Distinguishing Hemophagocytic Lymphohistiocytosis, Immune Reconstitution Inflammatory Syndrome, and HIV-Associated Immune Thrombocytopenic Purpura: A Challenging Case of Thrombocytopenia in AIDS.

Thrombocytopenia is a frequent hematologic complication in advanced HIV/AIDS, presenting significant diagnostic challenges due to overlapping etiologies. Hemophagocytic lymphohistiocytosis (HLH), immune reconstitution inflammatory syndrome (IRIS), and HIV-associated immune thrombocytopenic purpura (HIV-ITP) can all manifest with overlapping clinical features, which, despite their differing frequencies, may complicate diagnosis and management. We present a case of a 33-year-old male patient with advanced HIV/AIDS, metastatic Kaposi sarcoma, and inconsistent antiretroviral therapy (ART) adherence, who developed progressive thrombocytopenia, anemia, and pancytopenia.

Alice in Wonderland Syndrome in a Child Following Epstein-Barr Virus Infection: A Case Report.

Alice in Wonderland syndrome (AIWS) is a rare and often underrecognized neuropsychiatric phenomenon characterized by transient episodes of visual and somatosensory perceptual distortions, including micropsia, macropsia, altered body image, derealization, and disrupted perception of time. It most commonly affects children and adolescents and can be triggered by various conditions, including migraine, epilepsy, medications, and infections. We present the case of a 10-year-old previously healthy girl who developed intermittent episodes of micropsia, time distortion, and depersonalization shortly after recovering from a self-limited febrile illness.

Significant Improvement of Fibromyalgia Symptoms With Osteopathic Manipulative Treatment: A Case Report.

Fibromyalgia is a chronic pain syndrome characterized by widespread musculoskeletal pain, fatigue, sleep disturbances, and cognitive dysfunction. While pharmacologic therapies and lifestyle modifications are commonly used, many patients experience suboptimal relief. We present the case of a 41-year-old African American female with a seven-year history of fibromyalgia, who sought care in a family medicine clinic for persistent pain, fatigue, and functional impairment despite ongoing pharmacologic management.

Atypical Presentation of Bordetella pertussis in a Six-Month-Old with Cleaved Lymphocytes and Mild Respiratory Distress.

, the causative agent of whooping cough, typically presents in infants with paroxysmal coughing, inspiratory whoop, and post-tussive vomiting; however, atypical presentations are increasingly recognized, particularly in partially or recently immunized individuals. We present the case of a six-month-old previously healthy, fully immunized female infant who was evaluated for a three-day history of low-grade fever, feeding difficulties, increased irritability, and mild respiratory symptoms, in the absence of the characteristic pertussis cough or respiratory distress. Physical examination was largely unremarkable, with no signs of cyanosis, retractions, or abnormal lung sounds.

Co-presentation of Cotard's Syndrome and Autohemophagia: A Report of a Rare Case.

Cotard's syndrome is a rare neuropsychiatric condition characterized by nihilistic delusions in which patients believe they are dead, do not exist, or have lost their internal organs or bodily functions. Autohemophagia, the act of consuming one's own blood, is an exceedingly uncommon behavior often associated with underlying psychiatric pathology, particularly within the spectrum of psychosis or severe personality disturbance. We present the case of a 28-year-old female who presented with profound nihilistic delusions consistent with Cotard's syndrome, alongside repeated acts of deliberate self-injury followed by ingestion of her own blood.

From Brew to Bronchoscopy: A Case of Hyponatremia That Was Anything but Basic.

We present the case of a 53-year-old female with a history of chronic alcohol use, hypertension, chronic obstructive pulmonary disease (COPD), and significant smoking history, who presented with severe hyponatremia. Initial laboratory studies revealed a sodium level of 115 mEq/L. The patient reported chronic vomiting, poor oral intake, and heavy alcohol consumption.

Atypical Presentation of Moyamoya Disease Presenting With Severe Headache: A Case Report.

Moyamoya disease (MMD) is a rare and progressive cerebrovascular disorder characterized by the stenosis or occlusion of the terminal portions of the internal carotid arteries, accompanied by the formation of a compensatory network of abnormal collateral vessels at the base of the brain. The disease commonly presents with transient ischemic attacks (TIAs), ischemic and hemorrhagic strokes, seizures, cognitive impairments, and headaches. While most cases manifest in childhood or early adulthood, atypical or delayed presentations have been reported.

Monkeypox in a Non-endemic Setting: Challenges in the Diagnosis and Management of an Atypical Case.

Monkeypox is a zoonotic viral disease caused by the monkeypox virus, an Orthopoxvirus closely related to smallpox. While historically confined to endemic regions in Africa, recent outbreaks have demonstrated its capacity to spread globally, posing significant diagnostic and therapeutic challenges. We present the case of a 28-year-old previously healthy Caucasian male who repeatedly sought care in the emergency department (ED) for nonspecific flu-like symptoms, including fever, lymphadenopathy, dysphagia, and a progressive vesiculopustular rash.

Challenges in the Diagnosis and Management of Renal Cell Carcinoma With Sarcomatoid Differentiation: A Case Report.

Metastatic sarcomatoid renal cell carcinoma (sRCC) is a significant therapeutic and diagnostic challenge due to its rarity and aggressiveness, which contribute to its poor prognosis. This case report presents the case of a 47-year-old Caucasian man with shortness of breath and right-sided abdominal pain. History revealed an extensive smoking history, a left renal mass diagnosed two months ago with inconclusive results, and an enlarged mass on computed tomography (CT) scan one week ago in an emergency department (ED) visit that showed signs consistent with metastatic disease.

