Recurrent severe hypercalcemia caused by bone marrow sarcoidosis.

A 71-year-old woman with recurrent severe hypercalcemia was found to have multiple noncaseating granulomas in the bone marrow with low parathyroid hormone levels and high levels of [1,25 dihydroxycholecalciferol] that later decreased to normal levels with the normalization of calcium levels. No organ involvement other than of the bone marrow was detected, and the angiotensin-converting enzyme level was elevated. The diagnosis of bone marrow sarcoidosis is suggested.

Unilateral pulmonary edema: a rare presentation of congestive heart failure.

The authors present a case of an 85-year-old woman known to suffer from severe congestive heart failure who presented with dyspnea and a unilateral infiltrate in the right lung on chest x-ray. Following clinical judgment, she was diagnosed with unilateral pulmonary edema and was treated accordingly, with rapid improvement of symptoms and disappearance of the infiltrate within 12 hours. The patient had been hospitalized many times during the previous years with pulmonary edema affecting both lung fields. Unilateral pulmonary edema is an unusual clinical condition that has been reported as a manifestation of left heart failure, mostly affecting the right lung. The authors emphasize the possible presentation of unilateral pulmonary edema in a patient with heart failure and recurrent bilateral pulmonary edema.

Sweet's syndrome affecting the external auditory canal and tympanic membrane.

We report a patient who developed left ear pain, dry cough, and fever. The external auditory canal was tender, swollen, erythematous and full of debris. Later the patient developed widespread tender and red skin nodules and pustules that subsequently coalesced to form plaques. Identical lesions developed also in the external auditory canal and the tympanic membrane of the affected ear. Skin biopsy showed dermal neutrophilia, compatible with the diagnosis of Sweet's syndrome. Rapid improvement was achieved with prednisone after the failure of antibiotics.

[Contralateral hemothorax: a late complication of subclavian vein catheterization].

Central venous catheterization is extensively used in unstable patients who need hemodynamic monitoring and in patients who require prolonged treatment such as, chemotherapy, antibiotics therapy, parenteral nutrition, or temporary hemodialysis. Subclavian vein catheterization is the preferred approach for hemodialysis, especially as it does not restrict the patient. Most of the complications related to this procedure are insignificant, however, occasionally they may be life threatening and require surgical intervention. We present a case study of a 77-year-old woman suffering from chronic renal failure. A subclavian catheter was inserted, and the patient started hemodialysis. Three weeks later, during hemodialysis, she complained of right upper abdominal and right chest pain. Chest X-ray showed a moderate to large right pleural effusion, with pleurocentesis confirming the presence of hemothorax.

Sweet's syndrome after pneumonectomy.

We report the case of a 38-year-old woman in whom typical skin lesions of Sweet's syndrome developed 2 days after undergoing left pneumonectomy, which was done because of severe bronchiectasis related to remote chemotherapy and radiotherapy given for lung sarcoma at the age of 8 years. Later fever and leukocytosis appeared, and biopsy results of the skin lesions showed neutrophilic infiltration of the dermis compatible with the diagnosis of Sweet's syndrome. Postoperative Sweet's syndrome has been reported only twice in the world literature. These other two cases and possible pathogenic mechanisms are reviewed.