Variant Angina and Cannabis-Induced Myocarditis: A Rare Presentation of Myocardial Inflammation.

Myocarditis is a rare but serious inflammatory disease of the myocardium, often caused by viral infections. We present a unique case of myocarditis in a previously healthy 29-year-old male who developed symptoms and electrocardiography changes of variant angina following cannabis use. This case report discusses the patient's atypical presentation, diagnostic evaluation, management, and outcome.

Tick-Borne Myopericarditis With Positive Anaplasma, Lyme, and Epstein Barr Virus (EBV) Serology: A Case Report.

Myopericarditis has been reported only rarely in those with anaplasmosis and is typically difficult to diagnose. Lyme carditis can also be difficult to diagnose as it is relatively rare but potentially fatal and usually has nonspecific manifestations. We are presenting a 61-year-old male patient who presented in New Jersey, United States with unremitting fever, chills, and myalgia for two weeks along with nausea, vomiting, and diarrhea.

Cushing's Disease Associated With Partially Empty Sella Turcica Syndrome: A Case Report.

The association between empty sella turcica (EST) syndrome and Cushing's disease has been rarely reported. It is plausible to hypothesize that EST syndrome in association with Cushing's disease can be attributed to intracranial hypertension. In this case report, we present a 47-year-old male patient who presented with weight loss, fatigue, easy bruising, acanthosis nigricans, and skin creases hyperpigmentation.

Cannabis-Induced ST-Segment Elevation Myocardial Infarction With Possible Coronary Artery Dissection: A Case Report.

Spontaneous coronary artery dissection is a rare and commonly underdiagnosed cause of acute coronary syndrome. Here, we report the case of a 36-year-old male patient who presented with an acute onset of left-sided chest pain, preceded by several hours of nausea and vomiting. Past medical history was significant for chronic marijuana use and multiple episodes of nausea and vomiting requiring multiple hospitalizations.

Nivolumab-Induced Organizing Pneumonia in Management of Non-small Cell Lung Carcinoma: A Case Report.

Nivolumab is an immune checkpoint inhibitor (ICI) that has proven efficacy in managing certain malignancies, including non-small lung carcinoma. In this case, we present a 53-year-old female patient diagnosed with metastatic non-small lung carcinoma. After management with radiation (both external beam and brachytherapy) and tumor debulking by bronchoscopic cryotherapy, she developed an initial pneumonitis attributed to nivolumab and ipilimumab.

Spinal Hypertrophic Pachymeningitis in Antineutrophilic Cytoplasmic Antibody-Negative Vasculitis: A Case Report.

Hypertrophic pachymeningitis (HPM) is a rare but extremely debilitating disease. It is even rarer for HPM to be seen in association with antineutrophil cytoplasmic antibody (ANCA)-negative vasculitis. In this case, we are presenting HPM that was diagnosed in a 28-year-old female patient who presented with worsening back pain.

A Possible Association Between COVID-19 Vaccine and Complicated Pleural Effusion: A Case Report.

As COVID-19 vaccines gain more prevalence, previously unrecognized side effects continue to be reported. We report a case of 78 male with no significant past medical history who was found to have a unilateral pleural effusion with symptoms that started two days after the administration of a COVID-19 vaccine. The initial presumption was bacterial pneumonia with parapneumonic effusion.

Cardiac Tamponade Risk Associated With Anticoagulation for Atrial Fibrillation in Dialysis-Associated Pericarditis: A Case Report.

Heparin is a preferred initial anticoagulant in patients with new-onset atrial fibrillation (AF). Despite continuous debate about the risk, there has been a concern about heparin-induced hemorrhagic pericarditis and cardiac tamponade. We present a case of a new onset atrial fibrillation (AF) in a patient with renal impairment and evidence of pericardial effusion complicated by hemopericardium development after starting anticoagulation.

A Case of Advanced Multifocal Cholangiocarcinoma With Excellent Response to Pembrolizumab.

