A Very Unusual Presentation of Miliary Tuberculosis and Osteomyelitis as an Incidental Finding of Musculoskeletal Pain.

Tuberculosis (TB) is a highly infectious disease that takes the primary or latent route. In primary TB, the patient often presents with constitutional symptoms such as cough, fever, weight loss, and hemoptysis. This 83-year-old patient was sent to the emergency department (ED) by her primary care physician after abnormal imaging for acute back and neck pain. Imaging revealed pulmonary TB with possible tuberculosis osteomyelitis versus metastatic carcinoma to the cervical vertebrae. The case's unique presentation gives light to the need for more research on miliary TB and tuberculosis spondylitis/osteomyelitis in various populations and circumstances to ensure prompt and adequate patient care.

Massive Life-Threatening Saddle Pulmonary Embolism in a Healthy 28-Year-Old.

When Virchow's triad is disrupted, a deep vein thrombosis (DVT) can often occur and progress into a pulmonary embolism, and in rare cases, a saddle pulmonary embolism. This 28-year-old male patient showed up at the emergency department (ED) with shortness of breath, chest palpitations, and right calf pain. Additional imaging showed a massive saddle pulmonary embolism, and he was taken to immediate right femoral catheterization for thrombectomy. Though this patient presents with no known risk factors in his history or workup, he stretches the predefined boundaries with his cavalier presentation.

Accidental Acetone Ingestion in Liver Transplant Patient With Alcohol Relapse: A Case Report.

Acetone is one of the three main types of ketone bodies that can be found in ketoacidosis, along with acetoacetate, and beta-hydroxybutyrate. Any of these three ketone bodies can be found in the blood after the natural breakdown of fatty acids in diabetes, starvation, or alcoholic ketoacidosis. However, a patient can also develop acetone poisoning from ingestion of common household products such as nail polish removers, paint removers, isopropyl alcohol, or other detergents and cleaners. Ingestion is usually accidental in adults and children and can lead to severe damage to the liver, heart, nervous system, and kidneys. In rare cases, large amounts of ingestion can lead to life-threatening conditions or death. Our case reports a man with a history of alcoholic cirrhosis status post liver transplantation, who unintentionally ingested acetone, mistaking the contents of small bottles for vodka. The patient presented with several syncopal episodes, anion gap metabolic acidosis, transaminitis with hyperbilirubinemia, and pancreatitis.