Diagnostic Challenges in Rhino-Orbito-Cerebral Mucormycosis With Diabetes Mellitus, Hypertensive Emergency, and Excess Alcohol Consumption.

A 72-year-old male with a history of excessive alcohol intake (35+ units of alcohol daily) presented to the emergency department with bilateral vision loss, periorbital swelling, headache, and sinus congestion with bloody nasal discharge. He was newly diagnosed with diabetes mellitus and presented with severe diabetic ketoacidosis and a hypertensive emergency (blood pressure of 240/90 mmHg). Despite initial normal brain and orbital imaging, the clinical presentation was complicated by multiple life-threatening conditions and a prior immunocompetent status, thereby delaying the early suspicion of mucormycosis.

Diffuse Large B-Cell Lymphoma Presenting With Hypercalcemia.

Hypercalcemia is a common metabolic complication associated with malignancies, particularly in solid tumors, such as lung and breast cancers. However, its occurrence in hematologic malignancies, including diffuse large B-cell lymphoma (DLBCL), is rare. The pathophysiology of hypercalcemia in lymphomas is often related to the secretion of parathyroid hormone (PTH)-related peptide (PTHrP).

Pneumocephalus After Lumbar Epidural Steroid Injection: A Rare Complication With Spontaneous Resolution.

Pneumocephalus is a rare but potentially serious complication of spinal procedures, characterized by the presence of intracranial air. This report presents the case of a 40-year-old female who developed pneumocephalus following a lumbar epidural steroid injection. She presented to the emergency department with a persistent headache, blurred vision, and eye pain, which began shortly after the procedure.

Pulmonary Embolism: Hidden in the Disguise of Atrial Flutter/Atrial Tachycardia.

Every year, pulmonary embolism (PE) causes about 100,000 fatalities in the United States. Acute PE is a prevalent and occasionally fatal kind of venous thromboembolism (VTE). PE can appear in a variety of ways and is frequently nonspecific in its clinical presentation, making its diagnosis challenging.

A Case Report on Carcinomatous Meningitis in a Patient With Double-Hit Lymphoma.

A double-hit lymphoma is a high-grade B-cell lymphoma (HGBCL) with and rearrangements. It is characterized by a rapidly progressive advanced disease, high rates of central nervous involvement (CNS), refractoriness to conventional chemotherapy, and poorer clinical outcomes. Carcinomatous meningitis is a condition in which cancer cells metastasize to the meninges without involving the brain parenchyma; this phenomenon has also been reported in the literature by other terms like "leptomeningeal meningitis," "leptomeningeal carcinomatosis," "leptomeningeal metastasis," or "neoplastic meningitis.

Necrotizing Pancreatitis Due to Very High Triglyceride Level: A Case Report.

In the United States, acute pancreatitis is one of the most common gastrointestinal conditions that results in hospital admission. Necrotizing pancreatitis is a form of acute pancreatitis that can lead to various local and systemic complications. It is also associated with a high risk of mortality and morbidity without prompt intervention.

Unmasking Rheumatic Heart Disease Decades Later in a Patient With a Remote History of Rheumatic Fever Despite Prolonged Antibiotic Prophylaxis.

Rheumatic heart disease (RHD) is one of the leading causes of valvular heart disease worldwide and still persists in the USA, particularly among vulnerable populations with limited healthcare. Depending on the risk, severity, and types of valve involvement, treatment includes guideline-directed medical therapy (GDMT) and surgical interventions like valve repair or replacement. Here, we present a unique case of a patient in his late fifties who presented with worsening heart failure symptoms and several heart murmurs.

William Coley: The Pioneer and the Father of Immunotherapy.

William Coley was an unacclaimed hero of early cancer treatment. His work is often overshadowed by more recent advancements in immunotherapy. Coley's innovative work in the 1910s and 1930s laid the groundwork for what would become a major field in oncology.

Tools for Screening, Predicting, and Evaluating Sepsis and Septic Shock: A Comprehensive Review.

Sepsis is characterized by life-threatening organ dysfunction due to dysregulated host response to infection. It can progress to cause circulatory and cellular/metabolic abnormalities, resulting in septic shock that may significantly increase mortality. The pathophysiology of sepsis involves a complex interplay of invading pathogens and the body's immune defense, causing alteration in normal homeostasis, eventually leading to derangements in the cellular, humoral, circulatory, and metabolic functions.

Gut Dysbiosis and Cardiovascular Health: A Comprehensive Review of Mechanisms and Therapeutic Potential.

Cardiovascular diseases (CVDs) are a leading cause of mortality worldwide. Recent research has identified gut dysbiosis - an imbalance in the gut microbiota - as a significant factor in the development of CVDs. This complex relationship between gut microbiota and cardiovascular health involves various mechanisms, including the production of metabolites such as trimethylamine N-oxide (TMAO) and short-chain fatty acids (SCFAs).

It's Not Always Infections When It Comes to Resource-Poor Countries: A Fascinating Case Report.

A patient's demographics often guide healthcare providers toward clues to a diagnosis. A recent travel history becomes an essential piece of the puzzle when there is a high suspicion of an infectious cause. When a patient walks into the hospital after having traveled to or from a resource-poor country with systemic afflictions, a physician's mind quickly jumps to infectious causes, and in most circumstances, it proves to be correct.

An Aggressively Recurrent Squamous Cell Carcinoma of the Foot.

Squamous cell carcinoma is a malignant tumor that is most commonly found on the head and neck. The current global incidence of squamous cell carcinoma at any site is estimated to be more than 1 million cases per year, with a reported 3-year mortality rate of 30%. Recurrence of squamous cell carcinoma at any site is estimated to be 15% to 50% and has been associated with greater rates of infiltration, perineural invasion, and mortality.

