A Classic Presentation of Roseola Infantum.

Roseola is a common viral exanthem of childhood, most frequently affecting infants and toddlers before age three. The syndrome is characterized by an abrupt onset of high fever, which, upon resolution, yields to a centrally located maculopapular rash that spreads peripherally. This report describes the case of an 18-month-old child whose fever and defervescence rash provide insight into the typical presentation and progression of this pervasive yet mostly benign condition.

A Case of Right-Sided Infective Endocarditis Requiring AngioVac Debulking.

Infective endocarditis is an uncommon but consequential disease process that occurs after damage to the cardiac endothelium. Management depends on location and infection severity, but it can typically be treated with intravenous antibiotics. Still, in more complex presentations, surgical intervention may be warranted. Here, we examine a case of right-sided infective endocarditis affecting the tricuspid valve in a patient with a history of intravenous drug use. The purpose of this paper is to examine a case of right-sided endocarditis refractory to intravenous antibiotics, resulting in the need for an alternative treatment modality using AngioVAC debulking.

A Case of Spontaneous Coronary Artery Dissection.

Spontaneous coronary artery dissection (SCAD) is the development of an intramural hematoma that causes a false lumen to form, leading to occlusion and ischemia. It is a rare but separate pathologic cause of acute coronary syndrome, more commonly occurring in females and often associated with underlying vascular conditions. Definitive diagnosis requires invasive coronary angiography. Management is similar to that of myocardial infarction caused by atherosclerosis; however, the majority of SCADs are managed conservatively, as stenting often leads to worse outcomes. Diagnostic and management strategies are primarily based on consensus, with minimal randomized control trials or prospective analyses available to guide patient care.

Viral Myositis in an Eight-Year-Old.

Benign acute childhood myositis (BACM) is a pediatric syndrome characterized by mild self-limiting sudden onset of muscle pain during or following recovery from a viral illness. The case discussed in this report is of an eight-year-old female diagnosed with the common cold after presenting to her primary care physician. Five days later, the patient presented to the emergency department with lower extremity pain. The patient was sent home with supportive care and mild analgesics. Twelve hours later, the patient was seen again in the emergency department with severe bilateral lower extremities pain and difficulty walking. BACM most commonly affects school-age children and is usually caused by influenza A and B. The main goal of this case report is to help primary care and emergency medicine physicians diagnose benign acute childhood myositis as early as possible and treat the condition appropriately.

A Fleshy Mystery: Prurigo Nodularis.

Prurigo nodularis is a chronic dermatologic condition typically presenting as firm, dome-shaped pruritic nodules of various sizes that are often symmetrically distributed on extensor surfaces of the extremities. The diagnosis is clinical and based on a history of chronic, severe pruritis in the setting of characteristic, excoriated lesions. Treatment is difficult and aimed at reducing skin irritation and pruritus. Quality of life is impacted due to the chronic, intractable, and relapsing nature of the disease. Here, we report a case of prurigo nodularis diagnosed in the outpatient clinic setting. This paper aims to report the patient's clinical history, presentation, and histopathologic findings, as well as present a literature review to determine the significance of this case and the approach to ongoing management.

Neuromyelitis Optica: A Deceiving Disorder of Demyelination.

Neuromyelitis optica (NMO), also known as Devic syndrome, is an autoimmune inflammatory and demyelinating disorder that affects the optic nerves and spinal cord. It is believed to be attributed to aquaporin-4 antibodies, a water channel expressed on astrocytes. It commonly presents with isolated or recurrent attacks of myelitis and optic neuritis. Intractable vomiting and hiccups may also be seen as symptoms. Acute treatment is often achieved with high-dose steroids and is imperative to prevent permanent central nervous system damage. Relapse prevention is achieved using long-term immunosuppression. This paper examines the case of an African-American female who presented with ascending lower extremity weakness.

Cardiovascular Complications of COVID-19: A Scoping Review of Evidence.

This scoping review sought to identify the nature and extent of clinical evidence regarding the acute and long-term cardiovascular complications associated with COVID-19. Forty-nine studies published between 2020 and 2023 were selected for review. The studies were divided into two groups. The referential group included 22 studies. The second group of 27 studies was used for a detailed review to assess the strength of the evidence. The aggregate evidence indicates that the most common cardiac complications associated with COVID-19 include but are not limited to acute pericarditis, acute myocardial injury, acute myocarditis, various arrhythmias, microvascular angiopathy, left ventricular dysfunction, heart failure, acute cardiac injury, and acute coronary syndrome. Clinical and epidemiological implications of the findings are investigated, and future research recommendations are proposed.

Liver Abscess Caused by Ingestion of a Sewing Needle.

Liver abscesses have a low incidence and can be caused by multiple etiologies. We present an interesting case of a 74-year-old woman who presented with abdominal pain and leukocytosis. Imaging revealed a foreign body in the antrum of the stomach extending to an area of hypodensity in the liver. She was taken for an exploratory laparotomy and was found to have a gastric perforation due to a sewing needle. The needle had embedded in the liver causing the formation of an abscess. The patient was successfully treated with surgical management and a course of antibiotics.