A Neurosyphilis Case Mimicking Herpes Simplex Virus Encephalitis in an African American Male.

Neurosyphilis is one form of a multisystemic sexually transmitted disease caused by Treponema pallidum. Although typical presentations of neurosyphilis have become less common in the post-antibiotic era, a rising trend of atypical presentations can mimic other diagnoses like herpes simplex and autoimmune encephalitis. In this case, we diagnosed neurosyphilis in a patient with clinical and radiological features similar to herpes simplex encephalitis. We emphasize the need for a diagnostic approach combining imaging namely MRI, lumbar puncture, and use of treponemal and non-treponemal tests so that neurosyphilis cases with atypical neuroimaging findings are not overlooked.

A Rare Presentation of IgA Nephropathy in a 62-Year-Old Hispanic Female.

A case of immunoglobulin A (IgA) nephropathy is presented here that demonstrates an unusual clinical presentation in multiple ways and is vitally important for clinicians to consider. The patient is a Hispanic female in her 7th decade of life that presented with nephrotic-range proteinuria without hematuria ultimately leading to a diagnosis of IgA nephropathy. After diagnosis, her clinical course was complicated by continued poorly controlled type II diabetes mellitus and hypertension, and ultimately her kidney disease progressed to chronic kidney disease IV and then end-stage renal disease requiring hemodialysis. Though IgA nephropathy predominantly presents as nephritic syndrome, it can also present as nephrotic range proteinuria and even rapidly progressive glomerulonephritis which should be considered even when the patient's ethnicity and age group carry a smaller risk.

Thoracic Spinal Cord Compression Secondary to Metastatic Papillary Thyroid Carcinoma: An Unusual Oncological Phenomenon.

Hematogenous spread is fairly an unusual feature for papillary thyroid carcinoma (PTC) in comparison to follicular thyroid carcinoma (FTC). Thoracic spinal metastasis with complicating cord compression is an even rarer manifestation of PTC that was reported in a limited number of cases in the literature. Herein we present a 65-year-old female with a history of PTC on current radiotherapy, status post attempted surgery due to significant tumor burden and intraoperative bleeding, presented with a one-week history of rapidly progressive bilateral lower extremities weakness. Physical examination revealed paraplegia of both lower extremities with areflexia and a sensory level equivalent to the upper thoracic vertebrae. Urgent imaging depicted destructive epidural lesions at T1-T3 vertebrae with thoracic cord compression. Emergent laminectomy and debulking of these lesions were undertaken. Histopathological examination confirmed metastatic PTC. The patient proceeded to further treatment with radiotherapy following her successful neurological recovery. Thoracic vertebral metastasis is an unusual oncological phenomenon of PTC. Metastatic PTC should be considered in patients with a current or remote history of PTC who present with thoracic cord compression. Our case demonstrates that multidisciplinary management is the key to achieving a better outcome for metastatic PTC with thoracic cord compression.

Cardiac Arrest With Spontaneous Coronary Artery Dissection in a Young Female.

Spontaneous coronary artery dissection (SCAD) is a rare condition that has variable clinical presentations requiring a very high index of suspicion for diagnosis. We present here a case of a young female with SCAD who initially presented with chest pain and syncope, with progression to cardiac arrest.