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Abstract Number: 507

TULAREMIA PRESENTING AS FEVER OF UNKNOWN ETIOLOGY

SHM Converge 2026

Case Presentation: A 28-year-old male who was immunosuppressed with Infliximab for Crohn’s disease was seen in the hospital in early summer for non-resolving fever of four-week duration. Blood and urine cultures and computed tomographic (CT) imaging of chest, abdomen and pelvis was negative along with molecular testing for common tick-borne diseases like Anaplasmosis, Babesiosis, respiratory [...]

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Abstract Number: 593

BEYOND THE LIVER: AUTOIMMUNE HEPATITIS WITH UNUSUAL HEMATOLOGIC AND VASCULAR COMPLICATIONS

SHM Converge 2026

Case Presentation: We introduce a 17-year-old male with history of cholecystectomy two years prior, who presented to his pediatrician with transaminitis and hyperbilirubinemia. Workup revealed significant peripheral eosinophilia, along with elevated level of Immunoglobulin G (IgG). Autoimmune workup was significant for anti-smooth muscle antibodies and anti-neutrophil cytoplasmic antibodies (p-ANCA), but magnetic resonance cholangiopancreatography (MRCP) revealed [...]

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Abstract Number: 607

AVOIDING THE AUTOMATIC: A CURIOUS CASE OF PEDIATRIC ENCEPHALOPATHY

SHM Converge 2026

Case Presentation: A 17-year-old female presented to the ED with progressive encephalopathy. Three weeks prior, patient began experiencing pre-syncope, anorexia, increased sleep, and frequent urination. Her family described pressured, child-like speech. Patient endorsed smoking marijuana prior to symptom onset. History ascertainment was limited by her family’s inconsistent presence at bedside and her poor engagement during [...]

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Abstract Number: 958

A SILVER LINING TURNED BLUE: HEART FAILURE FROM CHRONIC COLLOIDAL SILVER INGESTION

SHM Converge 2026

Case Presentation: A 65-year-old Caucasian male presented with progressive blue-gray skin discoloration over six months and new-onset dyspnea with leg edema. He had ingested approximately 2 ounces of colloidal silver daily for 12 years as self-prescribed prophylaxis against Lyme disease.Examination showed diffuse slate-gray discoloration, most prominent on the face, neck, and hands, bibasilar crackles, and [...]

A CASE OF UNPROVOKED PULMONARY EMBOLISM IN A YOUNG WOMAN

SHM Converge 2026

Case Presentation: 21-year-old female presented with three weeks of progressive right-sided chest pain, shortness of breath, and fatigue. Her symptoms began shortly after a three-hour car ride. She had a history of a second-trimester miscarriage four months earlier, complicated by acute blood loss anemia requiring transfusion. She briefly used oral contraceptives following the miscarriage. She [...]

BEYOND THE GUIDELINES: SPLENIC INFARCTION AS A SENTINEL OF CATASTROPHIC BIOPROSTHETIC VALVE DEGENERATION

SHM Converge 2026

Case Presentation: A 35-year-old woman with end-stage renal disease (ESRD) on chronic hemodialysis, suspected drug-induced lupus with recurrent pericarditis, and severe bi-valvular disease requiring bioprosthetic aortic valve replacement seven months earlier, presented with progressive exertional dyspnea, early satiety, and worsening left upper quadrant abdominal pain initially thought to be a lupus flare. Laboratory evaluation was [...]

BEYOND THE USUAL SUSPECTS: NATIVE TRISCUSPID VALVE ENDOCARDITIS FROM CORYNEBACTERIUM PSEUDODIPHTHERITICUM

SHM Converge 2026

Case Presentation: A 48-year-old female with a history of cyclic vomiting syndrome, gastroparesis, postural orthostatic tachycardia syndrome (POTS), opioid dependence, and a right-sided Port-A-Cath presented with two days of generalized weakness, a witnessed seizure-like episode, and a fall. Initial trauma evaluation was unremarkable. Laboratory studies revealed leukocytosis (WBC 20.8), thrombocytosis (platelets 648), mild hyponatremia (Na [...]

COGNITIVE MANIFESTATIONS OF PERNICIOUS ANEMIA

SHM Converge 2026

Case Presentation: A 79 year old female with a past medical history of type 2 diabetes mellitus, hypertension, coronary artery disease, and prior ischemic stroke presented with a three day history of weakness and confusion. She was oriented to self and location at baseline, without a diagnosis of dementia. Initial investigation revealed an urinalysis with [...]

DELAYED IMMUNE CHECKPOINT INHIBITOR-ASSOCIATED POLYARTHRITIS MIMICKING SERONEGATIVE RHEUMATOID ARTHRITIS

SHM Converge 2026

Case Presentation: A 72-year-old male with lung adenocarcinoma in PET-confirmed remission developed rapidly progressive, symmetric inflammatory polyarthritis five months after completing immune checkpoint inhibitor (ICI) therapy with pembrolizumab. He reported diffuse joint pain, morning stiffness, fatigue, and functional decline involving multiple large and small joints. Examination revealed bilateral wrist and metacarpophalangeal synovitis, restricted wrist motion, [...]

FATAL AUTONOMIC FAILURE IN GUILLAIN-BARRÉ SYNDROME FOLLOWING IVIG-ASSOCIATED TRALI

SHM Converge 2026

Case Presentation: A 48-year-old man with alcohol use disorder presented with midsternal chest pain and progressive bilateral leg weakness following diarrhea and upper respiratory symptoms. Examination showed proximal weakness without sensory loss. Imaging and labs were unremarkable. Suspecting acute inflammatory demyelinating polyneuropathy (AIDP), IVIG was initiated after lumbar puncture; MRI spine was normal.Within 24 hours, [...]

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