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Abstract Number: 315

MYELOID SARCOMA OF THE GASTROINTESTINAL TRACT IN HIGH GRADE MYELODYSPLASTIC SYNDROME

SHM Converge 2026

Case Presentation: An 80-year-old male with high-grade myelodysplastic syndrome (MDS) on chemotherapy and chronic transfusion dependence presented with neutropenic fever and hematochezia for three days. His past medical history included recent hospitalization for gastrointestinal bleeding with endoscopic and capsule evaluation showing diffuse nonbleeding ileal ulceration and biopsy-confirmed nonspecific pseudopyloric metaplasia. On presentation, he was tachycardic [...]

Abstract Number: 316

SILENT BUT DANGEROUS: RECOGNIZING BOWEL-RELATED AUTONOMIC DYSREFLEXIA IN PATIENTS WITH SPINAL CORD INJURIES

SHM Converge 2026

Case Presentation: A 77-year-old man presented with one week of episodic pre-syncope. The symptoms were often associated with sitting up in the wheelchair. His past medical history was notable for a cervical spine injury after a bike accident complicated by quadriplegia, as well as neurogenic bladder and bowel dysfunction. Review of Systems was positive for [...]

Abstract Number: 317

THE BEDSIDE PARACENTESIS THAT WOULDN’T DRAIN: MUCINOUS ASCITES FROM STAGE IV APPENDICEAL ADENOCARCINOMA

SHM Converge 2026

Case Presentation: A 70-year-old woman presented with 5 months of increasing abdominal distension. Her exam was notable for a markedly distended abdomen with dullness to percussion. CT imaging revealed large volume ascites with average Hounsfield Unit around 20, obscuring underlying structures. Bedside POCUS showed a large pocket of complex fluid that appeared safe for paracentesis. [...]

Abstract Number: 318

ACUTE FEBRILE ILLNESS WITH SEVERE LIVER INJURY: AN UNCOMMON MANIFESTATION OF ANAPLASMOSIS

SHM Converge 2026

Case Presentation: A 37-year-old male with no significant past medical history presented to the emergency department (ED) in early October with recurrent fevers, chills, diffuse myalgias, headache, night sweats, and pleuritic midsternal chest pain associated with mild dyspnea. He reported hiking in upstate New York a week prior during late September—a season and region known [...]

Abstract Number: 319

FROM VIRAL MENINGITIS SUSPICION TO LEPTOSPIROSIS DIAGNOSIS: A CASE FOR BROAD DIFFERENTIALS

SHM Converge 2026

Case Presentation: A 24-year-old man with ADHD and chronic low back pain under rheumatologic evaluation for possible axial spondyloarthritis presented with six days of fever (to 100.9°F), fatigue, myalgias, nausea/vomiting, and inability to tolerate oral intake. Admission labs showed platelets 86 × 10³/μL, creatinine 2.04 mg/dL, AST 82 U/L, ALT 120 U/L; CT brain/abdomen and [...]

Abstract Number: 320

ENDOGENOUS ENDOPHTHALMITIS UNVEILED: A BLINDING COMPLICATION OF HYPERVIRULENT KLEBSIELLA PNEUMONIA IN A HOSPITALIZED PATIENT

SHM Converge 2026

Case Presentation: A 71-year-old man with a history of poorly controlled type 2 diabetes mellitus (complicated by polyneuropathy and diabetic nephropathy), chronic kidney disease, hypertension, hyperlipidemia, and prior left nephrectomy for trauma presented to the emergency department with acute right eye pain, right-sided headache, and sudden vision loss. Two weeks prior, he experienced occipital headaches, [...]

Abstract Number: 321

A RARE CASE OF ACUTE RESPIRATORY DISTRESS SYNDROME IN THE SETTING OF MULTIPLE PSYCHOGENIC DRUGS OVERDOSE

SHM Converge 2026

Case Presentation: A 41-year-old female with a past medical history of Bipolar 1 Disorder presented to the emergency department (ED) for psychogenic drug overdose. Patient took 2 mg of Risperidone and unknown amounts of Lamotrigine, Clonazepam, and Venlafaxine. Upon evaluation patient was minimally responsive to sternal rub. Poison control recommended ECG every 2 hours and [...]

Abstract Number: 322

AN UNSUSPECTED CASE OF VARICELLA-ZOSTER VIRUS ENCEPHALITIS

SHM Converge 2026

Case Presentation: A 51year old male with a past medical history of hyperlipidemia, anemia, tobacco abuse, and mild intermittent asthma who presented for evaluation of altered mental status. History was obtained from patient’s wife and brother who were present at the bedside as patient was intubated. Per family, patient reported having a headache 2 days [...]

Abstract Number: 323

CAN THE USE OF METHYLENEBLUE IN SEPTIC SHOCK BE LIFE-SAVING?

SHM Converge 2026

Case Presentation: A 66-year-old female with a past medical history of recurrent kidney stones bilaterally requiring stents and lithotripsy in 2022-24, hypertension, hyperlipidemia, type 2 diabetes mellitus, and lower back pain secondary to multilevel degenerative disc disease who presented to the emergency department with back pain, chills, nausea and vomiting from rehabilitation center (rehab). Patient [...]

Abstract Number: 324

GIANT ARACHNOID GRANULATIONS MIMICKING TRANSVERSE SINUS THROMBOSIS

SHM Converge 2026

Case Presentation: A 70-year-old female with a past medical history of hypertension, irritable bowel syndrome, hyperlipidemia, and migraines on Carbamazepine since age 30 who presented to the emergency department (ED) with recurrent headaches for the past week. Initially responded to Advil but it became worse which prompted her to come to ED. Denied any photophobia [...]

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