Histopathological Complexities and Diagnostic Challenges in Familial Adenomatous Polyposis: A Case Report.

Familial adenomatous polyposis (FAP) is a rare inherited disorder characterized by numerous adenomatous polyps throughout the colon and rectum, leading to a significantly increased risk of colorectal cancer. We present the case of a 19-year-old male patient with a known family history of FAP who presented with recurrent lower abdominal pain, altered bowel habits, and rectal bleeding. Initial examination identified rectal polyps, and subsequent colonoscopy revealed multiple adenomatous polyps.

Hypercalcemia-Associated Hodgkin's Lymphoma Presenting as Normal Pressure Hydrocephalus: A Case Report.

Hodgkin's lymphoma is a malignancy of the lymphatic system that can rarely present with advanced-stage features such as spinal cord involvement and hypercalcemia. We present the case of a 63-year-old Caucasian male with advanced Hodgkin's lymphoma, presenting with hypercalcemia and symptoms resembling normal pressure hydrocephalus. The patient exhibited gait impairment, altered mental status, and urinary incontinence, forming the classic triad seen in normal pressure hydrocephalus.

Pentalogy of Cantrell Marked With Ectopia Cordis, Gastroschisis, and Cystic Hygroma in the First Trimester: A Rare Case.

Pentalogy of Cantrell is a rare congenital syndrome characterized by defects in the abdominal wall, sternum, diaphragm, and heart. A severe manifestation of this syndrome is ectopia cordis, where the heart is located partially or entirely outside the chest cavity. Gastroschisis involves a defect in the abdominal wall, where the intestines protrude outside the abdomen without a protective membrane.

Complications of Untreated Advanced HIV/AIDS With Kaposi Sarcoma in a Young African American Male: A Case Report.

Kaposi sarcoma (KS) represents a neoplastic proliferation primarily affecting endothelial cells, characterized by the development of cutaneous lesions. However, its pathogenesis can extend beyond the skin, involving internal organs, lymph nodes, and mucous membranes. KS is associated with human herpesvirus 8 (HHV-8) and is often prevalent in immunocompromised patients, especially those with human immunodeficiency virus (HIV) and/or acquired immunodeficiency syndrome (AIDS).

Thymoma-Related Chest Pain and Dyspnea in a Middle-Aged Caucasian Female With Myasthenia Gravis and Good's Syndrome: A Case Report.

Thymomas are rare tumors originating from thymic tissue, often associated with various paraneoplastic syndromes that can pose significant clinical management challenges. Myasthenia gravis, one of the most common paraneoplastic syndromes linked to thymomas, is characterized by autoantibodies targeting the neuromuscular junction, leading to muscle weakness exacerbated by repetitive use. Good's syndrome, an adult-onset immunodeficiency associated with thymomas, results in hypogammaglobulinemia and susceptibility to opportunistic infections, which can be life-threatening.

Gut Microbiota Modulation in the Management of Chronic Obstructive Pulmonary Disease: A Literature Review.

Chronic obstructive pulmonary disease (COPD) represents a significant global health burden, characterized by progressive airflow limitation and exacerbations that significantly impact patient morbidity and mortality. Recent research has investigated the interplay between the gut and the lungs, known as the gut-lung axis, highlighting the role of the gut microbiome in COPD pathogenesis. Dysbiosis, characterized by microbial imbalance, has implications for COPD, influencing disease progression and susceptibility to exacerbations.

A Rare Case of Symptomatic Anomalous Origin of the Right Coronary Artery With a High Interarterial Course Between the Pulmonary Artery and the Aorta.

The congenital anomalous origin of the right coronary artery (AORCA) with an incongruous course is a rare malformation that can manifest as exertional chest pain, syncope, arrhythmias, heart failure, and sudden cardiac death. We present a case of a 42-year-old male with a history of hypercholesterolemia who presented with chest pain and dizziness upon exertion for two weeks. The physical examination was unremarkable, and the patient was hemodynamically stable.

Untreated Graves' Disease Complicated by Thyroid Storm and High-Output Cardiac Failure: A Case Report.

Thyroid storm is a rare yet critical complication of uncontrolled thyrotoxicosis, posing significant challenges in clinical management. We present the case of a 65-year-old African-American female with a medical history significant for untreated Graves' disease, hypertension, and diverticulosis, who presented with escalating abdominal pain, accompanied by nausea, vomiting, diarrhea, and chest discomfort. Upon admission, she exhibited atrial fibrillation with rapid ventricular response (RVR) and newly diagnosed high-output cardiac failure.

Emergency Hysterectomy Following Placental Abruption in a Patient With a History of Substance Abuse: A Case Report.

Placental abruption is a serious medical condition that can occur during pregnancy, involving the premature separation of the placenta from the inner uterine wall before childbirth. This detachment often leads to severe bleeding, and if conventional methods prove ineffective in managing the bleeding, a hysterectomy may be deemed necessary to ensure the mother's safety. This case report details the management of a 22-year-old female, gravida IV, para III, who experienced placental abruption during her fourth pregnancy.

Chronic Idiopathic Ulcers Mimicking Cecal Carcinoma: A Case Report.

Chronic idiopathic ulcers of the colon pose diagnostic challenges due to their elusive etiology and potential resemblance to other intestinal pathologies, such as cecal carcinoma. This case report outlines the clinical course of a 68-year-old female patient who presented to the emergency department (ED) with persistent right lower quadrant pain. Despite multiple hospital visits yielding varied diagnoses, a definitive diagnosis was only made following a laparoscopic partial colectomy, which revealed chronic idiopathic ulcers with transmural scarring and adhesions to adjacent small intestine loops.