Mystery Of Maha: Hypertension’S Twist Over Cancer’S Shadow,
2025
Rochester Regional Health
Mystery Of Maha: Hypertension’S Twist Over Cancer’S Shadow, Andrew Takla, Gabriel Vachon, John Hix, Nagesh Jadhav
Advances in Clinical Medical Research and Healthcare Delivery
Microangiopathic hemolytic anemia (MAHA) refers to nonimmune hemolysis resulting from the intravascular fragmentation of red blood cells. The etiology of such disorders can range from primary thrombotic microangiopathic syndromes (TMA) to various systemic conditions, posing a diagnostic challenge. Prompt identification requires a sharp clinical assessment to improve outcomes.
Intractable Hiccups As The Presenting Symptom Of Relapsed Salmonella Bacteremia Complicated By Salmonella Endocarditis,
2025
Rochester Regional Health
Intractable Hiccups As The Presenting Symptom Of Relapsed Salmonella Bacteremia Complicated By Salmonella Endocarditis, Sahej Arora, Tripti Jain, Hafsa Jawaid, Nada Hafez, Binita Neupane
Advances in Clinical Medical Research and Healthcare Delivery
Salmonella infections are generally acute diarrheal illnesses that uncommonly spread to deeper or endovascular tissues, with key symptoms being nausea, vomiting, diarrhea, abdominal pain and fever. We present a case of a 76-year male who presented chiefly with recurrent intractable hiccups after finishing two weeks of oral ciprofloxacin for a previous episode of Salmonella bacteremia. He was ultimately found to have an aortic root vegetation on transesophageal echocardiogram and focal adenomyomatosis on gallbladder ultrasound. He underwent cholecystectomy, aortic valve replacement and six weeks of antibiotic therapy with resolution of his hiccups. Our case demonstrates an atypical symptom of intractable hiccups …
Mirizzi Syndrome: A Case Report,
2025
Trinity School of Medicine
Mirizzi Syndrome: A Case Report, Elizabeth Barr, Keng Moua, Kavitha Vemuri
Advances in Clinical Medical Research and Healthcare Delivery
Mirizzi syndrome is a rare complication of chronic gallstone disease that occurs when an impacted gallstone at the gallbladder infundibulum or cystic duct causes common extrinsic hepatic or common bile duct obstruction. Contrary to other gallstone pathologies where gallstones affect the respective location in which they are lodged, Mirizzi syndrome is unique in that it is characterized by extrinsic gallstone compression. Chronic gallstone disease most commonly leads to acute cholecystitis, acute cholangitis, or acute pancreatitis. The extrinsic compression of the common hepatic or common bile duct may lead to eventual erosion which increases the risk for a cholecystocholedochal or cholecystohepatic …
A Budding Pancreatic Mass: A Review Of Disseminated Blastomycosis,
2025
Department of Medicine, University of Pennsylvania, Philadelphia, PA
A Budding Pancreatic Mass: A Review Of Disseminated Blastomycosis, Tina C. L. Phan, Chloe N. Hundman, Neena Thomas-Gosain, Christopher D. Jackson
Journal of Community Hospital Internal Medicine Perspectives
A 67-year-old male patient presented with anorexia, weight loss, skin masses, and flank pain over the past three months. Imaging revealed a lung mass and a cystic lesion in the pancreatic head. After initial diagnostic work-up and clinical deterioration, broad based budding, seen on pathology, led to a diagnosis of disseminated blastomycosis. After receiving a 14-day course of liposomal amphotericin B followed by itraconazole, the patient showed significant clinical improvement. We reviewed all disseminated blastomycosis cases in the medical literature involving gastrointestinal organs. Although pancreatic involvement is rare, we suggest that it should be suspected in those with a rapidly …
Iron Deficiency—More Than Just Anemia: A Literature Review,
2025
University of California Irvine, School of Medicine, Irvine, California, USA.
