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Abstract Number: 251

WHEN LIGHT CHAINS BREAK BONES

SHM Converge 2026

Case Presentation: A 61-year-old male presented to the emergency department (ED) with back pain. Approximately 1.5 months prior to presentation, he developed a sudden onset left clavicle pain. His pain progressed to involve multiple areas of the body, until finally he started to experience a severe low back pain, prompting evaluation.In the ED, examination was [...]

Abstract Number: 252

A HOLE LOT OF HEADACHE: WHEN PFO TRIGGERS MIGRAINE.

SHM Converge 2026

Case Presentation: A 44-year-old woman with a history of migraine headaches and generalized anxiety presented with sudden-onset, severe headache associated with left-eye lacrimation, blurry vision, and tingling and numbness of both upper extremities for one day. She described the headache as a throbbing pain mainly over the forehead. She denied nausea, vomiting, photophobia, or phonophobia. [...]

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Abstract Number: 253

ATYPICAL MULTIFOCAL MYONECROSIS MASQUERADING AS NECROTIZING FASCIITIS FOLLOWING COCAINE EXPOSURE: A CASE REPORT

SHM Converge 2026

Case Presentation: A 43-year-old man with no significant past medical history presented with 3–4 days of rapidly progressive right upper extremity pain, swelling, and bullae. Symptoms began with a bulla at the antecubital fossa and extended distally and proximally. He also developed bilateral thigh and hip cramping with difficulty walking. He denied trauma or IV [...]

Abstract Number: 254

GPC BACTEREMIA? THE TRIALS AND TRIBULATIONS OF TELEHEALTH, TRANSFERS, AND TOO MUCH MEDICINE

SHM Converge 2026

Case Presentation: The patient is a 45 year old female with a PMH of Ischemic Cardiomyopathy (LVEF 25-30%), CKD3b, recent BKA in 7/2025 with poor wound healing and subsequent MRSA bacteremia who presented to an outside hospital for shortness of breath and chest pain. She was diagnosed with an acute heart failure exacerbation and began [...]

Abstract Number: 255

CHALLENGES IN THE DIAGNOSIS AND MANAGEMENT OF ATYPICAL OPTIC NEURITIS IN AN ELDERLY PATIENT

SHM Converge 2026

Case Presentation: An 86-year-old female with hypertension, hyperlipidemia, and pre-existing left eye vision loss presented to an outside hospital after a fall with acute painless right eye vision loss. High dose IV methylprednisone was initiated at the OSH on day 2 due to concerns for giant cell arteritis (GCA) given acute vision loss and optic [...]

Abstract Number: 256

A CASE REPORT OF TRAVEL-ASSOCIATED MELIOIDOSIS INFECTION WISCONSIN, UNITED STATES

SHM Converge 2026

Case Presentation: The first case involved a 70-year-old Hmong-speaking man who presented with a few weeks of dry productive cough and worsening shortness of breath. He had decreased oral intake and postprandial fatigue with 20 pounds of unintentional weight loss in the preceding months. He was born in Laos but raised in Thailand, and had [...]

Abstract Number: 257

WHEN ANXIETY IS EPILEPTIC: TEMPORAL LOBE SEIZURES IMITATING PANIC DISORDER

SHM Converge 2026

Case Presentation: A 34-year-old male with a history of asthma, depression, and anxiety treated with fluoxetine presented to the ED following a motor vehicle accident. Prior to the accident, he felt anxious and lost awareness. He could not remember the collision. Trauma screen revealed extremity abrasions and sternal tenderness. There were no traumatic findings on [...]

Abstract Number: 258

WHEN FERRITIN REACHES 81,000: UNRAVELLING HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS IN A 22-YEAR-OLD WITH SICKLE CELL DISEASE

SHM Converge 2026

Case Presentation: We present a 25-year-old African American male with a known history of Hb SC disease who presented with fevers up to 104°F and an elevated ferritin of 22k with AST 179/ALT 235 and ALP of 110. Full infectious workup was negative. Hemoglobinopathy panel confirmed the patient was in acute sickle cell crisis, and [...]

Abstract Number: 259

WHEN ANTIHYPERTENSIVES HARM: A CASE OF SUPRATHERAPEUTIC INTERNATIONAL NORMALIZED RATIO (INR) SECONDARY TO OLMESARTAN-INDUCED ENTEROPATHY

SHM Converge 2026

Case Presentation: Our patient was an 85 y/o female with a history of pulmonary embolism/deep venous thrombosis on warfarin, paroxysmal atrial fibrillation, and hypertension who presented to an outpatient gastroenterology (GI) appointment for evaluation of chronic diarrhea. She reported intractable, watery diarrhea for the past 9 weeks, with 3-4 stools/day as well as poor oral [...]

Abstract Number: 260

EXTRAMEDULLARY MULTIPLE MYELOMA OF THE THYROID CARTILAGE: A RARE PRESENTATION WITH HIGH-RISK CYTOGENETICS

SHM Converge 2026

Case Presentation: A 49-year-old woman with epilepsy presented with progressive diffuse bone pain, chest and neck discomfort, and muscle spasms over several weeks. The pain was constant, aching, and most pronounced in the sternum, collar bones, and neck. Emergency department evaluation revealed diffuse osseous mottling on imaging and hypercalcemia. Laboratory studies demonstrated markedly elevated serum [...]

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