Disseminated Cryptococcus in an immunocompetent patient due to prison yard pigeon exposure.

Opportunistic infection by Cryptococcus is one of the most common occurrences in patients with Human Immunodeficiency Virus (HIV) disease or Acquired Immunodeficiency Syndrome (AIDS); however, it is a very rare discovery in the immunocompetent. This encapsulated, aerobic fungus can be found in bird droppings, the soil, or on trees, and breathing the spores can lead to pneumonia, meningitis, sepsis, skin lesions, or disseminate throughout the body. We discuss the unique presentation of an immunocompetent former inmate who was admitted to the hospital due to symptoms of dyspnea and fever.

Pharyngitis Workup Leads to the Discovery of Massive Tricuspid Vegetation.

Infective endocarditis (IE) is one of the leading causes of life-threatening infections and is most often observed among patients who use intravenous (IV) drugs. We discuss the unique presentation of a 31-year-old gentleman with a two-week history of sore throat and shortness of breath, who returned to his community emergency room with persistent symptoms of streptococcal pharyngitis. A thorough history, physical examination, and diagnostic workup were conducted, where a large, protruding, highly mobile vegetation was observed on echocardiogram.

Acute popliteal thrombus workup leads to discovery of primary peritoneal mesothelioma in the absence of any known asbestos exposure.

A 75-year-old man presented to the emergency department with 1-day history of right lower limb pain and 3-month history of vague abdominal pain. In the emergency department a thrombus was discovered in the right popliteal artery. CT scan of the abdomen and pelvis revealed high-density material in the pelvis, multiple hypodensities on the liver, ascites with omental nodularity, and high-density material along the stomach wall.