The role of immune checkpoint inhibitors (ICIs) continues to receive more attention as evidence emerges of their efficacy and improved survival in patients with advanced biliary tract malignancies including cholangiocarcinoma (CCA). In line with this evidence, we describe the case of a 52-year-old male patient who presented initially in October 2019 with abdominal pain. Investigations revealed multifocal hepatic masses that proved to be CCA that was considered unresectable.

The Rare Adverse Effect of Cefepime-Induced Neutropenia.

Cefepime is widely considered a safe and effective antibiotic, but it can have rare and serious side effects. We present a case of a 33-year-old female patient who developed severe and potentially life-threatening neutropenia after being on cefepime for 25 days. Despite extensive investigations, no other causes of neutropenia could be identified.

Extensive Unprovoked Thromboembolism in Steroid-Dependent Ulcerative Colitis: A Case Report.

The elevated risk of thromboembolism (TE) in association with inflammatory bowel disease (IBD) is well-established in literature. Herein, we present a case of a 70-year-old patient with steroid-dependent ulcerative colitis who presented with exertional dyspnea and abdominal pain. Investigations revealed extensive bilateral iliac and renal and caval venous thrombosis as well as pulmonary emboli.

Bulbar Onset Amyotrophic Lateral Sclerosis in a COVID-19 Patient: A Case Report.

Amyotrophic lateral sclerosis (ALS) is a devastating neurodegenerative disorder with a largely unknown etiology. In this case, we are presenting an 84-year-old male patient who was admitted for acute hypoxemic respiratory failure secondary to coronavirus disease 2019 (COVID-19) infection. He was neurologically intact.

Direct/Conjugated Hyperbilirubinemia as an Uncommon Presentation of Acute Alcoholic Hepatitis: A Case Report.

Alcoholic liver disease (ALD) is a common pathology in clinical practice and is clinically diverse. Acute alcoholic hepatitis is an acute inflammation of the liver with or without underlying cholestasis and steatosis. In this case, we are presenting a 36-year-old male with a past medical history of alcohol use disorder who presented with two weeks of right upper quadrant abdominal pain and jaundice.

Report of a Rare Case of Intracranial Extramedullary Hematopoiesis Mimicking a Brain Tumor.

Failure of the bone marrow to maintain adequate blood cell production to match blood metabolic demand incites the production of cell lines outside the bone marrow, which is known as extramedullary hematopoiesis. Herein, we are reporting an 80-year-old male patient who presented with two weeks of worsening headaches and behavioral changes. Labs showed thrombocytosis and imaging showed a large right-sided hemorrhagic brain mass.

The Importance of Early Imaging in Acute Pyelonephritis: A Case Report of Emphysematous Pyelonephritis.

Emphysematous pyelonephritis (EPN) is a rare life-threatening infection that is usually encountered in diabetic patients. Herein, we are reporting a 41-year-old male patient with a past medical history of stage 3B chronic kidney disease (CKD), neurogenic bladder, and poorly controlled diabetes who presented with left-sided pyelonephritis and septic shock. was detected in urine and blood.

Cortical Ribbon and Crossed Cerebellar Diaschisis in Subclinical Status Epilepticus: A Case Report.

Cortical ribbon is an uncommon finding that is characteristic of Creutzfeldt-Jakob disease but has a broad differential diagnosis. On the other hand, crossed cerebellar diaschisis is also an uncommon finding in brain magnetic resonance imaging (MRI). Herein, we are describing an 88-year-old male patient with dementia, ambulatory dysfunction, and frequent falls who presented with acute on chronic right-sided subdural hemorrhage that was discovered after an episode of seizure.

Miller Fisher Syndrome With Positive Anti-GQ1b/GQ1d Antibodies Associated With COVID-19 Infection: A Case Report.

