered by an underlying infection or systemic illness in the setting of preexisting severe hypothyroidism. Patients may exhibit multiorgan dysfunction with altered mentation ranging from disorientation and lethargy to obtundation and coma. Other physical exam findings may include dry scaly skin, non-pitting edema, delayed reflexes, bradycardia, and hypothermia. Prompt diagnosis and early treatment are crucial to reducing mortality rates associated with this severe condition. Case description A 74-year-old female with no known past medical …

Pleural Epithelioid Hemangioendothelioma: An Ultra Rare Etiology For Recurrent Pleural Effusion, Ali Khreisat, Paul Bozyk

Conference Presentation Abstracts

Introduction Epithelioid hemangioendothelioma (EHE) is an extremely rare sarcoma of vascular origin. EHE has an incidence of less than 0.1 per 100,000 patients per year. It can involve multiple organs; pleural involvement is relatively rare and under-reported in the medical literature. We present a unique case of pleural EHE presenting with recurrent pleural effusion, severe pleuritis, scarring, and trapped lung syndrome. Case presentation A 54-year-old Caucasian female was referred to the pulmonary clinic for two months of progressive dyspnea, fatigue, and right pleuritic chest pain. Initial chest x-ray showed a large right pleural effusion. Thoracentesis identified exudative lymphocyte predominant pleural …

Uterine Leiomyoma: Rare Cause Of Pulmonary Embolism, Pawan Gyawali, Prekchha Jha, Sant K. Yadav, Justin Skrzynski

Conference Presentation Abstracts

Pulmonary embolism is a life-threatening condition that most commonly occurs due to the embolization of deep venous thrombus in the lower limbs, arising from a constellation of risk factors that affect the flow, stasis, or coagulability of blood. Stasis is an important mechanism and is the primary factor in venous obstruction and long-haul flights. We present a case of a young woman who experienced pulmonary embolism due to venous compression in the pelvis from a massive leiomyoma. A 30-year-old female presented to the emergency department with dyspnea and palpitations lasting for a duration of 2 days. She had a past …

Navigating Recurrent Acute In-Stent-Thrombosis: Insights From A Single Admission Case Study, Antoine Egbe Bessong Tabot, Mariam Jamil, Hussein Gaith, Wafa Ahmed, Mohammad Ali Mozaffari, John Rajiv, Essa Kadiri

Conference Presentation Abstracts

In-stent thrombosis (ISR) is one of the dreaded complications of percutaneous coronary angioplasty. Despite marked reductions in ISR since the transition from bare metal stents to drug-eluting stents, ISR still occurs at a rate of 1% -2 % per year. We present the case of a 64-year-old Caucasian male who was admitted for staged angioplasty after a left heart catheterization had shown he had significant stenosis to the LAD and mid ramus intermedius. He had DES placed to the mid-LAD and to the mid-ramus intermedius. Despite being placed on dual antiplatelet therapy after the stent placement, 6 hours later he …

From Collapse To Recovery: Thiamine Intervention In Cardiac Beriberi, Khurram Arshad, Zaid Mahameed, Rabia Latif, Ruaa Elteriefi, Yazan Alamro

Conference Presentation Abstracts

Introduction: Thiamine deficiency, historically known as Beriberi, poses diagnostic dilemmas due to its potential occurrence without overt malnutrition or alcohol dependence. This case report explores the intricate dynamics of cardiocirculatory collapse coupled with pericardial effusion, unveiling an underlying thiamine deficiency. Case Description: A 68-year-old male with a medical history of hypothyroidism, heart failure, and chronic mild pericardial effusion presented with worsening dyspnea, leg edema, and hypotension. The patient's physical evaluation disclosed notable findings, including marked obesity, distant heart sounds, an audible S4 sound, and swelling in the lower extremities. Laboratory results revealed chronic anemia. Brain natriuretic peptide (BNP) was mildly …

Aggressive Renal Cell Carcinoma In A Patient With A Rare Genetic Syndrome, Nidhi Navaratna, Nitya Batra, Mohammad Chisti

Conference Presentation Abstracts

Hereditary leiomyomatosis and renal cell carcinoma (HLRCC) is an exceedingly rare genetic disorder characterized by skin and uterine leiomyomas and an increased risk of renal cell cancer. HLRCC follows an autosomal dominant pattern and is due to inactivating germline and somatic mutations in the gene encoding the fumarate hydratase enzyme (FH) involved in the citric acid cycle. The rarity and wide phenotypic variation in the presentation of HLRCC complicates suspicion and testing for this syndrome. We describe the case of a young woman who presented with pathological fracture secondary to bone metastasis from renal cell carcinoma. The patient presented to …

Burning Questions: Ed Management Of Pediatric Burns At A Non-Burn Center, Aksay Vivek Nandavar

Conference Presentation Abstracts

Background: Burn Centers (BC) with higher burn admissions have lower burn-related mortality. Inaccurate diagnosis causes negative outcomes. Excess BC referral can overburden these centers. The American Burn Association (ABA) has standardized burn center referral criteria. Minimal data exists on its application for patients at non-burn centers (NBC). Pre-hospital management of pediatric burns is also not well-defined in literature. Evidence suggests that an accurate assessment of burn size and depth can be made with photography. But its use has not been studied in relation to ED care, only being used for child protective services (CPS) reports with burns.

Objective: Primary objective: …