While mass immunization against coronavirus disease 2019 (COVID-19) rolls out around the globe, safety concerns and adverse events that need prompt evaluation are also emerging. We report a case of transverse myelitis and Bell's palsy after receiving Johnson and Johnson COVID-19 vaccination under the emergency use authorization in a healthy young woman with no past medical history. Other possible etiologies of her symptoms were ruled out, and she was treated successfully with steroids and plasma exchange.

The early shortage of novel coronavirus disease tests in the United States led many hospitals to first screen for common respiratory pathogens, and only if this screen was negative to proceed with COVID-19 testing. We report a case of a 56-year-old woman with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) coinfection with group A Streptococcus. The initial testing strategy resulted in delays in both diagnosis and implementation of appropriate precautions. Underlined is the importance of testing for both SARS-CoV-2 and other common respiratory pathogens during the current pandemic.

Stewart-Treves syndrome (STS) is defined as the development of cutaneous angiosarcoma in the presence of long-standing lymphedema and is a rare disease with only about 400 cases reported in world literature. We report a case of a 63-year-old morbidly obese woman with a long-standing history of lymphedema who developed angiosarcoma of the right lower extremity with metastasis and presented with acute respiratory distress. The patient underwent a thorough laboratory workup with a chest X-ray showing bilateral effusions. The hematology-oncology service was consulted and found the patient to have significant progression of angiosarcoma causing respiratory failure and cardiac instability. A decision to transition to hospice care was made and the patient eventually passed away in the intensive care unit. We present this case to raise awareness of STS in medical literature to understand its clinical manifestations better. Early detection is imperative as angiosarcoma is commonly an aggressive disease.

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Leptomeningeal carcinomatosis (LCM), also known as neoplastic meningitis, is a rare entity. It is generally seen in solid tumors. Ovarian cancers can infrequently cause LCM. The clinical presentation is variable. Diagnosis is made by a lumbar puncture that shows malignant cells in the cerebrospinal fluid (CSF) and usually correlates with imaging findings. Given the low individual sensitivities of lumbar puncture (55%) and magnetic resonance imaging (70%), it is recommended to combine both modalities for optimal diagnostic results. Treatment options vary depending on the type of primary carcinoma, however, the prognosis is guarded. We report a case of LCM in a patient with stage IV epithelial ovarian cancer in remission, which became a diagnostic challenge due to a lack of imaging findings.

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Ovarian vein thrombosis (OVT) is a rare entity. It is usually seen in hypercoagulable states such as pregnancy, peripartum period, active malignancy, recent pelvic surgeries, pelvic infections, and inherited or acquired thrombophilias. Idiopathic OVT is exceedingly rare. We report a case of OVT in a healthy 42-yearold post-menopausal female presenting with right lower quadrant abdominal pain for four days. The patient denied any recent pelvic surgery, pelvic infection, or any family history of thrombophilia. Right ovarian vein thrombosis was found on a computed tomography scan of the abdomen and pelvis. Laboratory workup including hypercoagulability studies was normal. The patient was treated with a therapeutic dose of lower molecular weight heparin and later transitioned to rivaroxaban for three to six months. This case emphasizes OVT as a differential diagnosis of lower abdominal pain in healthy females. Currently, there are no standard guidelines for the duration of anticoagulation in OVT, however based on literature review, deep venous thrombosis treatment guidelines can be followed.

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