COVID-19-associated thrombotic angiopathy improved after plasma exchange.

Utilization of therapeutic plasma exchange in select patients with COVID-19 microangiopathy may provide useful treatment by modulation of inflammatory cytokines and coagulation cascade to maintain homeostasis.

Corynebacterium striatum bacteremia associated with cellulitis in a patient with cirrhosis.

Corynebacteria are a bacteria usually associated as a contaminant due to their presence in normal human skin and mucosal membranes. However, they are increasingly becoming recognized as an opportunistic pathogen. Corynebacteria can be pathogens in immunocompromised patients or those with malignancies or prosthetic devices. We present a rare case of bacteremia due to multidrug resistant Corynebacterium striatum in a 52-year-old male with cirrhosis. The patient had lower extremity cellulitis which likely served as a port of entry.

Opportunistic Disease or Metastatic Lesions: A Rare Finding in a Patient with Bladder Cancer.

A 66-year-old male with a history of human immunodeficiency virus infection and metastatic bladder cancer presented to our hospital for a further workup of a focal seizure involving the patients left upper extremity. The patient was undergoing active chemotherapy at the time of admission and had a CD4 count of 111. Magnetic resonance imaging of the brain revealed multiple ring-enhancing lesions in the right frontal lobe associated with vasogenic edema, and mass effect at the right frontal horn of the lateral ventricles. As the imaging was not consistent with typical metastatic disease of the bladder, further testing was performed. A lumbar puncture was performed to assist in differentiating between malignant and infectious causes in the setting of a low CD4 count. The cerebral spinal fluid was sterile and no malignant cells were identified. Protein and glucose levels of the cerebral spinal fluid were within normal range. To confirm the presence of metastatic disease, a brain biopsy was performed and found to be consistent with metastatic carcinoma with a bladder primary. The patient subsequently underwent radiation therapy to the site of the brain metastasis.

Newly diagnosed AIDS with neurosyphilis, Kaposi sarcoma, pancytopenia, oropharyngeal candidiasis, and pseudomonal pneumonia: We shouldn't be seeing this anymore.

The incidence of new human immunodeficiency virus (HIV) infections is declining and is half of what it was in the mid 1990s. We present a case of newly diagnosed HIV with acquired immune deficiency syndrome (AIDS), Neurosyphilis, Kaposi Sarcoma, and multiple opportunistic infections. Although this type of patient was not uncommon in the pre-antiretroviral era, we do not often see such a constellation of conditions in a single individual. The significance of this case lies not in the diagnosis, but rather in the number of the diagnoses and the thought process used to attain them.