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Abstract Number: 283

A TUBULAR TALE: TENOFOVIR INDUCED FANCONI SYNDROME

SHM Converge 2026

Case Presentation: A 69-year-old male with history of HIV and disseminated tuberculosis presented to the Emergency department. He was found to be septic and ultimately diagnosed with VRE faecium bacteremia. During his hospitalization, he was noted to have decreased phosphate levels throughout the admission which required repletion nearly every day. His phosphate decreased to as [...]

Abstract Number: 284

AN UNUSUAL COMPLICATION OF COMMUNITY ACQUIRED PNEUMONIA: LUNG HERNIATION WITH EMPYEMA SECONDARY FROM COUGH INDUCED RIB FRACTURES

SHM Converge 2026

Case Presentation: A 74-year-old woman with a past medical history of mild asthma and a recent pneumonia presented to the hospital with left flank pain. She had no notable trauma or surgical history. She additionally endorsed left lateral chest wall pain exacerbated by coughing, with symptoms worsening over the preceding three days.  Initial CT imaging [...]

Abstract Number: 285

A FRIENDLY DOG, AN UNFRIENDLY PATHOGEN: NON-TRAUMATIC DOG EXPOSURE LEADING TO CAPNOCYTOPHAGA CANIMORSUS SEPSIS IN A PATIENT WITH WELL-CONTROLLED HIV

SHM Converge 2026

Case Presentation: A 67 year old man with a history of well-controlled HIV (undetectable viral load, CD4 509 cells/µL) presented with two days of progressive weakness and malaise. He was walking his dog when the weakness worsened, leading to a fall. On arrival to the emergency department, his vital signs were notable for SpO₂ 89%, [...]

Abstract Number: 286

RIB INFARCTION: AN OVERLOOKED CAUSE OF SICKLE CELL CHEST PAIN

SHM Converge 2026

Case Presentation: A 57-year-old man with sickle cell disease complicated by post-transfusion hyper-hemolysis, bilateral avascular necrosis, prior acute chest syndrome, and pulmonary fibrosis on home oxygen presented with a vaso-occlusive pain crisis in the setting of rhinovirus infection. His course was notable for severe hemolytic anemia (Hb 3.8 g/dL) and acute hypoxic respiratory failure requiring [...]

Abstract Number: 287

SEVERE QT PROLONGATION AND TORSADES DE POINTES IN PANHYPOPITUITARISM: A REVERSIBLE ENDOCRINE CRISIS

SHM Converge 2026

Case Presentation: A 27-year-old female with a history of craniopharyngioma status post resection with panhypopituitarism presented with intractable vomiting despite doubling her home hydrocortisone per sick-day protocol. At an outside hospital, she was given stress-dose hydrocortisone and IV levothyroxine. After receiving ondansetron for nausea, she developed Torsades de Pointes (TdP). She converted to sinus bradycardia [...]

Abstract Number: 288

EXPOSING THE IMPOSTOR: SEVERE B12 DEFICIENCY PRESENTING AS PSEUDO-THROMBOTIC MICROANGIOPATHY

SHM Converge 2026

Case Presentation: A 40-year-old woman reported six weeks of progressive fatigue and dyspnea. She had a history of severe anemia of unclear etiology despite an extensive workup ten years earlier. She was referred to the emergency department after outpatient labs found a hemoglobin of 5.5 g/dL (hemoglobin 10 g/dL two months earlier). On arrival, she [...]

Abstract Number: 289

CRAB WITHOUT MYELOMA: A CASE OF REFRACTORY HYPERCALCEMIA UNMASKING HTLV-1 ASSOCIATED ADULT T-CELL LEUKEMIA/LYMPHOMA

SHM Converge 2026

Case Presentation: An 83-year-old man with cerebrovascular disease, chronic kidney disease, and type 2 diabetes mellitus presented with altered mental status, characterized by three days of increasing somnolence. Five days earlier, he was started on levofloxacin for a cough and subsequently developed a diffuse maculopapular rash involving the trunk and extremities. A similar but milder [...]

Abstract Number: 290

FENTANYL-INDUCED SEROTONIN SYNDROME: A CASE OF OPIOID-ASSOCIATED SEROTONERGIC TOXICITY

SHM Converge 2026

Case Presentation: Immediately after completing a drug rehabilitation program, the patient relapsed and used fentanyl. That morning, he was evaluated in an emergency department (ED) for opioid overdose and first-time generalized tonic-clonic movements. He returned to baseline during observation, and the symptoms were considered secondary to fentanyl induced hypoxia. He was discharged home with suboxone. [...]

Abstract Number: 291

INFECTIVE ENDOCARDITIS MASQUERADING AS A GOUT FLARE

SHM Converge 2026

Case Presentation: A 76-year-old man with atrial fibrillation and gout presented with one week of worsening dizziness and headache. On arrival, his vital signs were normal, and laboratory studies showed an unremarkable leukocyte count and comprehensive metabolic panel. A brain MRI revealed no acute infarct. Overnight, he developed new acute left shoulder and right ankle [...]

Abstract Number: 292

ACUTE CORONARY SYNDROME DUE TO TYPE 1 SPONTANEOUS CORONARY ARTERY DISSECTION IN A YOUNG WOMAN FOLLOWING RECENT PREGNANCY TERMINATION

SHM Converge 2026

Case Presentation: A 30-year-old G2P1A1 woman with a history of gestational diabetes, pre-eclampsia, hypertension, and recent medical termination of pregnancy at around 8 weeks with mifepristone and misoprostol presented to the ED for pressure-like, non-radiating midsternal chest discomfort and dyspnea. Blood pressure was 135/105. Family history included MI in her grandfather at age 50-60, and [...]

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