Ali et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Introduction: Cocaine is a highly addictive substance that stimulates the sympathetic nervous system and cardiovascular system. A multitude of adverse cardiovascular events are associated with cocaine use including arrhythmia, congestive heart failure, coronary artery spasm and myocarditis. <br/> Case Report: We present a rare case of Takotsubo cardiomyopathy after recent use of cocaine in a female without any other identifiable risk factor.<br/> Discussion: Takotsubo cardiomyopathy (TCM) is a reversible cause of cardiomyopathy characterized by transient decrease in ejection fraction. Cocaine is a sympathomimetic that causes catecholamine surge and a variety of cardiovascular abnormalities. The association of cocaine use with Takotsubo cardiomyopathy is a rare occurrence, however the prognosis is generally good if diagnosis is made promptly. <br/> Conclusion: Physician vigilance is required to diagnose this rare cause of cardiomyopathy and reduce morbidity and mortality.
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that is characterized by an aberrant immune response leading to immune-mediated damage to tissues. Hemophagocytic lymphohistiocytosis (HLH), a life-threatening condition, consists of a constellation of symptoms caused by excessive immune activation and cytokine storm. HLH is categorized into the primary and secondary form. The secondary form is often referred to as the macrophage activation syndrome. HLH in the background of SLE is a rare and potentially fatal entity. It is often seen in the context of disease flare and is rarely associated with the initial diagnosis of SLE. Severe infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes a cytokine storm characterized by marked elevation of inflammatory markers including ferritin. Here, we describe the case of a young female with an inaugural diagnosis of SLE and features of HLH after a recent SARS-CoV-2 infection.
Extramedullary hematopoiesis can occur during normal fetal development or as a compensatory mechanism in chronic anemia when the primary sites of hematopoiesis fail. When it occurs, it is mostly seen in sites such as the liver, spleen, and lymph nodes. Extramedullary hematopoiesis is seen in patients with abnormal morphology of red blood cells like thalassemia and abnormal red blood cell shape like hereditary spherocytosis. The incidence of extramedullary hematopoiesis in sickle cell disease is very rare. We report a case of focal adrenal extramedullary hematopoiesis in a 21-year-old patient with sickle cell disease who presented with pain in the right thorax. A retroperitoneal mass was seen in the MRI of the abdomen of the patient suggestive of extramedullary hematopoiesis. Our case highlights the importance of physician awareness of this rare pathology for proper diagnosis and management.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has emerged as a public health hazard. It is commonly associated with respiratory symptoms including fever, cough and sore throat. Viral infections have historically been implicated in the exacerbations of gastrointestinal (GI) disorders. Coronavirus disease 2019 (COVID-19) has been associated with GI manifestations including diarrhea and vomiting. However, exacerbation of underlying functional GI disorders has been rarely reported with SARS-CoV-2 infection. Herein we report a case of a 31-year-old female with acute gastroparesis flare secondary to COVID-19 which was refractory to pharmacological therapy.
Esophageal respiratory fistula represents a connection between esophagus and the respiratory system. Esophageal tracheal and esophageal bronchial fistulas are common whereas esophageal pulmonary fistula is rarely seen. We report a case of esophageal pulmonary fistula in a middle aged African American male with a history of bronchoesophageal fistula who presented with pneumonia. The diagnosis was confirmed with fluoroscopy esophagram. Management with endoscopic stent placement was planned however the patient refused treatment. A diagnosis of esophageal pulmonary fistula should be kept in mind for patients with pulmonary symptoms and dysphagia. Early diagnosis and treatment are required to prevent complications and improve quality of life in these patients.
In the United States, influenza virus and bacterial pneumonia are known to be the leading causes of hospitalization in the winter season. Although healthcare workers are knowledgeable about the management of these co-infections, with the coronavirus disease 2019 (COVID-19) global pandemic that occurred in 2019, a significant change has occurred. The symptoms and clinical manifestations of COVID-19 are similar to that of influenza virus and bacterial pneumonia which can present a unique challenge for healthcare workers. Many reports are available for influenza virus and bacterial pneumonia but none about influenza, bacterial pneumonia, and COVID-19 co-infection.Here, we present the case of a patient who was admitted with COVID-19, influenza, and bacterial pneumonia co-infection, along with his clinical characteristics, laboratory findings, treatment plan, and outcomes.
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