Purulent Pericarditis Following Endobronchial Biopsy of Lymph Node (4R): A Rare Case of Streptococcus mitis.

Background: Purulent pericarditis is a rare but life-threatening complication of endobronchial ultrasound-guided fine-needle aspiration (EBUS-FNA) of intrathoracic lesions.

Case Summary: A 65-year-old man with hypertension and hearing loss presented with an aggressive case of purulent pericarditis leading to cardiac tamponade post-EBUS-FNA of a station 4R lymph node. Transthoracic echocardiogram demonstrated fibrinous stranding and tamponade physiology.

Implantable cardiac defibrillator outcomes in octogenarians.

Background: Implantable cardiac defibrillators (ICDs) are essential for preventing sudden cardiac death. Despite inclusion in national guidelines, older adults are often underrepresented in trials. Evaluating ICD use in the aging population, particularly with advancements in heart failure treatment, is crucial.

Buccal caffeine strips for reversal of adverse symptoms of vasodilator stress.

Background: Due to recurrent shortages of aminophylline, intravenous caffeine has emerged as a commonly used, safe and reliable method to treat adverse effects of vasodilator stress agents. We sought to evaluate the safety and effectiveness of buccal caffeine strips which are rapidly absorbed, inexpensive, readily available, and simplify caffeine administration.

Methods: Consecutive patients undergoing regadenoson stress SPECT MPI were assessed for the occurrence of symptoms during testing over an 11-week period at a single metropolitan hospital.

Hashimoto Encephalopathy With Status Epilepticus.

Hashimoto encephalopathy (HE) is a heterogenous neurological syndrome that can manifest with encephalopathy, seizures, headaches, and variable neuropsychiatric disturbances. The underlying mechanism remains unclear; however, autoimmune pathogenesis is suspected due to its association with autoimmune thyroid disease, high titers of anti-thyroid antibodies, and quick response to steroid therapy. We report a 59-year-old female patient with a remote history of hypothyroidism who presented with status epilepticus and complaints of chronic headaches and cognitive impairment.

An Observation of Racial and Gender Disparities in Congestive Heart Failure Admissions Using the National Inpatient Sample.

Background Congestive heart failure (CHF) is a frequent cause of inpatient admissions in the United States. The purpose of this study was to analyze the racial and gender disparities that occur in CHF admissions and determine the impact of these disparities on medical expenditure. Methods We analyzed the National Inpatient Sample (NIS) database from 2009 to 2014 for patients with a primary discharge diagnosis of CHF, and further stratified the cohort on the basis of race and sex.

Iatrogenic air embolism.

Air embolism should be treated promptly with high fraction of supplemental oxygen and repositioning to help facilitate reabsorption of the air bubble. Hyperbaric oxygen therapy should be given to those with severe disease.

Multidrug-Resistant Burkholderia cepacia, Candida dubliniensis, and Candida glabrata Infected Pancreatic Pseudocyst.

is a gram-negative bacillus that is most commonly associated with pneumonia in the immunocompromised patients. The most common organisms associated with pancreatic infections are , , spp, and spp. We report a case of a 45-year-old gentleman with recent acute pancreatitis who presented with hypoglycemia, altered mental status, worsening epigastric pain, and early satiety.

Case of Anthracycline-induced Cardiogenic Shock: A Call to Optimize Modifiable Cardiac Risk Factors Prior to Chemotherapy.

Anthracyclines, including doxorubicin, are an important class of chemotherapeutic agents. Their efficacy, however, is limited by cardiotoxicity. Risk factors for anthracycline-associated cardiotoxicity include dose, treatment-specific risk factors including adjunctive radiotherapy, patient-specific modifiable cardiac risk factors including hypertension, hyperlipidemia, diabetes mellitus, tobacco use and obesity, and patient-specific non-modifiable risk factors such as age.