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Abstract Number: 261

MULTIFOCAL INFLAMMATORY PSEUDOTUMOR: A CHALLENGING DIAGNOSIS

SHM Converge 2026

Case Presentation: A 40 year old woman with a history of pericarditis, initially thought to be due to a diagnosis of rheumatoid arthritis, presents with months of worsening fatigue, pleuritic chest pain, intermittent hemoptysis, and anemia. Had CT scans and subsequent PET scan showing multifocal FGD avid hypermetabolic lesions in the bilateral lungs, hypermetabolic soft [...]

Abstract Number: 262

THE KLATSKIN IMITATOR: PERIHILAR NEUROENDOCRINE TUMOR MASQUERADING AS CHOLANGIOCARCINOMA IN A YOUNG ADULT

SHM Converge 2026

Case Presentation: A 27-year-old woman with no significant past medical history presented with three months of sharp abdominal pain, pruritus, and dark urine. Her labs at admission revealed a mixed hepatocellular–cholestatic liver injury. CT demonstrated a hypo-enhancing mass at the hepatic duct confluence measuring 2.5 x 1.5 cm along with intrahepatic biliary dilatation, which was [...]

Abstract Number: 263

BEYOND RECURRENCE: DISTINGUISHING NEW LUNG PRIMARY FROM REMOTE THYROID CARCINOMA IN A DIAGNOSTIC CROSSROAD

SHM Converge 2026

Case Presentation: A 56-year-old Vietnamese woman, lifetime nonsmoker, with papillary thyroid carcinoma treated definitively in 2008 (undetectable thyroglobulin since), presented with acute dyspnea, orthopnea, and unintentional weight loss over several months. Imaging revealed a large right pleural effusion coinciding with symptom onset; thoracentesis drained 1.5 L amber fluid. Cytology showed malignant cells positive for AE1/AE3, CK7, [...]

Abstract Number: 264

AMEBA IN THE LIVER, PLATELETS IN THE SKY: AN UNUSUAL DIAGNOSTIC JOURNEY

SHM Converge 2026

Case Presentation: A 24-year-old previously healthy male presented with 4 days of right upper quadrant pain and intermittent fever one month after arriving from Liberia. On admission, he was febrile to 99.9°F, mildly tachycardic to 109. Pertinent lab studies showed leukocytosis of 22.3K and thrombocytosis of 665. He was also found to have cholestatic abnormal [...]

Abstract Number: 265

THE HIDDEN RISK OF A GREEK PHYSIQUE: STRENGTH AT A CELLULAR COST

SHM Converge 2026

Case Presentation: A healthy 21 year-old man presented with progressive headaches and altered mentation. He had severe hemolytic anemia, hemoglobin 3.2 g/dL, indirect hyperbilirubinemia, elevated LDH, undetectable haptoglobin, and a direct antiglobulin test positive for IgG. He developed encephalopathy requiring intubation and CRRT for acute kidney injury. Broad malignancy, infectious, and autoimmune evaluations were unrevealing; [...]

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Abstract Number: 266

KRATOM INDUCED MANGANESE TOXICITY

SHM Converge 2026

Case Presentation: We report a case of a 52-year-old woman with chronic pain, depression, and poorly controlled diabetes who presented with acute hypoxic respiratory failure secondary to multifocal Streptococcus pneumoniae pneumonia and empyema. During a protracted ICU course requiring mechanical venitation and tracheostomy, she exhibited persistent neurological abnormalities including dystonia and tremor, which, along with [...]

Abstract Number: 267

CONFLICTING GUIDELINES IN PREGNANCY: SHARED DECISION-MAKING FOR HYDROXYUREA MANAGEMENT IN SICKLE CELL DISEASE

SHM Converge 2026

Case Presentation: A G4P3 patient in her 30s with a past medical history of sickle cell disease (SCD) complicated by recurrent venous thromboembolism, prior transient ischemic attacks, a splenectomy, and avascular necrosis presented during her second trimester following her second pain crisis of the pregnancy. She had discontinued hydroxyurea and anticoagulation on her own six [...]

Abstract Number: 268

WHEN SHOCK IS NOT CARDIAC: THIAMINE-RESPONSIVE MIXED BERI-BERI IN THE SETTING OF CLOSTRIDIUM DIFFICILE COLITIS

SHM Converge 2026

Case Presentation: We report a 64-year-old woman with hypertension and lymphangioleiomyomatosis who had recently been hospitalized for C. difficile colitis with profound diarrhea and electrolyte abnormalities. She re-presented with rapidly worsening confusion, tachypnea, hypoxia (SpO₂ 78% on room air), sinus tachycardia up to 140 bpm, hypotension, and diffuse anasarca. Chest imaging showed cardiomegaly, pulmonary edema, [...]

Abstract Number: 269

A TUMOR WITH AN EMBOLIC TWIST: A RARE CASE OF PAPILLARY FIBROELASTOMA LEADING TO MYOCARDIAL INFARCTION.

SHM Converge 2026

Case Presentation: Papillary fibroelastomas are among the most common primary cardiac tumors, yet primary cardiac tumors overall remain exceedingly rare, making them an uncommon source of embolization. Although most reports describe cerebrovascular presentations such as stroke or transient ischemic attack TIA¹, papillary fibroelastomas can also cause coronary embolization. We present a rare case in which [...]

Abstract Number: 270

INFECTIVE ENDOCARDITIS WITH ALL POSSIBLE COMPLICATIONS, WHEN MEDICAL MANAGEMENT SUCCEEDS.

SHM Converge 2026

Case Presentation: Infective endocarditis is a well-recognized cause of persistent bacteremia, particularly from gram-positive organisms such as Staphylococcus aureus. Standard management includes pathogen-directed intravenous antibiotic therapy and, when indicated, surgical intervention. Nearly half of patients with infective endocarditis meet surgical criteria—such as valve abscess, paravalvular extension, valvular dysfunction, persistent bacteremia, or septic embolization—yet more than [...]

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