Painful subcutaneous nodules in an alcoholic: a case of pancreatic panniculitis.

Pancreatic panniculitis is an uncommon manifestation of pancreatic disease, affecting approximately 2-3% of patients with acute or chronic pancreatitis [1]. Its accurate diagnosis is crucial for effective treatment as skin manifestations usually precede systemic symptoms of pancreatitis. The diagnosis of pancreatic panniculitis requires identifying and confirming pancreatic disease in addition to the typical histopathological findings of lobular panniculitis without vasculitis. Herein, we present a patient with pancreatic panniculitis, underlying acute pancreatic failure, and kidney injury.

Bowel Obstruction From Biliary Stent Migration: An Unusual Case of Abdominal Pain.

Endoscopic biliary stent placement is an important procedure that is commonly done in patients with malignant obstruction of the biliary tree. However, it can also be done to relieve non-maligant obstructions short term until more curative surgical interventions can be performed. There are two main types of stents used for these procedures: self-expanding metal stents (SEMSs) and plastic stents. Each of these stent types has different indications, and determining the correct stent for each individual patient is important. Here, we present a case of a 73-year-old female who presented with abdominal pain due to small bowel obstruction caused by a dislodged biliary duct stent. We hope to promote more focus on selecting the right stent type for each patient and encouraging follow-up visits after placement, especially for those with a history of medical noncompliance.

Superficial Siderosis After Traumatic Brain Injury: A Case Report.

Superficial siderosis (SS) is a rare condition in which chronic accumulation of the blood in the subarachnoid space over time leads to the buildup of hemosiderin deposits, which in turn cause neurological dysfunction in those affected. While reversibility of the damage done by this condition is nearly impossible, early detection can allow for immediate surgical intervention and thus prevent further progression of ataxia, hearing loss, and other neurological deficits caused by SS. We present a case of a 53-year-old male who was successfully diagnosed with SS secondary to a chronic post-traumatic pseudomeningocele and underwent surgical repair with the resolution of his symptoms. We aim to encourage more extensive workups for common neurological dysfunctions such as tinnitus or vertigo in patients who have a history of traumatic brain injury or any significant motor vehicle accidents.

Amoxicillin-Induced Drug Reaction With Eosinophilia and Systemic Symptoms (DRESS) Syndrome With Acute Onset of Diffuse Rash and Acute Kidney Injury (AKI).

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is an uncommon and potentially fatal adverse drug reaction that can affect individuals with immunosuppression, viral reactivation, pharmacogenetic susceptibility, and recent exposures to new medications. Due to the ambiguous symptomology of DRESS syndrome along with a lack of diagnosis and treatment criteria, there can be delays in diagnosis and management. Here, we present a case of a 60-year-old female with an uncommon presentation of DRESS syndrome due to a less commonly implicated drug. We aim to bring awareness to the various presentations associated with DRESS syndrome and inform readers about current diagnostic and treatment modalities used today. In addition, this case serves to provide insights that further evidence is needed to have standardized guidelines in place to effectively diagnose and manage affected patients.

Paravertebral Abscess Secondary to Vertebral Osteomyelitis in an Intravenous Drug User.

Hematogenous pyogenic vertebral osteomyelitis (VO) is a rare and often fatal complication of osteomyelitis that can affect individuals with underlying medical conditions, hospital-acquired infections, and intravenous (IV) drug abuse. Pyogenic vertebral osteomyelitis can present with generalized back pain, pyrexia, motor weakness, and neurologic deficits. The enigmatic presentation of this condition often results in delays in diagnosis and an increase in mortality. This case report aims to bring awareness to complications of hematogenous pyogenic vertebral osteomyelitis as well as highlight the need for further studies in order to establish standardized treatment. In our report, we depict a case of complicated pyogenic VO that required pharmacological and surgical intervention.

Catamenial Pneumothorax: A Rare Diagnosis Among Menstruating Women.

Catamenial Pneumothorax is a rare condition often associated with endometriosis in menstruating women. Due to the rarity of this condition, its etiology is not well studied and, thus, effective treatment regimens have not been well established. We present a case of a 21-year-old female with no significant past medical history who developed recurrent episodes of spontaneous pneumothorax, chronologically associated with her menstrual cycle. This pattern is known as the sine qua non criteria and is one of the only established criteria in current literature for diagnosing catamenial pneumothorax. Our aim with this case report is to expand the current collection of published knowledge about this rare condition and to bring awareness so that those affected by catamenial pneumothorax can be diagnosed and treated more efficiently. Additional research on the pathophysiology of this disease needs to be done to aid in the development of effective treatment regimens.

Prolonged Fever in a Pediatric Patient: A Case of Systemic Juvenile Idiopathic Arthritis (sJIA) Complicated by Macrophage Activation Syndrome (MAS).

A prolonged fever in a child can be due to a range of causes including infectious, autoimmune, malignant, or genetic in etiology. In our report, we present the case of a previously healthy three-year-old female diagnosed with macrophage activation syndrome (MAS) due to complications of systemic juvenile arthritis (sJIA). MAS is considered a secondary subtype of hemophagocytic lymphohistiocytosis (HLH), a rare and life-threatening group of syndromes characterized by overstimulation of the immune system leading to systemic inflammation. Through our case, we wanted to bring awareness to this uncommon group of diseases as well as discuss the importance of differentiating between its subtypes. While HLH and MAS have similar clinical presentations, the treatment regimen for each is distinct. Moreover, further research should be conducted to create standardized criteria and treatment guidelines that are evidence-based in order to properly manage these patients.