Risk of Aspiration Pneumonitis After Elective Esophagogastroduodenoscopy in Patients on Glucagon-Like Peptide-1 Receptor Agonists.

Background Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are gaining popularity in the management of diabetes mellitus and obesity. It has been suggested that this class of medications causes delayed gastric emptying which raised concerns about the potential for aspiration of gastric contents in patients undergoing sedation. This led to a statement by the American Society of Anesthesiologists about their preoperative use.

Small Intestine Ectopic Varices as a Cause of Obscure Gastrointestinal Bleeding in a Cirrhotic Patient.

Portal hypertension is a major complication of liver cirrhosis, leading to various life-threatening conditions. The most common of these is the formation and bleeding of varices at the portosystemic anastomosis. Varices are most commonly esophageal or gastric and less commonly ectopic.

Small Bowel Ischemia and Ischemic Colitis Secondary to Thrombotic Thrombocytopenic Purpura in a Patient With Systemic Lupus Erythematous: A Rare Clinical Entity.

Thrombotic thrombocytopenic purpura (TTP) is a rare, life-threatening hematologic disorder characterized by microangiopathic hemolytic anemia, thrombocytopenia, and organ dysfunction. This report highlights a rare case of small bowel ischemia and ischemic colitis caused by TTP in a 35-year-old woman with systemic lupus erythematosus (SLE), hypertension, and end-stage renal disease on hemodialysis. She presented with severe abdominal pain, diarrhea, vomiting, and bloody bowel movements.

The Egyptian journey from having the highest prevalence of hepatitis C virus to being the first to achieve "gold tier" in conquering the disease.

Hepatitis C virus (HCV) is a major global health concern, particularly in Egypt, due to historic schistosomiasis control efforts that inadvertently led to widespread HCV transmission. This study aimed to evaluate the efficacy of Egypt's national strategies in controlling and reducing the prevalence of HCV, including introducing sofosbuvir and implementing the "100 Million Healthy Lives" campaign. The approach includes a review of epidemiological data, an analysis of the national HCV control strategies implemented, and an assessment of their outcomes, focusing on the period from 2006 to 2022.

Esophageal Cancer With Cardiac Metastasis: Approach to Cardiac Masses in Patients With a Known Malignancy.

Cardiac metastases occur in a significant proportion of cancer patients and profoundly affect clinical outcomes and management strategies, especially in esophageal cancer, where the metastasis typically targets the left heart due to its unique lymphatic spread. Diagnostic imaging is crucial for patients with cardiac symptoms or electrocardiogram (EKG) changes, as it significantly influences treatment decisions, including the operability of the primary tumor and the risks associated with left-sided metastasis, such as the potential for embolization leading to stroke. This case report provides a detailed analysis of esophageal cancer metastasizing to the left atrium, highlighting diagnostic challenges and discussing the appearance of cardiac metastasis across various imaging modalities.

Bilateral Inguinal Hernias Masking Cryptorchidism: A Case Report.

This case report discusses the uncommon occurrence of bilateral inguinal hernias masking cryptorchidism in a 47-year-old male, emphasizing the complexities and nuances of diagnosing and managing undescended testes in adults. Cryptorchidism is most often identified and treated during infancy; however, its rare adult manifestation presents significant diagnostic challenges and is fraught with serious implications for fertility and malignancy if left untreated. The subject presented with long-standing bilateral groin discomfort and was initially evaluated using clinical examination and CT imaging, which diagnosed bilateral inguinal hernias but did not initially detect cryptorchidism.

Secondary Evans Syndrome Presenting With Lupus Anticoagulant.

Evans syndrome (ES), characterized by autoimmune hemolytic anemia (AIHA) and immune thrombocytopenia (ITP), often poses diagnostic challenges due to its varied etiology and clinical presentation. We present a case of secondary ES in a 41-year-old male with a history of AIHA and ITP, who presented with lower extremity erythema, warmth, and sensation of chest pressure. Initial laboratory investigations revealed thrombocytopenia, mild anemia, and a prolonged activated partial thromboplastin time (aPTT), prompting further evaluation.

Alternative Dosing of Eltrombopag for the Treatment of Chronic, Steroid-Refractory Immune Thrombocytopenia.

Idiopathic thrombocytopenic purpura (ITP) presents challenges in management, particularly in cases refractory to corticosteroids. Thrombopoietin receptor (TPO-R) agonists, such as eltrombopag, offer alternative therapeutic options. We report a case of a 72-year-old South Asian male with steroid-refractory chronic ITP who achieved a favorable response with biweekly eltrombopag dosing.

The efficacy of Hemospray in managing bleeding related to gastrointestinal tumors: systematic review and meta-analysis.

Introduction: Gastrointestinal (GI) bleeding stemming from malignant tumors is increasingly recognized, due to advancements in oncology and detection methods. Traditional endoscopic hemostatic techniques have shown variable success rates in managing hemorrhagic GI neoplasms. Hemospray, an emerging endoscopic hemostatic powder, offers promise in treating upper GI bleeding, potentially extending its utility to neoplastic bleeding sites.

The Impact of Kidney Stones on Congestive Heart Failure Risk.

Introduction Heart failure (HF) represents a substantial global health concern, evidenced by its high prevalence, significant mortality rates, and considerable economic impact worldwide. Within this broader context, congestive heart failure (CHF) emerges as a critical subset, affecting millions and leading to high rates of morbidity and mortality. Recent explorations have started to uncover a potential link between kidney stones and broader systemic health problems, including coronary artery disease.