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Articles 1 - 30 of 193
Full-Text Articles in Internal Medicine
Operation No Noro: A Multidisciplinary Approach To Containing A Norovirus Outbreak In An Inpatient Rehabilitation Unit, Donika Marko, Roula Hilli, Priscila Bercea, Pamela S. Bozigar, Levi Launder, Stephanie Robertson, Trini A. Mathew
Operation No Noro: A Multidisciplinary Approach To Containing A Norovirus Outbreak In An Inpatient Rehabilitation Unit, Donika Marko, Roula Hilli, Priscila Bercea, Pamela S. Bozigar, Levi Launder, Stephanie Robertson, Trini A. Mathew
Conference Presentation Abstracts
Norovirus is a highly contagious viral gastroenteritis and can rapidly spread in healthcare settings, particularly in congregate environments such as inpatient rehabilitation units. In March 2025, a cluster of acute gastrointestinal illness was identified on a 34-bed inpatient rehabilitation unit within a 150-bed acute care hospital. Eight patients developed: • Nausea • Vomiting • Diarrhea • Abdominal pain Due to shared spaces, communal therapy activities, and high patient interaction, rapid intervention was initiated to prevent further spread.
A Hidden Giant: Tee Superiority In Mrsa Endocarditis With A Massive Supravalvular Aortic Mass, Mohammad Abed Alhaleem, Nebras Abu Abed, Salman Muslem, Fatma Bisher, Nadeen Sukhon, Wehbi Hanayni
A Hidden Giant: Tee Superiority In Mrsa Endocarditis With A Massive Supravalvular Aortic Mass, Mohammad Abed Alhaleem, Nebras Abu Abed, Salman Muslem, Fatma Bisher, Nadeen Sukhon, Wehbi Hanayni
Conference Presentation Abstracts
Background: A 66-year-old male with MRSA bacteremia developed septic pulmonary emboli, sternoclavicular joint infection, and prosthetic knee infection. While initial TTE was negative, subsequent TEE identified a large supravalvular aortic vegetation necessitating surgical excision and valve repair, underscoring the diagnostic superiority of TEE and the need for early surgical consideration in complicated MRSA endocarditis. Case Presentation: A 66-year-old male with diabetes, hypertension, and prior knee arthroplasty presented with MRSA bacteremia complicated by septic pulmonary emboli, sternoclavicular joint infection, and prosthetic knee infection. He underwent debridement of the chest wall and knee prosthesis with cultures confirming MRSA. Initial transthoracic echocardiography (TTE) …
Avoiding Anchoring Bias In Lymphadenopathy: Metastatic Thyroid Cancer Mimicking Tuberculous Lymphadenitis, Giuliano Romano, Mitchell Schwocho, Jacob Morton
Avoiding Anchoring Bias In Lymphadenopathy: Metastatic Thyroid Cancer Mimicking Tuberculous Lymphadenitis, Giuliano Romano, Mitchell Schwocho, Jacob Morton
Conference Presentation Abstracts
Introduction The differential diagnosis for a new neck mass is broad and includes malignant, infectious, and autoimmune etiologies. A systematic approach incorporating history, physical examination, and diagnostic testing is essential when developing and narrowing down a differential. Case Presentation A 52-year-old man with a history of diabetes, asthma, ankylosing spondylitis on weekly etanercept, and GERD presented with a 2-day history of painless right-sided neck swelling. He denied fever, chills, weight loss, night sweats, dysphagia, dyspnea, cough, recent illness, or constitutional symptoms aside from mild fatigue. He had recently returned from a 1.5- month trip to Bangladesh and had self-discontinued etanercept …
Targeted Therapy With Braf/Mek Inhibitors And Immune Check Point Inhibitors In Anaplastic Thyroid Cancer - A Case Report, Yagnapriya Ammakola, Muhammad Ibrahim Majeed, Ishmael Jaiyesimi
Targeted Therapy With Braf/Mek Inhibitors And Immune Check Point Inhibitors In Anaplastic Thyroid Cancer - A Case Report, Yagnapriya Ammakola, Muhammad Ibrahim Majeed, Ishmael Jaiyesimi
Conference Presentation Abstracts
Introduction- Anaplastic thyroid carcinoma (ATC) is a highly aggressive malignancy constituting about 1% of all the thyroid neoplasms. It has poor prognosis with median survival of around 3 to 6 months. Recent advancements with targeted therapies have improved the survival outcome in these patients. We report a case of anaplastic transformation of papillary thyroid cancer with BRAF V600E mutation who responded to targeted therapy. Case presentation- A 54 year old male presented with a palpable left sided mass. Labs were unremarkable but imaging with contrast enhanced CT scan showed a 3 cm left thyroid nodule with bilateral cervical lymphadenopathy. Biopsy …
