Complexities of Severe Leptospirosis: A Case With Acute Hypoxic Respiratory Failure, Acute Kidney Injury, and Hyponatremia.

Leptospirosis, an acute zoonotic infection caused by spirochetes of the genus Leptospira, poses significant health risks worldwide. Transmission occurs through contact with infected animals' urine, blood, or tissue. This case report examines a 44-year-old man with severe leptospirosis, presenting as Weil's disease, characterized by acute hypoxic respiratory failure and acute kidney injury (AKI) secondary to rhabdomyolysis, complicated by severe hyponatremia.

Vasopressin versus norepinephrine as the first-line vasopressor in septic shock: A systematic review and meta-analysis.

Background And Aim: Norepinephrine is currently the first-line vasopressor for septic shock. We conducted this meta-analysis to examine the outcomes of adult patients with septic shock who received vasopressin instead of norepinephrine.

Methods: We selected studies in adults with septic shock that compared the outcomes of patients treated with vasopressin versus norepinephrine.

Extracorporeal Membrane Oxygenation (ECMO) Dependent Acute Respiratory Distress Syndrome (ARDS): A Systematic Review and Meta-Analysis.

Background:  Extracorporeal membrane oxygenation (ECMO) has emerged as a newer method for managing severe acute respiratory distress syndrome (ARDS) and ARDS refractory to conventional management. However, its current role in the management of ARDS is not clear. Therefore, we conducted this meta-analysis to compare the mortality rates of ECMO over conventional management in ARDS.

Cerebral Salt-Wasting Syndrome in a Patient With Active Pulmonary Tuberculosis.

A 37-year-old female with a medical history of recently diagnosed active pulmonary tuberculosis and a new intracranial lesion presented with altered mental status, nausea, and vomiting for two days. An initial physical examination revealed that the patient was euvolemic. Laboratory findings revealed a serum sodium concentration of 105 mEq/L.

Myeloma Cast Nephropathy and COVID-19: A Case Report of Multiple Myeloma Presenting as Acute Kidney Injury in the Setting of COVID-19.

A 64-year-old African American male presented to the emergency department with subacute low back pain for two weeks and decreased urine output. He was found to have a potassium level of 9.2 mmol/L and was uremic with a creatinine level of 28.

A Unique Case of Valacyclovir Toxicity and Pseudobulbar Affect in a Patient On Peritoneal Dialysis.

There are a few cases of valacyclovir-associated neurotoxicity (VAN) reported. This case report documents a case of a 55-year-old male presenting with emotional lability or pseudobulbar affect as the predominant or sole manifestation of VAN. A failure to adjust valacyclovir's dose for herpes simplex infection in the setting of dialysis-dependent end-stage renal disease (ESRD) preceded VAN in this patient.

Primary Psychiatric Disorder Masking the Diagnosis of Lupus Cerebritis.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that is known to affect different organs in the body. Nervous system involvement is common and can manifest as neurological or neuropsychiatric symptoms. A 23-year-old female with no significant past medical history, presented with nausea and vomiting for two weeks and unusual behavior for three days.

Free Wall Myocardial Rupture and Ventricular Septal Defect in an Ambulatory Patient.

Myocardial rupture is a rare complication of acute myocardial infarction (MI), usually presenting with chest pain. The most common site of rupture is the anterior wall. Myocardial rupture presents similar to cardiac tamponade, most frequently as cardiogenic shock.

Extremely Elevated International Normalized Ratio in a Patient with Dabigatran Etexilate Use.

A 76-year-old male with a past medical history (PMH) of hypertension, type 2 diabetes mellitus, chronic kidney disease (CKD) stage three, chronic nonvalvular atrial fibrillation (AF) on anticoagulation, and status post-left-sided nephrectomy in 2000 for acute pyelonephritis presented with multiple episodes of epistaxis and shortness of breath. On exam, the patient was afebrile and saturating 95% on room air. There was crusted blood present in bilateral nares along with a 6 x 3-centimeter area of ecchymosis present on the lateral aspect of the right abdominal wall.

Paraplegia and acute aortic dissection: a diagnostic challenge for physicians in the emergency situation.

Acute aortic dissection presenting neurological symptoms is rare and entails significant diagnostic challenges. We present a case of 45-year-old woman with a medical history of essential hypertension and smoking, admitted with lobar pneumonia. During her inpatient treatment, she developed severe back pain and numbness below the level of the umbilicus.

An Incidental Finding of Anemia: Rectal Adenocarcinoma in a Young Adult.

Rectal adenocarcinoma is an uncommon finding in patients under the age of 40. However, epidemiological surveys have suggested that colorectal cancers are increasing in incidence among patients aged 20 to 39 years in the United States. Colorectal adenocarcinoma is often not considered in the differential diagnosis in this demographic because of age.

tricuspid valve endocarditis in an elderly patient without known predisposing factors.

A 73-year-old man with history of nephrolithiasis was admitted after a witnessed cardiac arrest. In the emergency department, the patient had several runs of ventricular fibrillation treated with defibrillation and amiodarone infusion. Echocardiography revealed reduced ejection fraction with multiple mobile structures attached to the tricuspid valve leaflets.