Cold Agglutinin Disease and COVID-19: A Scoping Review of Treatments and Outcomes.

Background: Reports suggest that patients with both acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and cold agglutinin disease (CAD) may experience poorer survival when treated with rituximab. We conducted a scoping review to evaluate severe outcomes, including intensive care unit (ICU) admission and mortality, in coronavirus disease 2019 (COVID-19) patients with CAD on various treatments, including rituximab.

Methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR).

The Reactivation of Immune Thrombocytopenic Purpura After SARS-CoV-2 Infection.

Immune thrombocytopenic purpura (ITP) is an autoimmune disease associated with bleeding symptoms and thrombocytopenia. It is diagnosed in patients with low platelet count after all the other causes of thrombocytopenia are ruled out. It can be presented as a primary condition, or it can be associated with other diseases.

Oh wait … It isn't MUDPILES! Acute toxic encephalopathy with an interesting anion gap metabolic acidosis resulting in prolonged invasive mechanical ventilation.

A 70-year-old white female patient with past medical history of migraine, fibromyalgia, diverticulitis, and hypothyroidism presented to the emergency department accompanied by her husband for one day of altered mentation, nausea and vomiting. Laboratory testing showed oligo-anuric acute kidney injury with a severely high anion gap metabolic acidosis. Urine drug screen was negative.

Is the thrombolysis in myocardial infarction (TIMI) score a reliable source in a rural hospital for the management of unstable angina/non-ST elevated myocardial infarctions (UA/NSTEMI)?

: The Thrombolysis in Myocardial Infarction (TIMI) score is considered a method for early risk stratification in patients with unstable angina/non-ST elevated myocardial infarctions (UA/NSTEMI). It is composed of seven factors and if present, each factor contributes a value of one point toward the TIMI risk score, making it a simple tool that does not require differential weights for each factor. A higher score implies a higher likelihood of adverse cardiac events and/or risk of mortality.

A Rare Cause of Drug-Induced Pancytopenia: Trimethoprim-Sulfamethoxazole-Induced Pancytopenia.

Pancytopenia is a decrease across cellular hematological lines. Many different etiologies can cause this clinical picture including viral and bacterial infections, chemicals, malignancy, and medications. Particular attention should be paid to the onset, timing, and severity as they can indicate the underlying cause.

Does Fecal Microbiota Transplant Have a Role in Treating Recurrent Infection in Rural Hospitals?

infection possesses a significant economical burden, specifically in the inpatient and rural settings. Fecal Microbiota Transplant has been used for treatment of recurrent but its utility is limited by current guidelines and resources. We conducted a retrospective chart review to evaluate the financial benefit of using Fecal Microbiota Transplant after first recurrence of infection.

Extremely high high-density lipoprotein cholesterol with coronary artery disease: Case report.

Whether this extremely high high-density lipoprotein (HDL) level due to chronic alcohol abuse or cholesteryl ester transfer protein or others, we report this interesting case of extremely high high-density lipoprotein to emphasize that serum HDL is not always protective from development of coronary heart disease.

An Uncommon Case of Secondary Organizing Pneumonia Due to Influenza Type B.

Secondary organizing pneumonia refers to a disease process caused by pulmonary tissue injury. Various insults can cause secondary organizing pneumonia, including multiple types of infections and cancer. The mainstay of diagnosis is a combination of imaging and lung biopsy showing inflammatory changes, specifically plugs with granulated tissue and fibrosis.

COVID-19-Induced Acute Bilateral Optic Neuritis.

A 44-year-old male patient with no past medical history presented 2 weeks after seropositive coronavirus disease 2019 (COVID-19) infection with vision problems suggestive of optic neuritis. Radiological testing showed findings suspicious for acute bilateral optic neuritis. The patient had also anti-MOG antibodies.

Capitalism is groovy, but at what cost?

Due to the COVID-19 pandemic, the FDA was forced to bypass normal protocol and issue Emergency Use Authorization for diagnostic testing. As a result, we have seen an explosion in the number of available molecular diagnostic tests developed by various private enterprises. Our case reports of an 85-year-old female who was suffering from a multitude of co-morbidities and underwent three different molecular diagnostic tests in a short timeframe.

It Is Just a Rash They Said! Acute Skin Manifestation in a Patient With Vasculitis in Rural Hospitals.

A 76-year-old Caucasian male with a history of rheumatoid arthritis, Raynaud's phenomenon, pulmonary embolism on warfarin, and a previous amputation of his left partial ring and fifth finger presented with acute onset of rash in bilateral lower extremities. He was recently started on trimethoprim-sulfamethoxazole due to concern for cellulitis. Differential diagnosis for acute-onset rash with the patient's history presented as a challenge to the internist, as the differential is broad.

Ehrlichiosis-Induced Atrial Flutter: An Unusual Cause of Atrial Flutter.

Tick-borne illness has been increasingly on the rise, since the first human case was reported in the late 1980s. is one of the most common reported causes of tick-borne illness, particularly in the southern states of the United States. The clinical picture presents as a paradigm to the clinician, often missing the diagnosis without an appropriate history being taken and sometimes mistreated for other conditions.

The Efficacy of Intravenous Insulin Infusion in the Management of Hypertriglyceridemia-Induced Pancreatitis in a Rural Community Hospital.

A 28-year-old female presented to the emergency room with epigastric pain, nausea, and vomiting; her lipase was elevated, and computed tomography of abdomen showed evidence of acute pancreatitis. Her past medical history was significant for poorly controlled insulin requiring type 2 diabetes mellitus and 2 previous admissions for hypertriglyceridemia-induced pancreatitis. Due to the severity of her pancreatitis presentation, she was admitted to the intensive care unit.