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Abstract Number: 389

WHEN THE FLAME IGNITES: A CASE OF ADULT-ONSET STILL’S DISEASE COMPLICATED BY MACROPHAGE ACTIVATION SYNDROME

SHM Converge 2026

Case Presentation: This is a 69-year-old male with a past medical history significant for prostate cancer on active radiation therapy and androgen deprivation therapy who presented to the emergency room for evaluation of hypotension. He reported four days of nausea, myalgias, and night sweats.On physical examination, he was noted to be tachycardic and hypotensive, with [...]

Abstract Number: 390

ACCIDENTAL FOREIGN BODY INGESTION – NOT JUST A PEDIATRIC PROBLEM!

SHM Converge 2026

Case Presentation: An 85-year-old woman with a history of heart failure, stroke, persistent atrial fibrillation, and recent myocardial infarction treated with a drug eluting stent presented to urgent care with 4 days of abdominal pain, loss of appetite, vomiting, and PO intolerance. Exam revealed tenderness in the right upper quadrant but no guarding or rebound [...]

Abstract Number: 391

TREATMENT-ASSOCIATED INFLAMMATORY RESPONSE IN LYME NEUROBORRELIOSIS

SHM Converge 2026

Case Presentation: A 33-year-old previously healthy woman presented with progressive facial paralysis, limb weakness, and dysesthesias. One month earlier, she was diagnosed with bilateral Bell’s palsy and treated with corticosteroids, which was later attributed to Lyme disease after a positive serum Lyme IgG. She was started on doxycycline but later required hospitalization for worsening symptoms [...]

Abstract Number: 392

PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHY ARISING IN HIV-NEGATIVE IDIOPATHIC CD4 LYMPHOCYTOPENIA: A MULTIDISCIPLINARY CASE

SHM Converge 2026

Case Presentation: A 46-year-old previously healthy female presented to a referring hospital with a 1-month of left-sided weakness, dysarthria, and dysphagia. An MRI which showed T2 hyperintense lesions in the right MCA territory and encephalomalacia in the left anterior temporal lobe. Neurology believed these findings to be more consistent with a demyelinating or inflammatory process [...]

Abstract Number: 393

LESSONS FROM AN INVASIVE FUNGAL INFECTION

SHM Converge 2026

Case Presentation: An 83-year-old female with myelodysplastic syndrome (MDS) presented to an outside hospital with a one day history of right facial pain, numbness, right eye drooping, and double vision. Prior to this, the patient had already completed two antibiotic courses as an outpatient for sinus symptoms without significant improvement. Chart review revealed poorly controlled [...]

Abstract Number: 394

CHRONIC HEMOTHORAX AS A MANIFESTATION OF THORACIC ENDOMETRIOSIS

SHM Converge 2026

Case Presentation: A 38-year-old female with a past medical history of suspected endometriosis presented to the hospital with lightheadedness, palpitations, and chest tightness. Vital signs were remarkable for slightly elevated temperature (38.7 C) and tachycardia to 136 bpm. A contrasted chest CT demonstrated a large right-sided pleural effusion with complete atelectasis of right lower and [...]

Abstract Number: 395

WHEN A COMMON PRESENTATION OF HEART FAILURE LEADS TO THE UNCOMMON DIAGNOSIS OF CARDIAC AMYLOIDOSIS CASE REPRT

SHM Converge 2026

Case Presentation: We present a 65-year-old female patient with 3-4 months of dyspnea, initially treated outpatient for pneumonia without improvement. She presented to the Emergency Department (ED) with worsening symptoms, and physical examination revealed volume overload but no fever. Labs showed BNP elevated to 345 pg/mL and a normal white blood cell count. Computed Tomography [...]

Abstract Number: 396

THE COST OF UNCERTAINTY: FRAGMENTED DECISION-MAKING IN ADVANCED CANCER CARE

SHM Converge 2026

Case Presentation: A 67-year-old female with no significant medical history presented for evaluation of a newly discovered metastatic lung adenocarcinoma. Prior imaging revealed a pelvic mass abutting the adnexa which raised suspicion for a second primary ovarian malignancy. Gynecology-oncology (Gyn-Onc), Surgical Oncology, Medical Oncology, Interventional Radiology (IR) and Colorectal Surgery were all consulted. Initially, Gyn-Onc [...]

Abstract Number: 397

A STROKE OF MISFORTUNE: THROMBOTIC THROMBOCYTOPENIC PURPURA-ASSOCIATED CEREBRAL INFARCT INITIALLY DIAGNOSED AS HIGH-GRADE CENTRAL NERVOUS SYSTEM TUMOR

SHM Converge 2026

Case Presentation: A 53-year-old female presented with acute expressive aphasia. CT/CTA showed multiple cerebral infarcts; MRI revealed a 1.7 cm mass-like lesion in the frontal lobe concerning for high-grade CNS neoplasm. Work-up including CSF studies, autoimmune testing and staging scans was largely unremarkable except for moderate thrombocytopenia (62 K/μL) and elevated creatinine (1.42 mg/dL; baseline [...]

Abstract Number: 398

FROM BACK PAIN TO BOWEL CRISIS: NAVIGATING THE THERAPEUTIC CHALLENGE OF DUODENAL DIVERTICULAR PERFORATION IN A HIGH-RISK PATIENT

SHM Converge 2026

Case Presentation: A 75-year-old man with CAD on aspirin, prior diverticulitis (status post-laparoscopic Low Anterior Resection 6 years prior to this admission), and chronic back pain managed with NSAIDs and long term prednisone presented with LUQ and epigastric pain. He denied nausea, vomiting, chest pain, or SOB, and reported normal bowel movements and flatus. On [...]

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