A year-old man with no significant past medical history presented with fatigue and a newly discovered 1. He reported a six-month history of progressive fatigue and over the last two months had developed orthostatic hypotension, erectile dysfunction, polyuria and polydipsia. Along with these symptoms, he noted weight loss of 18 pounds, loss of appetite and fevers. The patient also experienced rhinorrhea with clear water-like nasal secretions that did not respond to nasal steroids for the last three weeks. On exam, he appeared ill and fatigued.
Skin and Soft Tissue Infections
Evaluation of Nausea and Vomiting: A Case-Based Approach - American Family Physician
An 83 year old female with a past medical history of breast cancer, multiple strokes, dysphagia, hypertension and gastroesophageal reflux disease GERD presented to an outside hospital with altered mental status, metabolic encephalopathy, decreased appetite, acute kidney injury, and E. There, she was diagnosed with a perforated gastric ulcer, which was repaired, with a gastrostomy G tube in place. Due to her complex medical history, an additional intervention was not pursued and the family agreed to comfort measures, and the patient was discharged home. The family presented to our emergency department the same day of discharge, as the patient had not been eating and the family needed assistance in using the G tube. A medium-sized left pleural effusion with left lower lobe collapse due to the communication with the perforation was observed on CT. The patient received IV fluids and a dose of vancomycin and zosyn in the ED. A vascular and interventional radiology VIR consult was recommended for potential drainage of the perisplenic abscess and left pleural effusion.
Spinal epidural abscess is a rare but potentially devastating condition that must be immediately identified and treated. This localized infection or accumulation of pus in of the epidural space of the spinal canal has an estimated incidence of only. But when left untreated, the consequences can leave a patient severely disabled. The condition typically causes local or radicular back pain, percussion tenderness, and fever.
Figure 1: Demonstrates a focal region of isoechoic heterogeneity within the renal cortex of the left kidney. Figure 2: Demonstrates a thick walled cystic lesion with internal solid components and septations. Figure 3: Demonstrates a hypervascular peripheral halo around the lesion suggestive of a left sided renal abscess. Figure 4: MRI confirmed the diagnosis of a left sided renal abscess and recommended percutaneous drainage via ultrasound guidance. Hot Topics in Interventional Ultrasound March 19,