Mycobacterium Chimaera In A Young Patient Without Underlying Cardiac Surgery History, Kate A. Szczesniak, Rakesh Shah, Malitha Hettiarachchi
Mycobacterium Chimaera In A Young Patient Without Underlying Cardiac Surgery History, Kate A. Szczesniak, Rakesh Shah, Malitha Hettiarachchi
Conference Presentation Abstracts
Introduction/Objective Mycobacterium chimaera (M. chimaera), within the Mycobacterium Avium Complex (MAC), is a slow-growing nontuberculous mycobacterium (NTM) species that is most often characterized by nonspecific symptoms of night sweats, fever, and fatigue. Due to the nonspecific symptoms of M. chimaera and the rarity of this infection, delayed or misdiagnosis occurs in these patients. Risk factors of contaminated heater-cooler units used in cardiac surgery have been reported; however, cases without this exposure, such as this case, have been cited less commonly. This case of M. chimaera will present a young patient initially presenting with dyspnea who was found to have a …
A Pain That Wouldn't Sleep: Osteoid Osteoma Masquerading As Lateral Epicondylitis, Madelyn Bagley, Luca Halalau, Aimee Espinosa, Terrence Metz
A Pain That Wouldn't Sleep: Osteoid Osteoma Masquerading As Lateral Epicondylitis, Madelyn Bagley, Luca Halalau, Aimee Espinosa, Terrence Metz
Conference Presentation Abstracts
Osteoid osteoma is a benign osteogenic tumor that accounts for approximately 10% of all benign bone tumors and predominantly affects adolescents and young adults. It classically presents with nocturnal pain that responds dramatically to nonsteroidal anti-inflammatory drugs, a feature attributed to increased prostaglandin production within the nidus. The femur and tibia are most commonly involved, whereas upper extremity lesions are relatively uncommon. A 19-year-old male presented with nearly two years of chronic, progressive left lateral elbow pain and left wrist weakness. The pain was nocturnal, radiated along the left arm, and was markedly relieved by nonsteroidal antiinflammatory drugs. He was …
A Rare Convergence: Malignant Thymoma With Pericardial Invasion In A Brca2 Mutation Carrier With A Synchronous Breast Mass, Mahmoud Yacout, Mohammad Chisti
A Rare Convergence: Malignant Thymoma With Pericardial Invasion In A Brca2 Mutation Carrier With A Synchronous Breast Mass, Mahmoud Yacout, Mohammad Chisti
Conference Presentation Abstracts
Introduction Thymomas are rare epithelial tumors of the anterior mediastinum, accounting for < 1% of adult malignancies, with an estimated annual incidence of approximately 0.15 cases per 100,000 persons. Although often indolent, thymomas are malignant by definition and may invade locally, recur, and, less commonly, disseminate. They are classically associated with autoimmune conditions, most notably myasthenia gravis, yet their relationship with hereditary cancer syndromes remains poorly defined. Germline BRCA2 mutations are well established in the pathogenesis of breast, ovarian, pancreatic, prostate, and other malignancies through impaired homologous recombination DNA repair. However, an association between BRCA2 mutations and thymic epithelial tumors has rarely been reported. We describe an unusual case of invasive malignant thymoma with pericardial invasion in a BRCA2 mutation carrier, discovered concurrently with a synchronous FDG-avid breast mass suspicious for malignancy. Case Presentation An 85-year-old man with a history of CAD, hypertension, GERD, and prior radical prostatectomy presented with several months of unintentional weight loss and chronic diarrhea. During evaluation for recurrent appendicitis, imaging incidentally revealed a large anterior mediastinal mass measuring up to 7.9 cm with irregular margins. FDG-PET demonstrated moderate metabolic activity within the mass (SUVmax 3.8). CT-guided biopsy revealed a thymic epithelial neoplasm consistent with thymoma. There was no clinical evidence of myasthenia gravis. He subsequently underwent partial sternotomy with thymectomy. Pathology demonstrated a 6-cm type B2 thymoma with direct pericardial invasion, positive surgical margins (R1), and no regional lymph node involvement (pN0), consistent with pT2 stage III disease by the Masaoka–Koga system. Given high-risk features, adjuvant radiation therapy was initiated, with planned surveillance using PET imaging and circulating tumor DNA monitoring. Concurrent PET imaging identified a palpable FDG-avid right