DRESS Syndrome Following Metformin Administration: A Case Report and Review of the Literature.

The drug rash with eosinophilia and systemic symptoms syndrome also known as DRESS syndrome refers to an idiosyncratic drug reaction commonly characterized by rashes, fever, lymphadenopathy, and internal organ involvement. We report a case of this syndrome in a 40-year-old man presenting with a rash, generalized pruritus, lymphadenopathy, and eosinophilia after metformin treatment. To the best of our knowledge, this is the first report linking metformin to the DRESS syndrome.

Pneumomediastinum, pneumorrhachis, and subcutaneous emphysema in Pneumocystis jiroveci pneumonia in AIDS.

Pneumomediastinum, the presence of free air within the mediastinal cavity, is sometimes accompanied by subcutaneous emphysema and pneumorrhachis (air within the spinal canal). We report the case of a 28-year-old man with previously undiagnosed HIV who was diagnosed with extensive pneumomediastinum, pneumorrhachis, and subcutaneous emphysema secondary to Pneumocystis jiroveci pneumonia after presenting with chest pain, dyspnea, and central cyanosis. Surgical consultation was requested, but a conservative approach of observation proved sufficient as the free air was resorbed into the surrounding tissues.

Kaposi sarcoma can also involve the heart.

Kaposi sarcoma (KS) is a low-grade angioproliferative tumor associated with infection with human herpes virus 8 (HHV-8). The disease was named after Moritz Kaposi, a Hungarian dermatologist who first described it in 1872 as 'idiopathic multiple pigmented sarcoma of the skin.' HHV-8 infection is required for the development of KS, but not all infected persons develop the disease.

Microscopic polyangiitis causing diffuse alveolar hemorrhage and rapidly progressive glomerulonephritis.

Diffuse alveolar hemorrhage complicating small vessel vasculitis is a life-threatening emergency and should be considered in the differential diagnosis of patients who develop rapidly progressive dyspnea with alveolar opacities on chest imaging. In these patients, the coexistence of pulmonary and renal involvement suggests a multisystem disease. We present a case of a man who presented to our hospital with diffuse alveolar hemorrhage, severe anemia, and rapidly progressive glomerulonephritis.

A 26-year-old female with metastatic primary gastrointestinal malignancy presenting as menorrhagia.

Krukenberg tumor is a metastatic malignant tumor of the ovary arising from a wide variety of primary sources, with the stomach being the most common. The presenting symptoms are non-specific and the primary source is often un-identified. Here, we describe a case of a 26-year-old Hispanic gravida 4, para 3 female who presented to our hospital with dysuria, pelvic pain and irregular, heavy menstrual cycles for three months duration.

Pulmonary arterial hypertension secondary to ethanol sclerotherapy for renal artery embolization.

Pulmonary arterial hypertension (PAH) has been reported as a major complication to consider and promptly manage in the use of ethanol sclerotherapy. Most of the available data on the development of PAH is derived from the use of ethanol for embolization of arteriovenous malformation, but it has been rarely reported in its other fields of application. We describe a case of outpatient renal artery embolization using ethanol, in which respiratory failure develops secondary to PAH despite adhering to safe practice protocols.

Acinetobacter baumannii bacteremia, a rare complication of endoscopic retrograde cholagiopancreatography!

Bacteremia is a severe and sometimes fatal complication following endoscopic retrograde cholagiopancreatography (ERCP). Several bacteria have been implicated, with Enterobacteriaceae being the most common. We report a case of post-ERCP multi-drug resistant Acinetobacter baumannii bacteremia.

Malignant mesothelioma after household exposure to asbestos.

Malignant mesothelioma (MM) is an aggressive cancer that has been closely linked to asbestos exposure. Initially recognized as an occupational cancer in male workers, MM was later found to occur in their family members as well. We report the case of an 89-year-old female who presented with abdominal distention, pain, and findings consistent with malignant ascites.

Bleeding in a 43 year old female: a rare disease.

A 43-year-old gravida 2 para 2 Caucasian female with a past medical history of menorrhagia secondary to uterine fibroids and thyroid disease presented to the emergency department with complaints of bruising in her oral mucosa and vaginal bleeding. One week prior to this presentation, she was transfused with two units of packed red blood cells because of symptomatic anemia secondary to menorrhagia. Physical examination was normal, except for petechiae on the abdomen and the lower extremities as well as purpuric lesions on the buccal mucosa.

Contrast-induced nephropathy: current practices among cardiologists.

Objective: Contrast-induced nephropathy (CIN) is a serious complication of diagnostic and therapeutic coronary angiography. There are an increasing number of guidelines in the literature to help lessen this complication. Practice patterns in the cardiology community remain relatively unknown.

Carboplatin Induced Fatal Autoimmune Hemolytic Anemia: First Reported Case.

Carboplatin is an alkylating anti-neoplastic drug used in various cancers especially ovarian cancer, germ cell tumors, endometrial cancer besides others. We present a case of acute autoimmune hemolytic anemia during Carboplatin infusion in a patient previously exposed to the drug, resulting in the death of the patient. Published reports of Carboplatin induced autoimmune hemolytic anemia suggest these are usually nonfatal and improve after discontinuation of the drug.

Management of inpatient hyperglycemia: assessing knowledge and barriers to better care among residents.

To identify areas that should be targeted for improvement, we surveyed residents for their knowledge and barriers regarding management of inpatient hyperglycemia. One hundred thirty-five residents from 4 teaching hospitals completed a questionnaire to assess their knowledge about the different types of insulin, the perceived barriers toward managing inpatient hyperglycemia, and the problems they face when dealing with this commonly encountered problem. The majority of participants thought that managing inpatient hyperglycemia was very important in the critically ill and perioperative patients, whereas only 65% thought that it was very important for noncritically ill patients.

Coughing up a mass!! Unusual presentation of Kaposi's sarcoma.

Kaposi's sarcoma can affect any organ and sometimes has strange presentations or courses. We report unusual case of nasopharyngeal Kaposi's sarcoma where the patient coughed the mass up.