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A Depressing Diagnostic Error

To the Editor: A 52-year-old woman with diabetes presented to the hospital with acute onset of right flank pain, in the setting of profound lower extremity weakness and cachexia with a 30-lb unintentional weight loss over the past 6 months. She was diagnosed with ascending pyelonephritis and treated with empiric antibiotics. On hospital day 2, […]

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Elongated Mitral Valve Vegetation

To the Editor: A 41-year-old woman presented with a 2-week history of neck and back pain and suddenly developed pulseless electrical activity cardiac arrest while in the emergency department, with return of spontaneous circulation after 2 rounds of advanced cardiac life support. Physical examination and labs were notable for fever, sinus tachycardia, leukocytosis, and lactic […]

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Big Gain, No Pain: Tumoral Calcinosis

A patient’s odd physical presentation was the result of what could be termed a mineral deposit. The 40-year-old man reported that his right shoulder had been swelling progressively for more than 6 months. His medical history was significant for chronic kidney failure, and he had been undergoing hemodialysis for the previous 10 years. He had […]

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Provoked Dizziness from Bow Hunter’s Syndrome

  A 62-year-old man was experiencing debilitating bouts of dizziness provoked by head rotation until ultimately finding relief with cervical spine fixation. He had a history of coronary artery disease, human immunodeficiency virus, tobacco use disorder, and generalized anxiety, and initially presented to a routine primary care visit with 3 weeks of episodic dizziness. During […]

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Non-Classic Cystic Fibrosis: The Value in Family History

To the Editor: Since the advent of the Human Genome Project, opening doors to an era of genomic medicine, the family history has become a relevant and critical tool in individualized disease prevention. The family history has lasted through the years as a key component of history-taking in medical education. Yet it continues to be […]

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