breast mass. Genetic testing revealed a pathogenic germline BRCA2 mutation. The breast lesion is currently undergoing diagnostic biopsy and surgical evaluation. Discussion Thymomas are malignant neoplasms with a predilection for local invasion. Type B2 thymomas carry a higher risk of recurrence, particularly in the presence of pericardial invasion or incomplete resection. Complete surgical excision remains the cornerstone of management, while postoperative radiotherapy is recommended in invasive or R1 disease to reduce locoregional recurrence. The coexistence of invasive thymoma and a germline BRCA2 mutation is exceedingly rare and raises questions regarding shared oncogenic mechanisms. While thymic epithelial tumors are not classically associated with BRCA mutations, DNA repair defects may contribute to tumorigenesis in rare malignancies. The presence of a synchronous FDG-avid breast mass in a male BRCA2 carrier further underscores the importance of comprehensive oncologic and genetic evaluation and highlights the need for multidisciplinary management in complex hereditary cancer presentations. Conclusion We report a rare case of malignant type B2 thymoma with pericardial invasion in a BRCA2 mutation carrier, identified alongside a synchronous breast mass suspicious for malignancy. This case highlights the potential intersection between thymic epithelial tumors and hereditary cancer syndromes, reinforces the importance of genetic evaluation in patients with multiple malignancies, and underscores the need for long‑term multidisciplinary surveillance. Further investigation is warranted to elucidate any causal relationship between BRCA‑mediated DNA repair dysfunction and thymoma development.
Right Atrial Thrombosis In Behcet's Disease Presenting With Tricuspid Inflow Obstruction, Famta Basher Bisher, Thekrayat M. Asad, Sireen Shehadah
Right Atrial Thrombosis In Behcet's Disease Presenting With Tricuspid Inflow Obstruction, Famta Basher Bisher, Thekrayat M. Asad, Sireen Shehadah
Conference Presentation Abstracts
Introduction Behçet’s disease (BD) is a chronic multisystem vasculitis characterized by recurrent mucocutaneous, ocular, vascular, and neurologic manifestations. Cardiac involvement is rare but can be severe, with intracardiac thrombosis representing an uncommon and potentially life-threatening complication. Management is challenging, as first-line medical therapy may be limited by bleeding risk or hemodynamic compromise. Case Presentation A 26-year-old woman with a 9-year history of Behçet’s disease presented with two weeks of progressive dyspnea, palpitations, fever, fatigue, and cough. She denied chest pain, or syncope, or lower extremity swelling. One year prior, she had been hospitalized for pulmonary embolism and was found to …
Igg4-Related Aortitis Presenting As Intramural Hematoma Of The Descending Thoracic Aorta, Sarah Ibrahim, Tejasvini Khanna, Lark Steafo, Ioannis Karageorgiou, Judith Bateman
Igg4-Related Aortitis Presenting As Intramural Hematoma Of The Descending Thoracic Aorta, Sarah Ibrahim, Tejasvini Khanna, Lark Steafo, Ioannis Karageorgiou, Judith Bateman
Conference Presentation Abstracts
IgG4-related aortitis is a rare manifestation of IgG4-related disease and can closely mimic acute aortic syndromes, including intramural hematoma (IMH), on imaging. Isolated involvement of the descending thoracic aorta is particularly uncommon, and misdiagnosis may lead to unnecessary surgical or endovascular intervention. A 68-year-old man with extensive cardiovascular disease, including prior coronary artery bypass grafting, recent percutaneous coronary intervention with drug-eluting stent placement, permanent pacemaker implantation for complete heart block, and recent pulmonary embolism, presented with three days of chest pain, shortness of breath, and left lower quadrant abdominal pain. At presentation, he was receiving apixaban, aspirin, and clopidogrel. Computed …
Novel Applications Of Coronary Cta In Patients With Intermediate Risk Of Cad, Ashley Armstrong, Luai Madanat, Robert D. Safian
Novel Applications Of Coronary Cta In Patients With Intermediate Risk Of Cad, Ashley Armstrong, Luai Madanat, Robert D. Safian
Conference Presentation Abstracts
