Severe Esophageal Stricture Caused by Esophageal Candidiasis in a Non-HIV Patient.

Esophageal candidiasis (EC) is a common opportunistic infection in immunocompromised individuals, often encountered in situations such as untreated HIV/AIDS or following organ transplantation with immunosuppressant usage. While the main manifestation of esophageal candidiasis is mucosal inflammation, its progression and severe cases may lead to esophageal complications like dysphagia, odynophagia, and weight loss. One of the rare complications is esophageal stricture (ES). Few cases have been reported in the literature to date. Esophageal candidiasis can lead to the formation of ES through chronic inflammation, tissue damage, fibrosis, scarring, and ultimately narrowing of the esophageal lumen. Patients with ES often present with dysphagia, odynophagia, and other symptoms related to impaired swallowing. Esophageal strictures related to EC could seriously affect the patient's quality of life. Malnutrition and weight loss can be easily encountered in those cases. So, prompt diagnosis and appropriate antifungal therapy are important. Management should include addressing the stricture through endoscopic dilation interventions. Timely recognition of this complication is crucial for improving patient outcomes and quality of life. We present the case of a 46-year-old male with EC complicated by severe ES, dysphagia, and weight loss of more than 30 lbs. The diagnosis was made based on the histopathological examination of the esophageal biopsies.

Hemophagocytic Lymphohistiocytosis in a Patient with Hodgkin Lymphoma, HIV, and Epstein-Barr Virus.

Hemophagocytic lymphohistiocytosis (HLH) is an aggressive and life-threatening syndrome of excessive immune activation. It occurs in many underlying conditions and all age groups due to severe and uncontrolled inflammatory reactions, with the resultant overproduction of immune cells and cytokines. This leads to multi-organ damage (if not detected early and treated properly) with a mortality of more than 55%. We present a case of a 38-year-old male patient who presented with HLH with concurrent HIV/AIDS, and Epstein-Barr virus (EBV)-related Hodgkin lymphoma. We aim to emphasize the importance of considering HLH and cancer in patients with HIV/AIDS.

A Rare Case of Huge Schistosomiasis-Associated Cecal Polyp Mimicking Colon Carcinoma.

Schistosomiasis is a parasitic infection caused by Schistosoma species, commonly found in tropical and subtropical regions. It affects millions of people worldwide and can lead to different clinical presentations like abdominal pain, weight loss, anemia, and chronic colonic schistosomiasis. In rare cases, chronic infection can result in the development of polyps, which can mimic colon carcinoma, posing a diagnostic challenge. Here, we present a rare case of a huge Schistosomiasis-associated cecal polyp in a patient initially suspected to have colon cancer. The patient's clinical history and the histopathological analysis confirmed the diagnosis, emphasizing the importance of considering parasitic infections in the differential diagnosis of gastrointestinal polyps in Schistosomiasis-endemic areas. This case report highlights the need for increased awareness among healthcare professionals of the potential for Schistosomiasis-associated polyps and the importance of multidisciplinary management in such cases.

A Case Report of Acute Respiratory Distress Syndrome From Cannabis and Amphetamine Use.

Illicit drug usage (IDU) is a big challenge in clinical practice, with increasing incidence in the last decades. Daily, clinicians encounter a wide variety of complications related to IDU. Common infections related to illicit drugs are infective endocarditis, abscesses, osteomyelitis, pneumonia, HIV, hepatitis C, and B. Other rare complications could happen like leukoencephalopathy, IDU-related lung injury, and acute respiratory distress syndrome (ARDS) which is a severe and potentially life-threatening condition characterized by the sudden onset of respiratory failure, often necessitating mechanical ventilation. While the most common etiologies of ARDS are related to infections and sepsis, there is emerging evidence that substance abuse can also be associated with the development of ARDS with unclear mechanisms. IDU-related lung injury is a rare entity with few cases reported in the literature. Its management usually involves supportive care, including mechanical ventilation, oxygen therapy, and close monitoring of fluid balance. We present a case of a 25-year-old male presented with ARDS and multiorgan failure related to methamphetamine and cannabis abuse.

Disseminated Blastomycosis in an Immunocompetent Patient.