The association between Guillain-Barré Syndrome (GBS) and its variants including Miller Fisher syndrome (MFS) has been reported and debated in the literature. Herein, we are reporting a 59-year-old male patient who had flu-like symptoms for 10 days prior to presentation with rapidly progressive weakness, dysphagia, and dysarthria. He tested positive for COVID-19 and further workup showed positive anti-GQ1b and GQ1d antibodies.

Subarachnoid Hemorrhage With Multifocal Cerebral Aneurysms in a Patient With Crohn's Disease and Sjögren's Syndrome: A Case Report and Literature Review.

Only a few reports of the association between Crohn's disease (CD) and Sjögren's syndrome (SS) have been documented in the medical literature. Herein, we are presenting a 61-year-old female patient who presented with subarachnoid hemorrhage (SAH). She has a past medical history of primary SS on no active treatment, and CD in remission while on maintenance immunotherapy.

A Probable Catastrophic Antiphospholipid Antibody Syndrome/Thrombotic Storm Presenting As Rapidly Evolving Multifocal Ischemic and Hemorrhagic Strokes: A Case Report.

Catastrophic antiphospholipid antibody syndrome (CAPS) is a life-threatening disorder. It is a rare and severe form of antiphospholipid antibody (APL) syndrome characterized by widespread multisystemic thrombosis. We present a 55-year-old male patient with acute cerebellar hemorrhagic stroke who developed widespread progressive microthrombosis and macrothrombosis manifesting as progressive bilateral ischemic strokes with lower extremities deep vein thrombosis (DVT) and acute renal failure within a week of presentation.

Anti-Glutamic Acid Decarboxylase (GAD) 65 Encephalitis Mistaken for Herpes Encephalitis and Hashimoto's Encephalitis (HE): A Case Report.

Autoimmune encephalitis is increasingly recognized in clinical practice. We are presenting a 72-year-old female patient who initially presented with a new onset seizure with temporal lobe abnormality on imaging. This was initially attributed to herpes encephalitis although herpes polymerase chain reaction (PCR) was negative.

Primary MRSA Myositis Mimicking Septic Arthritis.

As the incidence of bacterial myositis and pyomyositis in the United States is rising, we aim to highlight the presentation of bacterial myositis which is known as a great imitator in tropical regions. This is a case report of a 61-year-old female patient with poorly controlled diabetes who presented initially with lateral hip pain and tenderness. This was initially believed to be septic arthritis and warranted arthrocentesis.

A Spontaneous Spinal Epidural Hematoma Secondary to Long-Term Low-Dose Aspirin and Clopidogrel Use: A Case Report.

The association between antiplatelet agents such as aspirin, clopidogrel, and ticlopidine and spontaneous spinal epidural hematoma is based on multiple case reports in the literature. Here, we present the case of a 76-year-old male patient who presented with acute low back pain associated with sudden-onset paralysis of the lower extremities. His past medical history was remarkable for coronary artery disease with a stent placement history on dual antiplatelet therapy including low-dose aspirin and clopidogrel.

The Clinical Challenge of Refractory Octreotide-Induced Thrombocytopenia in Active Gastrointestinal Bleeding: A Case Report.

The association between octreotide and thrombocytopenia has been documented in the literature but it remains a rare finding. We are reporting a 59-year-old female patient with alcoholic liver cirrhosis who presented with the gastrointestinal tract (GIT) bleeding secondary to esophageal varices. Initial management involved fluid and blood products resuscitation and initiation of both octreotide and pantoprazole infusion.

Important Clues for the Diagnosis of Anti-LGI1-Antibody Autoimmune Encephalitis: A Case Report.

Anti-leucine-rich-glioma-inactivated 1 (LGI1) antibody autoimmune encephalitis is a rare autoimmune encephalitis. We present a 68-year-old female patient who initially presented with episodic confusion, hallucinations, behavioral changes, and unexplained hyponatremia. History was also remarkable for intermittent abnormal movement affecting the left upper extremity and face.