Background: ACC/AHA guidelines provide class 1 and 2A recommendations respectively for coronary CTA and FFRCT in patients with chest pain and intermediate risk of CAD. We present a case in which novel applications of CTA excluded obstructive CAD, identified the correct diagnosis, and allowed optimization of medical therapy. Case: In a 72-year-old male with stable angina and HEART score 6, stress ECG was positive for angina and frequent PVCs (Fig 1A). Coronary CTA (Fig 1B) and FFRCCT (Fig 1C) showed non-obstructive CAD and intramyocardial bridging/severe systolic compression in the mid-LAD (Fig 1D). AI plaque analysis demonstrated a mixed plaque burden …
Leveraging State Of The Art Simulation-Based Education To Enhance Medical Student Interest In Internal Medicine And Cardiology, Mohamed Abdalaziz, Nicholas Mitchell, Ryan Madder
Leveraging State Of The Art Simulation-Based Education To Enhance Medical Student Interest In Internal Medicine And Cardiology, Mohamed Abdalaziz, Nicholas Mitchell, Ryan Madder
Conference Presentation Abstracts
Abstract Background: Early clinical exposure plays a critical role in shaping medical student interest, and therefore choice in medical specialty. Traditional curricula offer limited opportunities for hands-on engagement with cardiovascular decision-making and procedures. Simulation-based education may address this gap by providing immersive, low-risk learning experiences. Methods: An internal medicine resident and Cardiology fellow led, faculty-supported simulation curriculum was developed for third- and fourth-year medical students using a state-of-the-art simulation laboratory. Two 75-minute sessions were conducted over a two-month period, with a total of 27 students participating. The first session included a focused electrocardiography didactic emphasizing ST-elevation myocardial infarction (STEMI) recognition, …
Esophageal Diverticulum Presenting As Chest Pain In A Patient With Significant Cardiac History: A Diagnostic Challenge, Sujan Shrestha, Alnimer Khabbab, Kamal Khalil, Malitha Hettiarachchi
Esophageal Diverticulum Presenting As Chest Pain In A Patient With Significant Cardiac History: A Diagnostic Challenge, Sujan Shrestha, Alnimer Khabbab, Kamal Khalil, Malitha Hettiarachchi
Conference Presentation Abstracts
Introduction: Esophageal diverticula are uncommon structural abnormalities that may present with nonspecific symptoms such as dysphagia, regurgitation, and chest discomfort. It accounts for < 5% of all cases of dysphagia. In elderly patients with significant cardiac comorbidities, chest pain and dysphagia may be initially attributed to cardiovascular pathology, potentially delaying the correct diagnosis. This case highlights the importance of comprehensive history taking in identifying esophageal diverticulum as an alternative etiology of chronic symptoms. Case presentation: A 77-year-old female with a history of atrial fibrillation, unstable angina, chronic obstructive pulmonary disease, hypertension, and diastolic heart failure presented with chest pain. Given her significant cardiac history, she underwent extensive cardiac evaluation, including serial troponins, electrocardiography, echocardiography, and stress testing, all of which showed no evidence of acute ischemia. Further history revealed intermittent dysphagia to both solids and liquids for over three years, occurring approximately twice weekly. The patient described a sensation of food getting stuck in her throat, occasionally requiring expectoration. Gastroenterology was consulted, and esophagogastroduodenoscopy revealed minimal esophagitis with a distal esophageal diverticulum. The patient was managed conservatively with pantoprazole 40 mg daily, resulting in symptomatic improvement. Discussion: Esophageal diverticula are often associated with underlying esophageal motility disorders and can present with dysphagia to both solids and liquids. Symptoms may mimic or coexist with cardiopulmonary complaints, particularly in elderly patients with multiple comorbidities. While barium esophagography remains the diagnostic modality of choice, endoscopy can identify associated mucosal pathology and confirm the diagnosis. Management is individualized based on symptom severity and diverticulum size, with conservative therapy appropriate for mildly symptomatic patients. Conclusion: This case underscores the importance of considering esophageal diverticulum in the differential diagnosis of chronic dysphagia and chest discomfort, even in patients with significant cardiac disease. Careful history taking and multidisciplinary evaluation are essential to avoid misattribution of symptoms and to ensure timely diagnosis and appropriate management.
