For 9 months, a 39-year-old woman has had a pruritic rash on the posterior portion of one thigh. She had consulted another physician, who prescribed a medication that she does not recall, but there was no improvement.
A 16-year-old boy with asymptomatic, hyperpigmented, hairy lesion on his left upper back. The pigmentation, first noted 5 years earlier, had progressively spread across his torso. The coarse and dark hair confined to the hyperpigmented area had appeared at age 13 years. Medical history uneventful. Review of systems showed no abnormalities. No family history of similar skin lesions.
For the past year, a 52-year-old man had dysphagia, which he described as a “knot stuck in the throat” and an associated 25-lb weight loss. He denied fever, chills, headache, abdominal pain, and diarrhea. The patient had been living in the Dominican Republic until about 1 year earlier, when he moved to the United States. He had a 30 pack-year smoking history; he also had hypertension, asthma, and coronary artery disease (none of which were pharmacologically treated). He denied alcohol and illicit drug use.
A51-year-old man who was an active injection drug user was admitted to the ICU with septic shock and severe respiratory distress. Notable findings were fever, multiple opacities on a chest radiograph, and an elevated white blood cell count.
This 40-year-old man presented with fever and a generalized, painful, nonpruritic rash of 2 days’ duration. The rash first appeared on his face then spread to his hands, buttocks, and lower extremities. Two weeks earlier, he had an episode of severe rhinitis followed by high fevers, chills, muscle aches, and ankle pain.
Right Ventricular involvement in acute inferior MI is an independent predictor of major complications and in-hospital death, as this case demonstrates. While in-hospital prognosis after left ventricular infarction is directly related to the postinfarct LV ejection fraction, involvement of the right ventricle drastically alters that linear relationship.
A previously healthy 19-year-old woman presents with a sore throat that has become progressively more painful over the course of 1 week. She also has left-sided neck swelling, light-headedness, and intermittent headaches. She denies recent sexual activity.