In a set of 8,641 colonoscopy images containing 4,088 unique polyps, the CNN identified polyps with a cross-validation accuracy of 96.4% and an area under the receiver operating characteristic curve of 0.991. The CNN system detected and localized polyps well within real-time constraints using an ordinary desktop machine with a contemporary graphics processing unit. This system could increase the ADR and decrease interval colorectal cancers but requires validation in large multicenter trials.

A 63-year-old man presented with fever and generalized weakness for 2 days. Computed tomography scan showed an intramural duodenal abscess and a linear radiolucent foreign body penetrating the duodenal wall. Endoscopic drainage was performed. Endoscopic ultrasound showed fluid collection in the second portion of the duodenum. The duodenal lumen was punctured with the creation of stoma using a lumen-apposing metal stent and electrocautery system. The stent was deployed, and the drainage of purulent fluid followed. The foreign body was suspected to be a wire brush bristle. The patient received intravenous antibiotics for 14 days. Follow-up images showed the resolution of the abscess.

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Nitrous oxide, primarily used in the medical field and in the food industry, can cause symptoms of euphoria and analgesia. Recreational use of nitrous oxide is rising, as are reports of its adverse effects, including neurologic complaints secondary to an evoked vitamin B12 deficiency. We outline a case of a patient presenting with several neurologic symptoms and found to have myelopathy secondary to vitamin B12 deficiency in the presence of prolonged recreational nitrous oxide use.

Encephalitis is an inflammatory process of the brain that is most commonly related to infectious etiology; nonetheless, autoimmune encephalitis has been an increasingly identified entity that can cause it as well and should be considered. N-methyl-D-aspartate (NMDA) receptor encephalitis is a recently identified process but remains less recognized than autoimmune encephalitis. We report a case of an 18-year old female who initially presented with seizures and later developed behavioral symptoms of agitation, crying, screaming, and emotional lability. Ultimately, she was found to have NMDA receptor encephalitis related to ovarian paraneoplastic teratoma. The patient was treated with anti-epileptics and intravenous immunoglobulin and underwent oophorectomy that lead to her recovery. This case highlights the importance of early recognition of NMDA receptor encephalitis to facilitate appropriate investigations and management.

Streptococcus spp. and Staphylococcus aureus are the most common pathogens causing skin and soft tissue infections (SSTI). Guideline-recommended empiric antibiotics targeting these organisms would also treat coagulase negative Staphylococci, which are not typically considered skin and soft tissue pathogens. Coagulase negative Staphylococci are, however, well known for their propensity to cause indolent infections in the setting of prosthetic material. Here, we present a case of a patient with surgical clips from a femoral artery surgical repair one year prior, presenting with cellulitis at the prior surgical site, complicated by high-grade Staphylococcus hominis bacteremia. Signs of infection persisted after 4 days of appropriate antibiotic therapy and resolved rapidly upon non-steroidal anti-inflammatory administration. This case highlights the importance of recognizing coagulase negative Staphylococci as a possible etiology of cellulitis in patients with prosthetic material, and of considering anti-inflammatory medications as a supplement to antibiotic therapy to hasten resolution of cellulitis in appropriate patients.

Endogenous endophthalmitis (EE) is a potentially blinding ophthalmological emergency with poor visual prognosis requiring a high index of clinical suspicion to obtain a prompt diagnosis. The main factors associated with poor visual outcomes include the virulence of the causative organism and timing of intervention. Infective endocarditis can present with nonspecific ocular complaints and remains an important risk factor for developing EE. We report an unusual case of EE in a 78-year-old male caused by infective endocarditis secondary to Streptococcus viridans resulting in bioprosthetic aortic valve abscess with dehiscence.

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