Severe Transvalvular And Paravalvular Aortic Regurgitation As Late Tavr Failure Successfully Treated With Percutaneous Therapy, Ashley Armstrong, Luca Halalau, Ivan Hanson
Severe Transvalvular And Paravalvular Aortic Regurgitation As Late Tavr Failure Successfully Treated With Percutaneous Therapy, Ashley Armstrong, Luca Halalau, Ivan Hanson
Conference Presentation Abstracts
BACKGROUND - Transcatheter aortic valve replacement (TAVR) is an established therapy for severe aortic stenosis. With improving long-term survival, late prosthetic valve–related complications are increasingly recognized. CASE SUMMARY - We report a 74-year-old man who presented eight years after TAVR with progressive dyspnea, orthopnea, and bilateral lower extremity edema, identified to be acute decompensated heart failure with a new diastolic murmur. Transthoracic echocardiography demonstrated severe aortic regurgitation. Subsequent transesophageal echocardiography identified concomitant severe paravalvular and severe transvalvular regurgitation of the bioprosthetic valve. Invasive hemodynamic assessment revealed acute volume overload with markedly elevated filling pressures, secondary pulmonary hypertension, and right ventricular …
Buprenorphine/Naloxone Therapy For Opioid Withdrawal, Medication-Assisted Treatment, And Pain Management In An Adolescent Patient, Sindhu H. Manjunath, Michael Spickler, Annas Aljassem
Buprenorphine/Naloxone Therapy For Opioid Withdrawal, Medication-Assisted Treatment, And Pain Management In An Adolescent Patient, Sindhu H. Manjunath, Michael Spickler, Annas Aljassem
Conference Presentation Abstracts
Introduction: Opioid addiction is a chronic disorder centered around craving and compulsive use of prescription or non-medical opioids. The last three decades have seen a dramatic increase in opioid use order (OUD) in the United States, with about 87,000 adolescents in the 12–17 age group estimated to have OUD in 2019. Less than 10% receive medication-assisted treatment (MAT). We present a case of a 17-year-old male who received treatment with buprenorphine-naloxone (Suboxone) for withdrawal management, MAT and acute pain.
Case Description: A 17-year-old-male with a history of anxiety, depression, and attention deficit/hyperactivity disorder (ADHD) presented to the emergency department (ED) …
When To Tap: Complex Febrile Seizure With Atypical Course As Early Presentation Of Hsv-1 Meningoencephalitis, Isabella Comsa, Sindhu H. Manjunath, Elise Gross, Rawad Obeid, Graham Krasan
When To Tap: Complex Febrile Seizure With Atypical Course As Early Presentation Of Hsv-1 Meningoencephalitis, Isabella Comsa, Sindhu H. Manjunath, Elise Gross, Rawad Obeid, Graham Krasan
Conference Presentation Abstracts
Introduction: Febrile seizures have a prevalence of 2-5% among children ages 6-60 months. Less than 1% of complex febrile seizures without meningeal signs are associated with bacterial or viral meningitis. Current literature supports limiting routine lumbar puncture in this population. We present a case of Herpes Simplex Virus (HSV) encephalitis presenting with complex febrile seizure, who progressed to cerebritis requiring decompressive craniectomy, and discuss indications for further diagnostic evaluation.
Case Description: 2-year-old male with a history of simple febrile seizure presenting with a 10 minute tonic-clonic seizure with right-sided gaze deviation. He had tactile fever and low energy at home …
Disparities In Mortality Associated With Disseminated Intravascular Coagulation: A Nationwide Study, Manas Pustake, Atulya Khosla, Saif Syed, Avi Harisingani
Disparities In Mortality Associated With Disseminated Intravascular Coagulation: A Nationwide Study, Manas Pustake, Atulya Khosla, Saif Syed, Avi Harisingani
Conference Presentation Abstracts
Background : Disseminated intravascular coagulation (DIC) is a serious and often life-threatening condition that can result in widespread morbidity and mortality. Despite its clinical significance, there remains a lack of comprehensive, national-level data analyzing trends in DIC-related mortality. Understanding these trends is crucial for identifying at-risk populations, informing public health strategies, and optimizing clinical interventions. Aims : This study aims to analyze DIC mortality trends from 2018 to 2023, focusing on key demographic and regional factors, to provide insights that can guide future healthcare policy and practice. Methods : An analysis of DIC mortality trends from 2018 to 2023 was …
Disparities In Pulmonary Embolism Mortality In Us-Mexico Border Regions: A Population-Based Study, Manas Pustake, Atulya Khosla
Disparities In Pulmonary Embolism Mortality In Us-Mexico Border Regions: A Population-Based Study, Manas Pustake, Atulya Khosla