Iron Deficiency—More Than Just Anemia: A Literature Review, Arianna S Moss, Zahra Pakbaz
Journal of Community Hospital Internal Medicine Perspectives
Iron deficiency (ID) is a global public health concern, as it can be a prodrome of gastrointestinal (GI) malignancies, exacerbate chronic conditions, and lead to an overall decreased quality of life. Despite being the most prevalent nutritional deficiency, it remains underdiagnosed by many healthcare professionals. Misconceptions regarding the clinical and laboratory manifestations of ID lead to delayed or missed diagnoses, contributing to poor patient outcomes. Though anemia is a commonly known consequence of ID, there are additional consequences that remain underrecognized by the medical community, including vague signs and symptoms, such as fatigue, depression, and abnormalities in white blood cell …
Preserving What Matters: A Multimodal Approach To Maintaining Fat-Free Mass During Anti-Obesity Medication Based Weight Loss,
2025
Valparaiso University
Preserving What Matters: A Multimodal Approach To Maintaining Fat-Free Mass During Anti-Obesity Medication Based Weight Loss, Sarah Gore
Evidence-Based Practice Project Reports
Weight loss is often associated with reductions in fat-free mass (FFM), which can negatively impact metabolic rate, thermoregulation, bone density, functional capacity, and overall quality of life (Roth et al., 2022; Sedlmeier et al., 2021). This Evidence-Based Practice project aimed to reduce FFM loss in adults prescribed anti-obesity medications (AOMs) for weight management through a targeted, multimodal intervention. Twenty-two patients beginning AOM treatment at a family practice in northwest Indiana were invited to participate, with 19 consenting to enroll. Each participant received personalized guidance, including tailored calorie and protein intake goals to support a hypocaloric, high-protein diet, alongside evidence-based aerobic …
When Pressure Rises: Identifying Abdominal Compartment Syndrome Amid Critical Illness,
2025
Corewell Health East Resident
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,
2025
Corewell Health East Resident
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,
2025
Corewell Health East Resident
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,
2025
Corewell Health East Resident
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 Esophageal Perforation: Esophageal Perforation Following Cervical Spine Hardware Removal,
2025
Corewell Health East Resident
A Rare Case Of Esophageal Perforation: Esophageal Perforation Following Cervical Spine Hardware Removal, Amira Al-Nabolsi, Jessica Kopchia, Cameron Hubbard, Hussein Hamade, Mouhamed Shatila
Conference Presentation Abstracts
An esophageal perforation is an uncommonly encountered life-threatening emergency that can lead to leakage of gastric contents into surrounding esophageal tissue. It is most commonly due to iatrogenic injury, typically involving endoscopy, intubation, or esophageal surgery. We describe an unusual case of esophageal perforation secondary to the removal of infected cervical spine hardware. A 73-year-old male with cervical spine central stenosis with history of an anterior cervical spinal fusion of C5-C7 over 40 years ago presented to the emergency department at the request of his pulmonologist. A CT scan of the neck was obtained in the outpatient setting, as the …
Acne On The Valve: A Case Of Cutibacterium Acnes Prosthetic Valve Endocarditis And Aortic Root Abscess,
2025
Corewell Health East Resident
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,
2025
Corewell Health East Resident
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,
2025
Corewell Health East Resident
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,
2025
Oakland University William Beaumont School of Medicine Medical Student
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,
2025
Corewell Health East Resident
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,
2025
Corewell Health East Resident
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,
2025
Oakland University William Beaumont School of Medicine Medical Student
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,
2025
Oakland University William Beaumont School of Medicine Medical Student
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, …
Streptococcus Pneumoniae Cervical Abscess In A Pcv-Immunized Female With Waldenstrom's Macroglobulinema: Exploring The Role Of Opsosonization Failure And Functional Hyposplenesim Beyond The Spectrum Of Malignant B-Cell Disorders,
2025
Corewell Health East Resident
Streptococcus Pneumoniae Cervical Abscess In A Pcv-Immunized Female With Waldenstrom's Macroglobulinema: Exploring The Role Of Opsosonization Failure And Functional Hyposplenesim Beyond The Spectrum Of Malignant B-Cell Disorders, Tanya Amal, Paul Johnson, Ayesha Sharif, Usman Bin Hameed
Conference Presentation Abstracts
A 64-year-old female with recently diagnosed Waldenström's macroglobulinemia presented with pain and swelling in the neck. Three weeks prior, she had accidentally punctured her neck with her fingernail, leading to initial swelling. She visited the ER, but workup showed no acute infection. A contrast-enhanced CT scan revealed enlarged bilateral cervical lymph nodes. Over the next two weeks, the swelling became increasingly painful. On presentation, she had sharp, localized pain (10/10 intensity), tachycardia, and a 3x3 cm swelling on the right side of her neck, with redness, warmth, and tenderness. Laboratory results showed lymphocytic leukocytosis (WBC 31.5, lymphocyte 24.8%, neutrophil 6.1%). …
