A Case of Isolated Pulmonary Mycobacterium Avium Complex Being the First Presentation of a Newly Diagnosed HIV/AIDS.

We report a case of a 39-year-old HIV positive transgender female with isolated manifestations of pulmonary Mycobacterium avium complex (MAC) infection. Although MAC infection is common in immunocompromised patients, the classical presentation is extra-pulmonary. Pulmonary MAC infection is extremely rare. The majority of cases involve patients with underlying structural lung disease. There are no case reports of isolated pulmonary MAC in HIV/AIDS patients without any structural lung disease in the last 17 years. Also, we have not found any cases of newly diagnosed HIV/AIDS patients with pulmonary MAC being the initial presentation.

Diagnosis and Management of 1:1 Atrial Flutter in the Setting of Aortic Valve Endocarditis and Embolic Stroke.

Atrial flutter is a rapid, regular atrial tachyarrhythmia that occurs most commonly in patients with underlying structural heart disease. Spontaneous 1:1 conduction of atrial flutter is indeed rare, but its diagnosis and management is of critical importance. We describe a case of a 65-year-old man with hypertension, preserved ejection fraction heart failure, end-stage renal disease, Parkinson's disease, and Alzheimer's dementia, in whom atrial flutter was associated with 1:1 atrioventricular conduction. Our patient was hemodynamically unstable with aortic valve endocarditis and recent septic embolic stroke. This case report emphasizes the importance of recognition and management to avoid hemodynamic compromise.