Blastomycosis is caused by Blastomyces dermatitidis, which is endemic in certain areas in North America. It usually causes lung infection, and it can disseminate to other organs in immunocompromised individuals. Common sites for dissemination include skin, central nervous system (CNS), and bone. Dermatological spread is the commonest site for extrapulmonary spread. The diagnosis can be easily missed due to nonspecific presentation and variable dermatological presentations. Treatment is necessary even if the patient has improvement in symptoms without previous treatment. We present a case of disseminated blastomycosis in a 40-year-old male without known risk factors that went undiagnosed for over a year.

Acute Non-glue Pulmonary Embolism Following Endoscopic Ultrasound (EUS)-Guided Glue/Coil Treatment for Gastric Varices: A Case Report and Literature Review.

Decompensated liver cirrhosis (DLC) is sometimes associated with the development of esophageal varices (EV) and gastric varices (GV). GV is less common than EV. One of the treatment methods for GV is the injection of glue into the varices, which can be complicated by the embolism of the glue into the pulmonary vessels called glue pulmonary embolism (GPE). Non-glue pulmonary embolism (NGPE) after treatment of gastric varices is not very commonly reported in the literature. Herein, we present a case of the development of non-GPE after the treatment of the GV with glue injection and coiling.

Brown Recluse Spider Bite Resulting in Coombs Negative Hemolytic Anemia in a Young Male Requiring Blood Transfusion.

Spider bites, including the bites of recluse spiders (Loxosceles, also known as brown spiders), usually lead to local symptoms; however, severe systemic symptoms have also been reported in the literature. Management of spider bites is based on symptoms. In severe cases involving the development of angioedema, hemolytic anemia, skin necrosis with superimposed bacterial infection or disseminated intravascular coagulation, antibiotics, steroids, blood transfusions, and plasma exchange may also play a role. We present a case of a brown recluse spider bite resulting in symptomatic hemolytic anemia and jaundice requiring blood transfusion.

Mycotic Aneurysms and Recurrent Intracranial Hemorrhages in a Patient With Infective Endocarditis.

The increase in the use of IV drugs has been accompanied by an increase in the incidence of infective endocarditis (IE). The clinical picture, vitals, examination, blood cultures, laboratory tests, and imaging can help diagnose IE. The Duke criteria also play a role in the diagnosis of IE. Prolonged antibiotic use and even interventions may be needed in the management of specific cases. Rare complications such as mycotic aneurysms and intracranial hemorrhages can be fatal and must be promptly addressed to prevent loss of life and serve debilitation in these patients.

Endoscopic Retrieval of an Ingested Mobile Phone From the Stomach of a Prisoner: When Gastroenterologists Answer the Call.

Foreign body ingestion (FBI) is a common problem among the pediatric population. The intentional ingestion of foreign bodies in the adult population is common among psychiatric patients, patients with developmental delay, alcohol use disorder, and prisoners. The management of complex FBI cases like mobile phones is not standardized in the literature. The care was discussed in a few case reports, and till the end of 2020, there were only four cases reported. We present this rare case of mobile phone ingestion, which was successfully managed by upper esophagogastroduodenoscopy (EGD) without the need for surgical intervention.

Celiac Artery Compression Syndrome as an Uncommon Cause of Intractable Postprandial Abdominal Pain: A Case Report.

Celiac artery compression syndrome (CACS) is an uncommon and poorly understood condition. Compression of the celiac artery by the median arcuate ligament causes intractable postprandial abdominal pain, weight loss, vomiting, and nausea. We present a case of a 68-year-old male who suffered recurrent severe episodes of postprandial abdominal pain associated with occasional nausea, vomiting, and elevated blood pressure. The diagnostic workup was significant for celiac artery compression on computed tomography angiography. Diagnosis of CACS was made after the exclusion of the other possible pathologies, and the patient was referred to the surgical team for further management for median arcuate ligament release on an elective basis.

A Peek at LVADs Pumping to Recovery.

Left ventricular assist devices (LVADs) have revolutionized the management of patients with advanced heart failure refractory to medical therapy. Current indications of LVADs include Bridge to Transplantation (BTT), Destination Therapy (DT) for long-term use, Bridge to the Decision (BTD) used as a temporary measure, and lastly Bridge to Recovery (BTR). Here, we briefly review the clinical evidence and the molecular mechanisms behind myocardial recovery following LVAD placement. We also share institutional protocols used at 2 major medical centers in the USA.