A 55 year old woman with a long history of hypertension presented to the hospital with a 1-day history of periorbital discomfort, inferior chemosis, and conjunctival injection of the left eye (Panel A). She reported having a 2-year history of episodic headache and pulsatile tinnitus in the left ear. Examination of the left eye revealed […]
Read MoreFigure 1 A 38-year-old woman’s left thumb was amputated by a boat propeller while she was scuba diving, and it was not retrieved. Panel A shows her left hand three weeks after the accident. Four months after the accident skin from the groin was attached to the thumb stump and web area, and three months later […]
Read MoreA 26 year old woman presented with pain and discoloration in the fingertips of both hands on exposure to cold (Panels A and B) . She had had the same symptoms every winter for the past decade. The patient’s history and physical examination revealed no signs or symptoms suggestive of systemic lupus erythematosus or scleroderma. […]
Read MoreA 42 year old woman presented with nearly complete defects of the left auricular and lateral temporal bone as a result of advanced basal-cell carcinoma. She did not want an adhesive auricular prosthesis and was not a candidate for traditional repair techniques because of trauma and irradiation damage to the postauricular skin. A prelaminated radial […]
Read MoreA 67-year-old man presented with a large right inguinal mass that had progressed in size for 25 years. Eighteen years earlier, he had been hospitalized in a general surgery clinic with an inguinal hernia but declined surgical repair because of concern about the complications associated with the procedure. He returned to the clinic after an […]
Read MoreA 10 year old Kenyan girl presented with abdominal pain that had grown progressively worse over a period of 3 days. Nonprojectile, nonbloody vomiting and abdominal distention had also developed. On examination, she was cachectic, with a distended abdomen and a soft, tender mass at the right iliac fossa that was associated with guarding and […]
Read MoreA 34-year-old female, Gravida 4 Parity 3+0, was seen in the emergency room of a tertiary care hospital, in Karachi, with labor pains. She had all previous uneventful vaginal deliveries with healthy and alive babies. The baby was the fourth outcome of a consanguineous marriage, the couple being maternal first cousins. The parents did not […]
Read MoreVassilios Lougaris, Vincenzo Salpietro, Maricia Cutrupi, Manuela Baronio, Daniele Moratto, M. R. Pizzino, Kshitij Mankad, Silvana Briuglia, Carmelo Salpietro & Alessandro Plebani We report the case of a 15 years old girl with Proteus syndrome and describe novel immunological findings in PS. The index patient, born to non consanguineous parents, was born via caesarian section at 36 weeks of gestation, with normal weight and length (3500 g and […]
Read MoreA 57-year-old man with a 5-year history of intermittent edema of the legs was admitted to the hospital because of varices in the right abdominal and chest walls (Panel A). The varices had been gradually increasing in size and number over a period of 18 years. Abnormal results of laboratory tests included a total bilirubin […]
Read MoreA 37-year-old Chinese woman presented to our department four years and 11 months ago with bilateral lower limb crush injuries sustained in a traffic accident. The lower limb injuries were at different anatomic levels (Figure 1A-C). On the right side, her lower limb was crushed from her hip joint to 16cm below her knee joint, but the […]
Read MoreA 41-year-old woman presented to the ophthalmology clinic with a 2-month history of intermittent pain, blurry vision, and sensitivity to light in her left eye. She wore monthly disposable soft contact lenses that she kept in her eyes while swimming and showering. The patient had difficulty keeping her left eye open during the physical examination, […]
Read MoreA 17-year-old boy presented with a 1-week history of proptosis of the left eye. Physical examination revealed a tumor involving the periorbital region (Panel A). Magnetic resonance imaging revealed an orbital mass (Panel B). Laboratory test results included a hemoglobin level of 89 g per liter, a platelet count of 90,000 per cubic millimeter, and […]
Read MoreIn December 2012, a 35-year-old Berber man, without any past medical history, presented to our Emergency Department with incomplete amputation of his penis after being assaulted by an unknown actor who cut off his penis using a shaving blade 3cm distal from the mons pubis. A physical examination did not show any other remarkable finding. […]
Read MoreThe hand of an infant girl who was born at 24 weeks of gestation and weighed 540 g (1 lb 3 oz) at birth is shown. The infant was found to have jejunal atresia on the sixth day of life and underwent a small-bowel resection with primary anastomosis. She recovered from the surgical procedure, was […]
Read MoreFigure 1 A 30-year-old man with the acquired immunodeficiency syndrome (CD4 cell count, 14 per cubic millimeter) presented with a six-month history of enlarging facial lesions. The lesions had not responded to a six-week course of oral acyclovir (800 mg five times a day). The patient had no history of herpes or any other opportunistic infections. […]
Read MoreFigure 1 A 54-year-old man was struck by lightning and was initially stuporous. The emergency medical team found him conscious and in sinus rhythm, with normal vital signs and numbness and paresthesia of the left shoulder, flank, and leg. On his arrival at the emergency department, he felt well, and an examination revealed a fern-leaf pattern […]
Read MoreFigure 1 A 45-year-old man with autosomal dominant polycystic kidney disease presented to the urology clinic for consideration of bilateral nephrectomy as treatment for severe abdominal pain and distention. Magnetic resonance imaging of the abdomen (Panel A) demonstrated profound enlargement and complete replacement of the liver (top arrow) and kidneys (lower arrows) by cysts. A bilateral […]
Read MoreA 46-year-old farmer presented to the emergency department 3 hours after his penis was bitten by a snake while he was urinating in an open field. The snake was identified by the patient as “gunas,” which is the local name of the Levantine viper (Macrovipera lebetina). Physical examination revealed stable vital signs, with a grossly […]
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