Conference Presentation Abstracts
Background : Health disparities in pulmonary embolism (PE) mortality are notably evident along the US-Mexico border, where limited healthcare access and socioeconomic challenges contribute to poorer outcomes. While PE is increasingly recognized as a major health concern, little research has been done to understand the specific difficulties faced by border communities in managing and preventing the condition. Identifying these disparities is essential to closing healthcare gaps and implementing targeted interventions to reduce PE mortality in these areas. Aims : To analyze and compare PE mortality rates between the US-Mexico border and non-border regions, while examining the influence of demographic factors. …
When Pressure Rises: Identifying Abdominal Compartment Syndrome Amid Critical Illness, Mariam Jamil, Muhammed Hussain, Amna Jafri, Asim Mohamed, Rajiv John
When Pressure Rises: Identifying Abdominal Compartment Syndrome Amid Critical Illness, Mariam Jamil, Muhammed Hussain, Amna Jafri, Asim Mohamed, Rajiv John
Conference Presentation Abstracts
Introduction Abdominal Compartment Syndrome (ACS) occurs in approximately 15% of patients with severe acute necrotizing pancreatitis and is associated with a poor prognosis. Treatment typically involves urgent decompressive laparotomy. However, diagnosing ACS in an intensive care unit (ICU) setting can be challenging, as patients often present with primary illnesses that independently drive end-organ dysfunction. This case highlights a diagnostic framework for ACS while emphasizing common pitfalls and challenges. Case Description A 54-year-old male with a history of alcohol abuse presented with a two-week history of abdominal discomfort and shortness of breath. Initial evaluation, including clinical examination, imaging, and laboratory findings, …
Water-Associated Bacterial Infection Without Aquatic Exposure, Meghan Glaser, Ashley Armstrong, Justin Skrzynski
Water-Associated Bacterial Infection Without Aquatic Exposure, Meghan Glaser, Ashley Armstrong, Justin Skrzynski
Conference Presentation Abstracts
Introduction: Shewanella algae is a gram-negative, facultatively anaerobic bacterium most commonly found in marine environments. It is an emerging human pathogen, most often associated with hepatobiliary and skin and soft tissue infections (SSTI) following water exposure. Known risk factors for infection include those participating in recreational water activities, flood victims, and those with underlying liver disease, immunosuppression, or IV drug use. This case involves a 70-year-old male who was involved in a motor vehicle accident in 2008 leading to multiple orthopedic surgeries complicated by recurrent prosthesis infections who presented with concern for sepsis. Case Description: Patient is a 70-year-old male …
Hiding In The Midgut: A Case Of Small Bowel Diverticular Bleeding In An Elderly Female, Aagamjit Singh, Nishant Aggarwal, Faid Odish
Hiding In The Midgut: A Case Of Small Bowel Diverticular Bleeding In An Elderly Female, Aagamjit Singh, Nishant Aggarwal, Faid Odish
Conference Presentation Abstracts
Introduction Diverticulosis in the colon is a common cause of lower gastrointestinal (GI) bleeding. Non-Meckel diverticula in the small bowel have been reported in the literature; however, they rarely cause significant bleeding. We present a case of an 88-year-old woman with a bleeding jejunal diverticulum that was diagnosed and treated with a push enteroscopy. Case Description An 88-year-old African-American female with a past medical history of colonic diverticulosis and atrial fibrillation on rivaroxaban presented with a 4-day history of melena. She reported having soft, black stools 2–3 times a day, associated with persistent epigastric discomfort and nausea. Her last dose …
Double Trouble: A Case Of Persistent Left-Sided Superior Vena Cava, Lark Steafo, Kateryna Strubchevska, Olena Strubchevska, Marko Kozyk, Shazil Mahmood, Steven Timmis
Double Trouble: A Case Of Persistent Left-Sided Superior Vena Cava, Lark Steafo, Kateryna Strubchevska, Olena Strubchevska, Marko Kozyk, Shazil Mahmood, Steven Timmis
Conference Presentation Abstracts
A persistent left-sided superior vena cava (PLSVC) is a rare vascular anomaly where the left superior cardinal vein fails to regress during embryogenesis, resulting in an additional venous structure that drains into the right atrium, often via the coronary sinus. It is usually asymptomatic but may be discovered incidentally during imaging or procedures, but its presence can have implications for central venous access and pacemaker placement. Our case features an 82-year-old male with a past medical history of coronary artery disease, remote esophageal cancer, hypertension, hyperlipidemia, and tobacco use disorder, referred to the emergency department from his primary care doctor’s …
