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Abstract Number: 303

THE HIDDEN CULPRIT: A DUPLICATE GASTRODUODENAL ARTERY TRIGGERING RECURRENT DUODENAL ULCER BLEEDS

SHM Converge 2026

Case Presentation: A 63-year-old male presented with complaints of progressive shortness of breath and palpitations for three weeks, in addition to melena for the two days and an episode of coffee-ground emesis. He had been taking multiple ibuprofen tablets for the last 6 weeks for the lower extremity pains. He was tachycardic on arrival, but [...]

Abstract Number: 304

FROM DENTAL CHAIR TO CRITICAL CARE: A MALIGNANT CAUSE OF REFRACTORY LACTIC ACIDOSIS

SHM Converge 2026

Case Presentation: A 57-year-old woman with a history of stage I breast cancer (status post bilateral mastectomy in 2021), anxiety, PTSD, PCOS, and recent dental crown placement in January 2025 presented with one week of severe shock-like left mandibular pain, facial swelling, progressive fatigue, dyspnea, night sweats, anorexia, and 4–5 lbs weight loss.Given above symptoms [...]

Abstract Number: 305

FROM REFLEX TO REFLECTION: RHABDOMYOLYSIS DISGUISED AS ACUTE CORONARY SYNDROME

SHM Converge 2026

Case Presentation: A 91-year-old man with stable ischemic coronary artery disease presented with classic anginal chest pain relieved by nitroglycerin, initially suggesting acute coronary syndrome (ACS). Labs revealed elevated troponin I (353 ng/L), acute kidney injury (creatinine 2.54 mg/dL from baseline 1.3), and marked transaminitis (AST 506 U/L, ALT 369 U/L). ECG and imaging were [...]

Abstract Number: 306

FROM SILENT LAB CLUE TO LIFE-CHANGING DIAGNOSIS: A HOSPITALIST’S DETECTION OF EARLY MULTIPLE MYELOMA

SHM Converge 2026

Case Presentation: An 80-year-old man with a history of heart failure was admitted for mild decompensation, treated with intravenous diuretics, and was about to be discharged when routine labs were noted to have mild hypercalcemia (10.9 mg/dL), a declining hemoglobin trend (12.4 → 10.6 g/dL), and an elevated protein gap (total protein 8.7 g/dL, albumin [...]

Abstract Number: 307

WHEN NEGATIVE TESTS MISLEAD: MYCOPLASMA PNEUMONIA UNCOVERED THROUGH COLD AGGLUTININ HEMOLYSIS

SHM Converge 2026

Case Presentation: A 28-year-old man presented with five days of fever, non-productive cough, progressive shortness of breath and hypoxia on admission. CT pulmonary angiography was negative for embolism but revealed multifocal ground-glass infiltrates. Initial management with ceftriaxone and doxycycline for community-acquired pneumonia was started; however, doxycycline was discontinued when atypical infectious workup including respiratory pathogen [...]

Abstract Number: 308

BEYOND COMMUNITY-ACQUIRED PNEUMONIA: A DETOUR TO PJP AND UNDIAGNOSED HIV IN A 70-YEAR-OLD

SHM Converge 2026

Case Presentation: A 70-year-old woman with hypertension and dyslipidemia presented with several days of shortness of breath, anorexia, and confusion. She was afebrile, hypotensive, and hypoxemic to 50% on room air. Examination revealed cyanotic lips, minimal bilateral air movement, and right-sided wheezing. Lab studies showed lymphocytopenia and an LDH of 414 U/L. There were confluent [...]

Abstract Number: 309

MORE THAN SKIN DEEP: A SYSTEMIC CAUSE OF LEUKOCYTOCLASTIC VASCULITIS

SHM Converge 2026

Case Presentation: A 66-year-old man presented with several days of fevers, arthralgias, fatigue, and a progressive non-blanching purpuric rash of the face, abdomen, and extremities. One month earlier, biopsy had shown IgM and C3-positive leukocytoclastic vasculitis (LCV), and a course of prednisone had not improved his symptoms. Infectious and autoimmune evaluations, including lumbar puncture, were [...]

Abstract Number: 311

FROM VOGUE TO MORGUE: A FATAL CASE OF E-CIGARETTE OR VAPING USE ASSOCIATED LUNG INJURY REQUIRING EXTRA CORPOREAL MEMBRANE OXYGENATION

SHM Converge 2026

Case Presentation: 25-year-old female with PMH of anxiety, depression and daily vape use of 1 g of THC was admitted to the hospital for acute hypoxic respiratory failure requiring intubation. Chest x-ray and CT imaging confirmed diffuse bilateral opacities. Infectious workup including influenza, RSV PCR, bronchioloalveolar lavage (BAL) and blood cultures were negative. Rheumatological work [...]

Abstract Number: 312

A THERAPEUTIC CHALLENGE: MASSIVE BILATERAL HEMOPTYSIS IN CHRONIC CYSTIC BRONCHIECTASIS WITH CONCURRENT PULMONARY EMBOLISM

SHM Converge 2026

Case Presentation: A 70-year-old male with a history of chronic bronchiectasis and prior smoke inhalation lung injury presented with presumed hematemesis, but was quickly found to have large-volume hemoptysis. He became unstable and required emergent intubation. Initial Bronchoscopy showed blood clots bilaterally, but no active source; repeat bronchoscopy localized bleeding to the left lower lobe. [...]

Abstract Number: 314

IT CAME AS A (SEPTIC) SHOCK: AN UNEXPECTED CASE OF LEPTOSPIROSIS AT AN URBAN U.S. HOSPITAL

SHM Converge 2026

Case Presentation: A 55-year-old male with a history of hypertension and diabetes mellitus presented with fatigue, myalgias, vomiting, and diarrhea for two days. He worked as a grocery clerk in New York City and reported no recent recreational water activities or international travel. On physical exam, he was febrile, tachycardic, and hypotensive with bilateral calf [...]

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