RESUMO
Urinothorax is one of the rare causes of pleural effusion of extra-vascular origin, commonly presents with a transudative pleural effusion due to obstruction, injury or trauma to the genitourinary tract. It is not a common cause which increases the likelihood of underdiagnosis or misdiagnosis. Herein, we are presenting a 65-year-old gentleman who presented with urinary symptoms found to have urinothorax secondary to urinary tract obstruction by benign prostatic hypertrophy. This case was further complicated by urinoma and pyelonephritis. We are reporting this case to highlight the importance of including this entity in the differential diagnosis in patients who have pleural effusion especially if they presented with obstructive urinary symptoms.
RESUMO
Stress-induced or Takotsubo cardiomyopathy (TCM) is a phenomenon that typically occurs in postmenopausal women in the setting of acute emotional or medical stressors. It typically causes reversible akinesis of the heart apex with opposite hyperdynamic basal segments. An electrocardiogram (ECG) would show ischemic ST elevation in anterior leads in >90% of cases with elevated troponin, yet coronary angiography rules out occlusive disease. Takotsubo cardiomyopathy in the setting of diabetic ketoacidosis (DKA) is a rare phenomenon that has been attributed to severe acidosis. Here, we report the case of a 37-year-old male with severe DKA that was complicated by stress cardiomyopathy and progressed to cardiogenic shock.
RESUMO
Hyperhemolysis syndrome (HHS) is a catastrophic unpredictable consequence of blood transfusion in sickle cell disease. It leads to further drop in hemoglobin via immune mechanisms complicating a hospital course and prolonging length of stay. Although sickle cell patients receive multiple transfusions throughout their disease course, this condition remains underreported by health care professionals or misinterpreted for other sickle cell crises. We present a similar case highlighting the importance of early recognition of HHS and judicious blood transfusion in sickle cell disease patients to avoid such a complication.
RESUMO
Hemophagocytic lymphohistiocytosis (HLH) is a rare and life-threatening syndrome that is often underdiagnosed. There are limited treatments and clinical outcomes documented in adults, more so in the immunocompromised population. Here, we described the clinical features, diagnosis, treatment, and clinical outcome of an HLH secondary to histoplasmosis in an AIDS patient.