A Diagnostic Challenge: Periorbital or Orbital Cellulitis?

The authors present the case of a 39-year-old male who presented to the hospital with worsening eye pain, swelling, and blurred vision of the left eye. His symptoms grew worse despite initial over-the-counter medication and a trip to the urgent care center. A physical exam was concerning for a possible orbital cellulitis given the appearance of the eye and the amount of discomfort, as well as their immunocompromised status, necessitating imaging and workup to confirm the diagnosis. The patient was ultimately diagnosed with periorbital cellulitis and bacterial conjunctivitis, and he received intravenous antibiotics for treatment. This case underscores the importance of a comprehensive diagnostic approach to managing ocular infections.

Subungual Hematoma.

The authors present the case of a 64-year-old male who presented to the emergency department due to foot trauma. He sustained a large subungual hematoma, which was drained. Following the procedure, the patient achieved complete resolution of his pain. He also reported no complications at two-week phone follow-up. The management of subungual hematoma, including the trephination procedure, is discussed. Potential complications, although rare, are reviewed.

Geographic Liver.

The authors present the case of a man with a relatively benign clinical presentation who had a computed tomography scan that revealed a "geographic liver" pattern. The radiologic appearance of hepatic steatosis, its significance, and its association with metabolic syndrome highlight the importance of this radiologic finding.

Acute Cardioembolic Stroke in the Setting of Subtherapeutic Anticoagulation.

Acute ischemic stroke is a sudden neurological deficit secondary to decreased or lack of blood flow (perfusion) due to a thrombus or an embolus. Embolic strokes are ischemic strokes that occur due to a distal clot that results in hypoperfusion upstream. Cardioembolic strokes are embolic strokes due to a cardiac origin. Almost a quarter of ischemic strokes are of cardioembolic etiology. Here, we present the case of an 83-year-old female presenting with right-side weakness and aphasia who arrived 45 minutes after symptom onset. Cardioembolic stroke symptoms, diagnosis, treatment, and risk factors are discussed.

Stercoral Colitis Secondary to Opiate-Induced Constipation.

The authors present the case of a 62-year-old woman who had stercoral colitis secondary to opiate use for rheumatoid arthritis leading to chronic constipation. Computed tomography imaging demonstrated stool along a significant length of the colon. Stercoral colitis is a seldom suspected cause of severe abdominal pain. Although constipation may seem benign, when it gets to the level of a stercoral colitis, mortality due to colonic perforation is a very real concern. The authors review the presentation, risk factors, and management of stercoral colitis.

Frykman VIII Fracture Secondary to Falling Onto an Outstretched Hand (FOOSH).

This is the case of a 41-year-old woman who presented with pain in the wrist after a fall from her bicycle, after which she tried to block her fall by outstretching her hand. She sustained a Frykman VIII fracture, with a fracture of the distal radius and ulnar styloid. Her labs were unremarkable, and she had no previous medical history. Her case was an example of a classic fracture due to FOOSH (falling onto an outstretched hand) which can easily be avoided by learning how to break falls properly. The patient's symptoms, diagnosis, treatment, and ways to avoid this injury are presented.