RESUMEN
The COVID-19 pandemic has resulted in significant worldwide morbidity and mortality. One of the less studied clinical manifestations is Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) associated with COVID-19 pneumonia. We present a single case of COVID-19 pneumonia-associated SIADH in a 71-year-old male with a history of alcohol use disorder. This case highlights the importance of full diagnostic workup of the underlying cause of hyponatremia to avoid significant morbidity.
RESUMEN
Primary small bowel adenocarcinoma is rare, with an estimated U.S. annual incidence of 3.9 cases per million persons, and is often associated with a poor prognosis. We report a case of a 68-year-old male diagnosed with primary duodenal adenocarcinoma with hepatic artery and gastroduodenal artery encasement. The patient initially presented with persistent nausea and vomiting unresponsive to ondansetron and metoclopramide, and initial computed tomography (CT) of abdomen and pelvis revealed significant stomach distension concerning for gastric outlet obstruction. Esophagogastroduodenoscopy (EGD) revealed significant duodenal stricture, with results of triple phase CT of pancreas significant for tissue encasing the common hepatic artery and the origin of the gastroduodenal artery. Pathology results verified the presence of a moderately differentiated adenocarcinoma involving the small bowel. Due to artery encasement by the tumor, the patient was deemed to be a poor surgical candidate, and instead received a duodenal stent for symptomatic relief with initiation of a chemotherapy regimen consisting of folinic acid, oxaliplatin, and fluorouracil (FOLFOX) as an outpatient. This case highlights the presentation and diagnostic workup of a rare cancer.
RESUMEN
We report the case of a 76-year-old male who developed anuric acute kidney injury from infection-related glomerulonephritis (IRGN) secondary to foot osteomyelitis, confirmed via renal biopsy. The patient initially presented with wound dehiscence of the left foot following transmetatarsal amputation and Lisfranc operation in the setting of osteomyelitis. Hospitalization was complicated by worsening acute kidney injury requiring the initiation of hemodialysis. Despite successful surgical correction and the removal of the infectious source, the patient was unable to regain significant renal function and remained hemodialysis dependent. This case highlights a rarely seen complication of osteomyelitis and underscores the value of prompt and aggressive management of osteomyelitis in patients with infection-related glomerulonephritis.
RESUMEN
Zinc deficiency is a relatively common condition in various American populations but is frequently unrecognized and under-diagnosed. It typically presents with nonspecific symptoms, including lethargy, immune dysfunction, dermatitis, diarrhea, and decreased taste sensation (hypogeusia). Zinc deficiency often occurs concurrently with iron deficiency and has been linked to more severe clinical manifestations of iron deficiency anemia. We describe a 66-year-old man who presented with weakness and fatigue and was found to have persistent iron-deficiency anemia attributable at least in part to malnutrition caused by zinc deficiency-induced hypogeusia. The hypogeusia rapidly improved and nutritional intake normalized with zinc supplementation.
RESUMEN
Staphylococcus caprae (S. caprae) is a catalase-positive, coagulase-negative organism that was first isolated from goat milk, and was later found to colonize healthy human skin, nails, and nasal mucosa. Rarely, this commensal organism can become pathogenic in humans. S. caprae has been implicated in a variety of human infections, with the highest incidence being in bone and joint infections. We describe a man who, after receiving facet joint injections for back pain, developed native vertebral discitis, vertebral osteomyelitis with phlegmon, and bilateral psoas abscesses, from which S. caprae was isolated.