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LOWER EXTREMITY GIANT BASAL CELL CARCINOMA MASQUERADING AS PYODERMA GANGRENOSUM

SHM Converge 2026

Case Presentation: The patient is a 62-year-old female with a history of a chronic right lower extremity wound and tobacco use disorder who presented to the emergency department for increased discharge from her chronic wound. She states the wound started as a small laceration and has slowly progressed in size for 15 years; she has [...]

PJP IN HEALTHY PATIENT LEADING TO HLH

SHM Converge 2026

Case Presentation: 50 year old male with PMH significant for seizure disorder (on Keppra) and COPD (not on home oxygen) presenting with weakness, fatigue, dyspnea on exertion, and 50-pound weight loss over four months. During this admission, he was found to have acute hypoxic respiratory failure secondary to right basilar pneumonia with small right pleural [...]

PRIMARY CNS VASCULITIS: DIAGNOSTIC CHALLENGES AND INSIGHTS

SHM Converge 2026

Case Presentation: A 51-year-old woman presented to the ER with acute altered mental status, left-sided weakness, and fever. Her medical history includes hypertension, hyperlipidemia, complex migraines, and strokes (2021, 2024). A stroke code was activated. Vital signs showed fever 40.6°C, HR 120, and BP 180/100 mmHg. Labs showed leukocytosis and lactic acidosis. Physical exam revealed [...]

Chapter Winner

REFRACTORY SEIZURES AS A MANIFESTATION OF ANTI-EPILEPTIC DRUG INDUCED HYPOCALCEMIA AND VITAMIN D DEFICIENCY

SHM Converge 2026

Case Presentation: A 34-year-old female with a history of focal epilepsy diagnosed during childhood complicated by status epilepticus, anxiety, depression, ADHD, and history of chronic hyponatremia presented to the hospital at 25 weeks gestation with complaints of recurrent seizures. During the admission process she had multiple witnessed generalized tonic-clonic seizures with nystagmus requiring multiple rounds [...]

Chapter Winner

ROCKY MOUNTAIN SPOTTED FEVER AND HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS PRESENTING AS MULTI-ORGAN DYSFUNCTION IN A 40-YEAR-OLD FEMALE

SHM Converge 2026

Case Presentation: A 40-year-old female presented in June of 2023 with emesis and a fever of 38.9 °C. She complained of epigastric pain radiating to the back. The patient reported no recent travel. She worked in a daycare and had a pet dog. She had not hiked or camped recently. She walked her dog at [...]

SEMAGLUTIDE AND IMMUNE MODULATION: A CASE OF SEMAGLUTIDE-INDUCED NEW ONSET LUPUS CAUSING DEMYELINATING GUILLIAN-BARRE SYNDROME

SHM Converge 2026

Case Presentation: A 31-year-old female with a past medical history of obesity, angioedema, and ADHD presented to the ED for progressive bilateral numbness and weakness in both extremities starting after she increased her Semaglutide dosage by an unknown amount 6 days prior . The vital signs demonstrated slight tachycardia, otherwise were unremarkable. On physical exam, [...]

SILENT GIANT: CHRONIC URINARY RETENTION PRESENTING AS 12-LITRE BLADDER DISTENSION IN A 65-YEAR OLD MALE

SHM Converge 2026

Case Presentation: A 65-year-old male with hypertension, hyperlipidemia, and alcohol use disorder presentedwith sudden severe generalized abdominal pain after a year of intermittent lower abdominaldistention but no urinary symptoms. He denied dysuria, hematuria, frequency, urgency,hesitancy, or recent urologic procedures. Prior outpatient evaluations had suggestedpossible urinary retention, but no definitive diagnosis or treatment had been implemented.In [...]

THE ECLAMPSIA THAT NEVER ENDED: MALIGNANT HYPERTENSION AND PRES AS THE DEBUT OF MIXED CONNECTIVE TISSUE DISEASE

SHM Converge 2026

Case Presentation: For this 18-year-old woman, the pregnancy ended but the diagnosis never did. Eighteen months after an eclamptic delivery, she presented with occipital headache, photophobia, and a generalized tonic–clonic seizure. In the intervening months, she had difficult blood pressure and recurrent seizures, repeatedly framed as lingering eclampsia and post-pregnancy hypertension despite escalating polypharmacy. On [...]

THE FLAIR OF VZV ENCEPHALOMYELITIS: VARICELLA ZOSTER ENCEPHALOMYELITIS WITH CSF ENHANCEMENT ON T2/FLAIR IMAGING

SHM Converge 2026

Case Presentation: An 88-year-old male with a past medical history of type 2 diabetes, hypertension, and hypothyroidism presented with acute onset right leg paralysis.The patient awoke with complete right leg paralysis, but otherwise asymptomatic and had normal mentation. Vital signs were unremarkable. Physical exam was notable for decreased sensation in the entire right lower extremity, [...]

THE TAVR RESCUE: A CASE OF A 23-YEAR-OLD WITH TAKAYASU ARTERITIS AND SEVERE AORTIC REGURGITATION

SHM Converge 2026

Case Presentation: A 23-year-old woman with juvenile idiopathic arthritis, large vessel vasculitis, and prior pulmonary embolism presented with progressive dyspnea, fatigue, and hemoptysis. Diagnostic evaluation revealed large vessel vasculitis and right-sided pneumonia on imaging; echocardiography showed a dilated left ventricle with global hypokinesis, severe aortic insufficiency (ejection fraction 39%), and moderate hypertrophy. Her cardiac catheterisation [...]

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