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Abstract Number: 840
SHM Converge 2023
Case Presentation: A 26-year-old male with no significant past medical history was intubated due to respiratory failure from cocaine and fentanyl overdose. Admission labs showed severe rhabdomyolysis (creatinine kinase> 22K U/L), hyperphosphatemia (>20mg/dL) and hyperkalemia (>10mmol/L) with creatinine 2.9mg/dL. ICU course was complicated by hypoalbuminemia, chronic hypocalcemia (corrected calcium-7.6-8.4 mmol/L) and chronic hyperphosphatemia (5.6-10mg/dL). He […]
Abstract Number: 841
SHM Converge 2023
Case Presentation: Lemierre’s syndrome is a clinical syndrome characterized by septic thrombophlebitis of the internal jugular (IJ) vein after an oropharyngeal infection. We present a case of a 36-year-old man with no significant past medical history who presented with one week of subjective fevers/chills, sore throat, and dysphagia. On initial evaluation, vital signs were only […]
Abstract Number: 842
SHM Converge 2023
Case Presentation: A 32-year-old female was admitted after a seizure. Brain MRI was unremarkable and lumbar puncture yielded 133 white blood cells with 100% lymphocytes. Within a few days, refractory seizures occurred. Due to suspected autoimmune encephalitis, plasma exchange and high-dose steroids were started. Cerebral spinal fluid (CSF) studies returned with IgG antibody levels for […]
Abstract Number: 844
SHM Converge 2023
Case Presentation: 79-year-old man presented with recurrent syncope. He had a history of tonsillar squamous cell carcinoma (SCC) in 2005 s/p resection, pyriform sinus SCC in 2019 s/p total laryngopharyngectomy with tracheostomy and PEG placement. He had multiple prior admissions for the same presentation, which had been attributed to vasovagal syncope and dehydration from intermittent […]
Abstract Number: 845
SHM Converge 2023
Case Presentation: This is a case of a 58-year-old male with history of urethral stricture s/p dilation who presented with progressive dyspnea, nonproductive cough and fever. Chest x-ray revealed bilateral diffuse opacification concerning for pneumonia, CTA showed no PE. The patient was initiated on levofloxacin for Pneumonia, heparin infusion for NSTEMI and was admitted to […]
Abstract Number: 846
SHM Converge 2023
Case Presentation: Patients presenting with melena are often found to have an upper gastrointestinal source: melenic stool on exam has a likelihood ratio of 25 for upper gastrointestinal bleed (1). But what if repeated endoscopies are unimpressive? Mr. S is a 75 year old male with a history of atrial fibrillation on apixaban for three […]
Abstract Number: 847
SHM Converge 2023
Case Presentation: An 84-year-old woman with a medical history of asthma and hypertension presented with generalized weakness and poor oral intake. Initial vital signs showed heart rate of 108 beats/minute, blood pressure 146/77 mmHg, temperature of 105.5 F and respiratory rate of 15 breaths/minute. Admission labs showed a leukocytosis (78.56 K/uL cells) with blasts, thrombocytopenia […]
Abstract Number: 848
SHM Converge 2023
Case Presentation: A 43-year-old woman with general anxiety disorder and benzodiazepine abuse was brought to the emergency department by her husband with nausea, diarrhea, agitation, and altered mental status. She also endorsed restlessness and muscle tension. Examination revealed an agitated, disoriented woman with three days of amnesia. Vitals signs were within normal limits. Drug and […]
Abstract Number: 849
SHM Converge 2023
Case Presentation: A 20-year-old female with systemic lupus erythematosus and end stage renal disease (ESRD) secondary to lupus nephritis on hemodialysis via left upper extremity arteriovenous graft presented to the emergency department for pain, erythema, and swelling of the right inferior breast. She was initially treated for cellulitis with resolution of erythema and warmth of […]
Abstract Number: 850
SHM Converge 2023
Case Presentation: A 78-year-old female with a medical history of deep vein thrombosis, ovarian cancer status post resection and currently in the TESARO trial (receiving Dostarlimab and Niraparib or placebo; last dose was 3 months ago) presented to the emergency department from her outpatient provider due to inability to obtain a blood pressure reading in […]