Influenza, typically recognized as a respiratory ailment, can manifest severe cardiac complications, notably, myocarditis and pericarditis, with potential fatal outcomes. Interestingly, influenza B demonstrates a reduced occurrence of troponin I elevation despite the risk of cardiac issues, such as isolated pericarditis. Interpreting the absence of troponin elevation as an indication of no cardiac involvement in cases of influenza B-related pericarditis may be contributing to poorer clinical outcomes.
View Article and Find Full Text PDFSepsis-induced cholestatic disease occurs in a fair amount of critically-ill patients. Although the mechanism is poorly understood, hypoperfusion to the liver is one of the most common mechanisms that lead to liver dysfunction and subsequently biliary disease. Hepatic conditions such as cirrhosis and hepatitis A may have an impact on how sepsis-induced cholestatic disease can present.
View Article and Find Full Text PDFHemorrhagic pericardial effusion is a rare presenting sign of undiagnosed rheumatoid arthritis (RA). We present a case of a 58-year-old female with a history of mucinous cystadenoma with subsequent omental caking status-post small bowel resection, chronic intermittent bilateral knee pain, carpal tunnel syndrome of the left hand, and drainage of a peritoneal inclusion cyst two days prior to admission. The patient had pleuritic chest pain and acute-onset shortness of breath but was hemodynamically stable on presentation.
View Article and Find Full Text PDFInfective endocarditis (IE) is a condition that can involve endocardial tissue and possibly lead to valvular disease. Not only is it important to recognize the clinical presentation difference between acute and subacute IE, but physicians should understand that underlying risk factors, such as immunosuppression secondary to non-Hodgkin lymphoma (NHL), can alter an acute presentation into that of a subacute one. We report an NHL patient, who presented with subacute clinical symptoms of IE, but had a clinical test workup that showed evidence of acute IE rather than subacute.
View Article and Find Full Text PDFEnoxaparin is commonly used for prophylaxis as an anticoagulant in hospital settings. Although enoxaparin has been known to cause many minor adverse reactions, hepatocellular injury is one of the rare side effects which can impact clinical course, marked by an asymptomatic rise in liver function panel tests. In this paper, we not only delineate the relationship between enoxaparin-induced hepatocellular injury but also associate it with fevers that have not been previously documented.
View Article and Find Full Text PDFElevated beta-human chorionic gonadotropin (beta-hCG) levels in postmenopausal women is a finding known in the literature; however, it still commonly leads to unnecessary and extensive diagnostic workup. We present the case of a 48-year-old African-American postmenopausal female with acute kidney injury on chronic kidney disease (CKD) stage 5 and an incidental finding of elevated serum beta-hCG. Abdominal and transvaginal ultrasound showed no evidence of intrauterine or ectopic pregnancy or gestational trophoblastic disease.
View Article and Find Full Text PDFAutoimmune hepatitis (AIH) is a condition that affects the liver which, potentially, may render it fibrotic and eventually cirrhotic. This condition has many etiologies ranging from genetic predispositions and immunological defects to medication and environmental side effects. Essentially, we will explore the risks, presentation, diagnosis, and treatment of this condition as it relates to a medication-induced etiology.
View Article and Find Full Text PDFChilaiditi sign is a rare incidental radiographic finding where bowel is interposed between the diaphragm and the liver, often seen as air under the right hemidiaphragm. A majority of patients with Chilaiditi sign are asymptomatic and remain so throughout their lifetime. Chilaiditi sign is recategorized as Chilaiditi syndrome if it becomes symptomatic and is a very rare etiology of bowel obstruction.
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