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Abstract Number: 271

A SINGLE LESION, MANY SYMPTOMS: MESIAL TEMPORAL SCLEROSIS MISDIAGNOSED AS DELIRIUM, INFECTION, AND SYNCOPE

SHM Converge 2026

Case Presentation: A 48-year-old woman presented with recurrent episodes of confusion, disorientation, and unexplained falls over several months. Initially, she was treated in multiple healthcare settings for delirium, presumed urinary tract infection, and syncope. Her past medical history included repeated minor head trauma in early adulthood and a long-standing psychiatric evaluation for intermittent behavioral disturbances. [...]

Abstract Number: 272

TROUSSEAU’S SYNDROME UNMASKED: A CASCADE OF ARTERIAL AND VENOUS THROMBOSIS REVEALING METASTATIC ADENOCARCINOMA

SHM Converge 2026

Case Presentation: A 71-year-old woman with hypertension and asthma initially presented with a right-leg tattoo infection and was incidentally found to have a right lower extremity deep vein thrombosis and bilateral pulmonary emboli, initially attributed to recently initiated estrogen therapy. She was discharged on apixaban.Ten days later, she re-presented with flank pain. CT imaging revealed [...]

Abstract Number: 273

DISSEMINATED NOCARDIA FARCINICA PRESENTING AS AN ABDOMINAL WALL ABSCESS IN AN IMMUNOCOMPROMISED PATIENT

SHM Converge 2026

Case Presentation: Nocardiosis is an opportunistic infection caused by aerobic, weakly acid-fast, branching gram-positive organisms of the genus Nocardia. The disease typically begins as a pulmonary infection and disseminates hematogenously to the central nervous system (CNS) and other organs.¹ Nocardia farcinica is particularly virulent, with higher rates of dissemination and CNS involvement.² Primary cutaneous nocardiosis [...]

Abstract Number: 274

SECUKINUMAB-ASSOCIATED FULMINANT ULCERATIVE COLITIS REQUIRING TOTAL COLECTOMY IN A PATIENT WITH REFRACTORY HIDRADENITIS SUPPURATIVA

SHM Converge 2026

Case Presentation: A 52-year-old woman with hidradenitis suppurativa (HS), previously unresponsive to multiple topical and oral antibiotics, was escalated to Secukinumab. Shortly after initiation, she developed five weeks of progressively worsening bloody diarrhea. A colonoscopy at an outside hospital showed findings concerning for ulcerative colitis (UC), and she was started on prednisone 60 mg daily, [...]

Abstract Number: 275

EDTA CHELATION AND NEPHROTIC SYNDROME – CAUSAL OR SPATIAL CORRELATION

SHM Converge 2026

Case Presentation: A 77-year-old male with CKD stage IIIb, hypertension, and treated hepatitis C, with long-term welding exposure, underwent heavy-metal testing revealing elevated copper, cobalt, manganese, strontium, and zinc. He began EDTA chelation therapy and developed progressive generalized swelling within 48 hours of his third dose on 10/23/2025, which he reported was infused over only [...]

Abstract Number: 277

HYPERCALCEMIA-INDUCED ENCEPHALOPATHY AND ACUTE STROKE IN A YOUNG WOMAN WITH METASTATIC PANCREATIC CANCER

SHM Converge 2026

Case Presentation: The patient is a 27-year-old with past medical history that includes pancreatic tail adenocarcinoma involving the liver, status post multiple treatments and on admission she was status post cycle #2 of gemcitabine, Abraxane. Patient presented to the cancer center with complaints of worsening altered mental status for 2 days accompanied by her mother. [...]

Abstract Number: 278

FROM FLU TO FALL TO PARALYSIS: AN UNEXPECTED CASE OF POST-INFLUENZA TRANSVERSE MYELITIS

SHM Converge 2026

Case Presentation: A 78-year-old male, ambulatory, independent in ADLs with a medical history of atrial fibrillation and diffuse large B cell lymphoma in remission presented to the Emergency Department (ED) for fever, malaise, and cough. The patient was found to be Influenza A positive and was discharged from the ED with Tamiflu. The patient reported [...]

Abstract Number: 279

RED-HOT JOINT TO COOL RECOVERY: SUCCESSFUL TREATMENT OF SEPTIC ARTHRITIS WITH DALBAVANCIN

SHM Converge 2026

Case Presentation: A 38-year-old previously healthy male presented with 2 weeks of progressive right sternoclavicular (SC) swelling, shoulder pain, fevers, and night sweats. He denied trauma, injection drug use, or recent illness. CT showed right SC joint distension and cortical irregularity with overlying muscular swelling and subcutaneous soft tissue infiltration. MRI showed osteomyelitis of the [...]

Abstract Number: 280

THE HIDDEN GROWTH: UNMASKING THE DIAGNOSIS OF ACROMEGALY

SHM Converge 2026

Case Presentation: A 68-year-old male with a history of hypertension, type 2 diabetes mellitus, stable angina, and osteoarthritis presented to the emergency department (ED) after an acute episode of difficulty swallowing and dyspnea while eating dinner. Additionally, he reported acute on chronic right-sided neck and chest pain. Initial assessment in the ED raised concern for [...]

Abstract Number: 281

A THICKENED SOLUTION: SUCCESSFUL COLONOSCOPY PREPARATION IN A PATIENT WITH OROPHARYNGEAL DYSPHAGIA WITHOUT A NASOGASTRIC TUBE

SHM Converge 2026

Case Presentation: An 89-year-old man with a past medical history of Parkinson’s disease (PD), achalasia status post botulinum toxin, and prior stroke presented with two episodes of hematochezia, for which colonoscopy was indicated. The patient had oropharyngeal dysphagia (OD) secondary to PD that was recently diagnosed via an outpatient modified barium swallow study. During hospitalization, [...]

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