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Abstract Number: 533

ADRENAL CRISIS SECONDARY TO NIVOLUMAB THERAPY IN A 70 YEAR OLD MALE

SHM Converge 2026

Case Presentation: A 70 year old male with a history of urothelial cancer on nivolumab presented to the hospital for confusion. Patient developed worsening confusion over the past two days causing family to take him to the emergency room. He was initially hemodynamically stable though he was found to have a sodium of 116. He [...]

Abstract Number: 534

PYODERMA GANGRENOSUM, ACNE AND SUPPURATIVA HIDRADENITIS (PASH) SYNDROME

SHM Converge 2026

Case Presentation: A 40 year old female with a history of acne vulgaris and hidradenitis suppurativa presented with bilateral lower extremity pain.Patient had two prior admissions for extensive suppurative hidradenitis (SH) complicated by abscess development within the past two years. Patient began developing bilateral lower extremity edema, pain and ulcerating sores for the past 6 [...]

Abstract Number: 535

SEVERE STARVATION HEPATITIS IN A 36 YEAR OLD MALE WITH ANOREXIA NERVOSA

SHM Converge 2026

Case Presentation: A 36 year old male with anorexia presented for weakness Due to concerns of being overweight, patient began to increasingly restrict his diet (ie eliminating carbs, smaller calorie goals) over the past three years and also began taking milk of magnesia daily over the past year, losing approximately 120 lbs over this time. [...]

Abstract Number: 536

FEVER IN THE RETURNING TRAVELER: DENGUE IN WISCONSIN AND THE INDISPENSABILITY OF A SAGE H&P

SHM Converge 2026

Case Presentation: A 58-year-old male presented to the emergency department with a 48-hour history of nausea, diarrhea, headache, and fever roughly 24 hours after returning from a 14-day trip to the Philippines. Additional symptoms included a retroorbital headache and erythematous rash across his chest (initially felt to be sunburn). He described staying in a small [...]

Abstract Number: 537

LONGITUDINALLY EXTENSIVE TRANSVERSE MYELITIS (LETM) AND CMML, UNHEARD OF, RARE BUT POSSIBLE

SHM Converge 2026

Case Presentation: A 71-year-old male with history atrial fibrillation presented with dyspnea and splenomegaly. Patient was admitted for worsening hypoxemia found to have large bilateral pleural effusions. Peripheral smear performed for anemia and splenomegaly notable for monocytosis. Patient had 20 lbs weight loss in two months. Bone marrow biopsy revealed absolute monocytosis, morphologic findings suspicious [...]

Abstract Number: 538

SULFHEMOGLOBINEMIA: THE PROOF IS IN THE PHENAZOPYRIDINE

SHM Converge 2026

Case Presentation: A 95-year-old woman required admission for asymptomatic hypoxemia incidentally discovered at her nursing home with an oxygen saturation (SpO2) of 57% while breathing ambient air. The cardiopulmonary examination was unremarkable, and peripheral cyanosis and clubbing were absent. Chest imaging was normal. Her SpO2 failed to improve despite administration of 15L of oxygen via [...]

Abstract Number: 539

HIDDEN IN PLAIN SIGHT: MANGANESE TOXICITY MASQUERADING AS PARKINSON DISEASE

SHM Converge 2026

Case Presentation: A 61-year-old man with hypertension, hyperlipidemia, and a presumed diagnosis of Parkinson disease was admitted after sustaining burn injuries following a ground-level fall with loss of consciousness. CT head revealed a left extra-axial hypodensity with mild mass effect and bilateral basal ganglia hypodensities. One year earlier he developed a resting tremor of the [...]

Abstract Number: 540

THE DECEPTIVE CONTAMINANT: STAPHYLOCOCCUS EPIDERMIDIS PROSTHETIC VALVE ENDOCARDITIS LEADING TO AORTIC ROOT ABSCESS AND INTRACARDIAC FISTULA

SHM Converge 2026

Case Presentation: A 76-year-old woman with prior bioprosthetic aortic valve replacement, coronary artery disease, chronic kidney disease on hemodialysis, and multiple comorbidities presented with acute left upper-extremity ischemia requiring thrombectomy. A single blood culture grew S. epidermidis and was considered a contaminant after rapid clearance on repeat testing. Ten days later, recurrent methicillin-resistant S. epidermidis [...]

Abstract Number: 541

A RARE CASE OF ASEPTIC ABSCESS SYNDROME

SHM Converge 2026

Case Presentation: A 47-year-old woman with psoriasis and psoriatic arthritis (on Enbrel) presented to our ER with a three-week history of abdominal pain, back pain, nausea, significant weight loss, and one week of severely painful groin and oral ulcers. Before admission, the patient had a recent negative CT abdomen and pelvis as well as had [...]

Abstract Number: 543

IMAGING THE INVISIBLE: ULTRASOUND IDENTIFICATION OF A WOODEN TOOTHPICK

SHM Converge 2026

Case Presentation: An obese 69-year-old man with diabetes mellitus complicated by peripheral neuropathy presented with left foot and leg cellulitis. He recalled stepping on a sharp object while walking barefoot in his garage. He attempted dislodging the object with a flathead screwdriver. Three days later, he developed unbearable pain, swelling, and erythema which brought him [...]

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