A Rare Case Of Lenalidomide Associated B Cell Lymphoblastic Leukemia, Yagnapriya Ammakola, Nitya Batra, Ashbita Pokharel, Ishmael Jaiyesimi
A Rare Case Of Lenalidomide Associated B Cell Lymphoblastic Leukemia, Yagnapriya Ammakola, Nitya Batra, Ashbita Pokharel, Ishmael Jaiyesimi
Conference Presentation Abstracts
Introduction Autologous stem cell transplantation followed by maintenance with Lenalidomide has improved the overall survival and progression free survival in patients with Multiple Myeloma. However, maintenance therapy with Lenalidomide can increase the risk of several hematological adverse events including secondary B cell lymphoblastic leukemia. We present a case of 61 year old female who was previously treated for multiple myeloma and on maintenance Lenalidomide developed B lymphoblastic leukemia/lymphoma. Case presentation A 61 year old female initially presented with left sided hip pain and lower back pain in 2018.Chest X ray revealed mass like opacity in the left upper lobe and …
Acne On The Valve: A Case Of Cutibacterium Acnes Prosthetic Valve Endocarditis And Aortic Root Abscess, Aiden Van Loo, Mitchell Schwocho, Francisco Davila
Acne On The Valve: A Case Of Cutibacterium Acnes Prosthetic Valve Endocarditis And Aortic Root Abscess, Aiden Van Loo, Mitchell Schwocho, Francisco Davila
Conference Presentation Abstracts
Introduction Infective endocarditis (IE) is a serious infection of the endocardium and the cardiac valves. Its incidence is on the rise, and this has been attributed to the aging population, healthcare-associated infections, and the growing use of intracardiac devices and prosthetic valves. IE is typically caused by gram positive cocci; although other more fastidious organisms can present in a subacute fashion. One such organism that is now becoming identified is Cutibacterium Acnes. It is a gram-positive anaerobe, most commonly known for causing acne. Given its ubiquity as skin flora, it can enter the blood stream and cause systemic infections. Here …
A Case Of Futile Mechanical Thrombectomy In Chronic Thromboembolic Pulmonary Hypertension, Daivd Connolly, Michael Barnes
A Case Of Futile Mechanical Thrombectomy In Chronic Thromboembolic Pulmonary Hypertension, Daivd Connolly, Michael Barnes
Conference Presentation Abstracts
Introduction Percutaneous mechanical thrombectomy is a mainstay therapy in the management of high-risk acute pulmonary embolism (PE), as it reduces pulmonary artery pressure and improves right ventricular function. However, the role of percutaneous mechanical thrombectomy in the management of chronic PE or acute on chronic PE is unclear. Case Description We present the case of a 46-year-old male who presented to the emergency department with 4 days of worsening dyspnea and pleuritic chest pain. Past medical history is significant for class II obesity, prior transient ischemic attack, pulmonary hypertension with right-sided heart failure, and four admissions over the previous 10 …
Unmasking Lupus Through Myopericarditis, Athanasios Rempakos, Lark Steafo, Tawhida Khatoon
Unmasking Lupus Through Myopericarditis, Athanasios Rempakos, Lark Steafo, Tawhida Khatoon
Conference Presentation Abstracts
Systemic lupus erythematosus (SLE) is a complex, multisystem autoimmune that often presents with nonspecific symptoms, complicating diagnosis. Myopericarditis is a rare initial manifestation, mimicking infections or malignancies. We present a case underscoring the importance of considering SLE in refractory multisystem illness. A 26-year-old previously healthy male presented to an outside hospital with a one-week history of left-sided pleuritic chest pain, fever, chills, palpitations, fatigue, cough, sinus congestion, and headache. Initial evaluation revealed marked tachycardia (heart rate 180s/min on exertion). CT pulmonary angiography excluded pulmonary embolism but identified a large right-sided consolidation consistent with pneumonia. His initial troponin was 223 with …
Stroke With Pfo, Uncovering Underlying Mutations And Malignancy: A Case Report, Haiqi Guo, Karan Chhabra, Atulya Khosla, Florian Bukovec, Dilip Khanal
Stroke With Pfo, Uncovering Underlying Mutations And Malignancy: A Case Report, Haiqi Guo, Karan Chhabra, Atulya Khosla, Florian Bukovec, Dilip Khanal
Conference Presentation Abstracts
