Chronic venous insufficiency (CVI) is a common condition characterized by lower extremity edema, discomfort, and skin changes due to venous hypertension caused by incompetent or obstructed venous valves. We report a case of chronic venous insufficiency and lymphedema with papillomatosis cutis lymphostatica, hyperkeratosis, and skin ulcers with proteus superinfection. A 67-year-old male presented to the emergency department (ED) for wound evaluation and was found to have severe hyperkeratosis, multiple ulcers with purulent discharge, and "tree bark" skin changes. Prophylactic treatment for deep vein thrombosis (DVT) was initiated, followed by successful surgical debridement. A subsequent diagnosis of Proteus mirabilis superinfection was treated accordingly. This report highlights the importance of adequate long-term management of chronic venous insufficiency as it may lead to serious complications.
Beer potomania is a unique condition characterized by hyponatremia secondary to excessive beer drinking and low daily solute intake. We report a case of a 41-year-old African American female with multiple comorbidities, notably alcohol use disorder, who was initially treated for hypertensive emergency and was subsequently found to be hyponatremic during the same visit. Beer potomania was suspected as a leading etiology of hyponatremia. This report emphasizes the importance of the proper diagnosis and appropriate management of beer potomania in the setting of concomitant comorbidities. Clinician awareness is crucial in implementing immediate treatment and in the prevention of potentially fatal sequelae such as severe malnutrition and osmotic demyelination syndrome.
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