Paracentral Bitemporal Hemianopsia and Acquired Supranuclear Ocular Motor Paresis Following Cardiac Surgery.

Acquired supranuclear ocular motor paresis (ASOMP) is a rare complication following cardiac surgery, characterized by limited voluntary eye motility. The exact cause and development of ASOMP after cardiac surgery remain unclear. We report a case of ASOMP with paracentral bitemporal hemianopsia with optic atrophy after cardiac surgery, which, to our knowledge, is novel.

Antibiotic Stewardship and Inpatient Clostridioides difficile Testing in Solid Organ Transplant Recipients: The Need for Multilevel Checks and Balances.

Background: Diarrhea among recipients of solid organ transplants is a commonly encountered problem and is often multifactorial in etiology. Owing to the combination of perioperative antibiotic administration and the immunosuppressed status of transplant recipients, a high degree of suspicion for Clostridioides difficile (C. difficile) colitis is prudent.

Challenging Biopsy of a Benign Breast Lesion With Malignancy Features: Cystic Apocrine Metaplasia.

Apocrine metaplasia is a benign epithelial change that primarily occurs in the terminal lobule, where the normal cuboidal epithelium is replaced by secretory apocrine cells with abundant eosinophilic cytoplasm. Even with the most recent advances in imaging modalities, radiographic findings can sometimes be equivocal in the characterization of breast lesions, leading to the necessity of tissue sampling. We report a challenging case of biopsy-proven cystic apocrine metaplasia that presented in the posterior depth with initially suspicious imaging findings concerning for malignancy.

Massager-Induced Anterior Subcapsular Cataracts and Keratoconus in a Patient With Multiple Epiphyseal Dysplasia.

Multiple epiphyseal dysplasia (MED) is a phenotypically heterogeneous disease associated with orthopedic abnormalities among other systemic manifestations. While the spectrum of ocular abnormalities in this disorder is yet to be fully reported, MED has been rarely associated in the literature with the development of cataracts and keratoconus. Here, we report a case of bilateral massager-induced anterior subcapsular cataracts and keratoconus in a 46-year-old female with MED.

Intra-Peritoneal Pseudocyst as a Rare Complication After Peritoneal Dialysis: The Use of a Staged Surgical Approach in Management.

Despite its numerous benefits, peritoneal dialysis (PD) can rarely result in dangerous and even life-threatening complications, including peritonitis, hernias, encapsulating peritoneal sclerosis (EPS), and rarely peritoneal pseudocysts. Herein, we present a rare case of a giant intra-peritoneal pseudocyst that presented four months following the discontinuation of a 5-year course of complicated PD. Despite the initially successful drainages, the patient's symptoms continued to recur, and the imaging findings were concerning for underlying neoplastic processes.

Magnetic Resonance Imaging Enhancement Two Years Post Lumpectomy: An Unusual Timing for Fat Necrosis.

Breast fat necrosis is a common benign inflammatory process in the post-surgical or post-traumatic breast. It is often clinically silent with a wide spectrum of imaging findings that range from the characteristically benign to the suspiciously malignant. These characteristics pose a significant challenge for clinical providers to identify this common entity and distinguish it from more ominous diagnoses, especially in patients with a prior history of breast malignancies.

Torsion of the Epididymal Appendage in a Child.

The epididymal appendage, or the appendix epididymis, is a developmental remnant of the mesonephric duct that sprouts from the head of the epididymis. Due to its pedunculated anatomical configuration, the epididymal appendage is prone to torsion and can become a rare cause of an acute scrotum. Given its often challenging and atypical presentation, high clinical suspicion and Doppler ultrasonography are needed to guide diagnosis.