Introduction: Stroke is the leading cause of long-term disability, with most cases being ischemic. In patients aged 18–60 years, patent foramen ovale (PFO) is implicated in 10% of strokes. Pathophysiologies include paradoxical thromboembolism and thrombus formation in the PFO, leading to cerebral or systemic embolism. Cancer is a comorbidity in 5–10% of patients with acute stroke, with mechanisms such as direct tumor effects, coagulopathy, and cancer therapy. Two common inherited thrombophilia predisposing to deep vein thrombosis (DVT) are Factor V Leiden (FVL) and G20210A Prothrombin gene mutation (PTM). FVL results in poor anticoagulant response to activated Protein C, while PTM …
Not A Cyst, But Gist: A Case Report, Jessica Kopchia, Amira Al-Nabolsi, Barbara Senger, Gurveer Gill, Yevhen Drobot
Not A Cyst, But Gist: A Case Report, Jessica Kopchia, Amira Al-Nabolsi, Barbara Senger, Gurveer Gill, Yevhen Drobot
Conference Presentation Abstracts
Gastrointestinal Stromal Tumors (GISTs) are the most common mesenchymal neoplasms found in the gastrointestinal (GI) tract, although they only account for 1-2% of gastrointestinal tumors. It is suspected that GISTs originate from the Cajal cells, necessary for regulating peristalsis. Diagnosis relies heavily on histopathologic examination, majority of GISTs being caused by an oncogenic mutation in the KIT gene, responsible for the regulation of tyrosine kinase. KIT upregulates the interstitial cells of Cajal, resulting in tumor formation. Therefore, these tumors are predominantly found in the stomach and small intestine, less frequently in colon, esophagus, and rectum. Often these neoplasms are benign, …
An Incidental Finding Of Inferior Vena Cava Thrombosis In A Patient Presenting With Gastroenteritis, Berk Celik, Ovidiu Niculescu
An Incidental Finding Of Inferior Vena Cava Thrombosis In A Patient Presenting With Gastroenteritis, Berk Celik, Ovidiu Niculescu
Conference Presentation Abstracts
Introduction Inferior vena cava (IVC) thrombosis is an under-recognized entity that is associated with significant morbidity and mortality. IVC thrombosis is prevalent (60% to 80%) among patients with congenital IVC anomalies. These anomalies occur in 0.5%–1% of the general population. Thrombosis of the IVC in the absence of congenital abnormalities is rare and is usually a result of a predisposing hypercoagulable state or IVC filter. Here, we present a case of an incidental finding of IVC thrombosis in a patient presenting with gastroenteritis. Case description A 57-year-old female with a past medical history of obstructive sleep apnea, and non-alcoholic steatohepatitis …
Recurrent Malignant Retroperitoneal Solitary Fibrous Tumour Leading To Obstructive Uropathy And Sepsis, A Case Report, Wesam Almasri, Imran Bitar, Aagamjit Singh, Yusra Zakria, Dilip Khanal
Recurrent Malignant Retroperitoneal Solitary Fibrous Tumour Leading To Obstructive Uropathy And Sepsis, A Case Report, Wesam Almasri, Imran Bitar, Aagamjit Singh, Yusra Zakria, Dilip Khanal
Conference Presentation Abstracts
Introduction Solitary Fibrous Tumours (SFT) are rare mesenchymal tumours. Although initially described pleural in origin, they can arise from virtually any site. SFTs of retroperitoneal origin are especially rare, with limited literature on their management. Here we present a unique case of an aggressive recurrent retroperitoneal SFT causing mass effect leading to obstructive uropathy. Brief case description A 47-year-old Hispanic man without past medical history presented to a neighboring hospital with months-long abdominal pain and urinary retention. CT showed a 14x12x12 cm pelvic mass that could not be separated from the prostate, together with right hydroureteronephrosis. He was discharged with …
Severe Digital Necrosis In The Context Of Raynaud's Phenomenon, Antiphospholipid Antibody Syndrome, And Vasculitis: A Diagnostic Dilemma, Silvana Iskandar, Karan Chhabra, Omar Jameel, Tucker Billups
Severe Digital Necrosis In The Context Of Raynaud's Phenomenon, Antiphospholipid Antibody Syndrome, And Vasculitis: A Diagnostic Dilemma, Silvana Iskandar, Karan Chhabra, Omar Jameel, Tucker Billups
Conference Presentation Abstracts
Abstract: A 73-year-old male with polyarticular gout, hypertension, and rheumatoid arthritis presented with non-healing necrotic wounds on the distal aspect of his upper extremity digits, most severely affecting the left index finger with eschar. His symptoms had been present for the past six weeks. He also had a history of Raynaud’s phenomenon, which preceded these symptoms. Examination revealed necrotic wounds on the nail beds of seven fingers bilaterally, with significant left index finger necrosis. Despite the severity of his condition, he remained hemodynamically stable throughout hospitalization. Laboratory studies showed positive cardiolipin IgM and beta-2 glycoprotein antibodies on two separate occasions, …