A 60 year-old man sustained severe facial injury after a car accident. He was conscious at admission and had a laceration on his right fronto-temporal area. On ophthalmologic examination, the right eye was normal with 20/20 vision and only had echymosis on right lower lid. Visual acuity of the left eye was no light perception […]
Read MoreA 26-year-old previously healthy man presented to the emergency department with a 3-day history of fever, dry cough, and nonpruritic rash. A physical examination was notable for crackles on the left side of the chest and a macular, targetoid rash on his hands and feet, including the palms and soles. A radiograph of the chest […]
Read MoreA 52-year-old man presented to the emergency department with painless, bloody tears from both eyes. The bleeding had begun spontaneously approximately 2 hours earlier, had lasted a few minutes, and had recurred just before presentation. He reported no orbital, ocular, or nasal trauma and no history of bloody tears, epistaxis, gingival bleeding, or easy bruising. […]
Read MoreA 17-year-old boy presented to the emergency department with pain and swelling in his jaw 2 hours after an e-cigarette exploded during use. The patient was in a hemodynamically stable condition and had no respiratory distress. He had a circular puncture to the chin, extensive lacerations in his mouth, multiple disrupted lower incisors, and bony […]
Read MoreA 9-year-old girl with a single dysplastic kidney and chronic kidney disease presented to the hospital to undergo transplantation of a kidney from a deceased donor. During preparation of the kidney for transplantation, the donor kidney was found to have five renal arteries. During fetal development, multiple mesonephric arteries supply blood to the kidney. Typically, […]
Read MoreOn April 23, 1986, a 3-year-old girl was brought to our institution after a 1.5-ton truck ran over her left lower limb. She suffered a floating knee injury with fractures at the supracondylar level of the femur and middle third of the tibia. An above the knee and near-total amputation was sustained at the supracondylar […]
Read MoreA 51-year-old right-handed man presented to the clinic with a 3-year history of worsening swelling of the left wrist associated with pain and numbness in the fingers. His medical history included type 2 diabetes and human immunodeficiency virus infection; he was adherent to an antiretroviral therapy regimen and his CD4 cell count was 357 per […]
Read MoreA 19-year-old woman (gravida 0, para 0) presented to the emergency department with severe abdominal pain that had started 9 hours earlier. On examination, the abdomen was soft and nondistended without guarding, but rebound tenderness was present in the suprapubic and left iliac fossa regions. A urine test for beta human chorionic gonadotropin was negative. […]
Read MoreCase Presentation A 38-year-old male, a chronic alcoholic who committed an attempt of suicide, was presented to the emergency department of the University Hospital “St. George”- Plovdiv. On initial presentation, the patient was in a prone position, awake, oriented, and hemodynamically stable (blood pressure 140/90 mmHg and heart rate 92 bpm). The external examination revealed […]
Read MoreA 19-year-old man presented to the dermatology clinic with a 3-month history of an enlarging ulcer on the dorsal aspect of the right hand and multiple tender subcutaneous nodules on the right forearm and elbow. Five months earlier, the patient had traveled to Ecuador, where he had worked at an organic produce farm. On physical […]
Read MorePatient is a 30-year-old male who presented to the ED from the field with extensive facial trauma secondary to a firework blast to the face. His airway was secured immediately upon arrival due to an altered mental status with a GCS of 3 and poor oxygenation. A glidescope intubation with a size 7 tube was […]
Read MoreA 6-year-old female patient with a low socioeconomic status, with an incomplete immunization schedule according to her age (only one dose of pentavalent vaccine and rotavirus had been applied). She began her clinical presentation 11 days prior to hospital admission, after having a sharp slice of wood on her right arm. She went to the […]
Read MoreA 56 years old female presented with history of road traffic accident with resultant avulsion of her left side of face. There was degloving and avulsion of the left hemi-face including the upper lip nose, forehead skin and eyebrow, upper and lower eyelids and the entire left cheek. The zygomatic bone was also avulsed and […]
Read MoreA 32-year-old woman presented to an ophthalmologist with a 2-week history of nodules that moved around her face. She had first noted a nodule below her left eye (Panel A). Five days later, it had moved to above her left eye (Panel B), and 10 days after that to the upper lip (Panel C). She […]
Read MoreCaput medusae is the appearance of distended and engorged superficial epigastric veins, which are seen radiating from the umbilicus across the abdomen. Case report: A 53-year-old man, with history of alcohol consumption of 60 gm/day for 20 years, presented with swelling of the legs, abdominal distension, and a collapsible localized swelling over the abdomen since 3 […]
Read MoreA 26-year-old female presented to our emergency department (ED) with the chief complaint of “sores on arms.” The patient was resting comfortably on the stretcher in a long sleeve jacket. She was a pleasant young woman who explained that she was an intravenous (IV) heroin drug user and that earlier that day, she had tried […]
Read MoreA 13-year-old boy presented to our hospital because of snakebite on his left hand that had occurred six hours before. He was hunting bush rats, and when he put put his hand in a hole, he was bitten. On arrival he presented clinical hemorrhagic syndrome with gingival bleeding and an edema extending to his back […]
Read MoreGiant cell arteritis is a form of vasculitis involving the medium- and large-sized arteries that chiefly affects older people. Clinical findings are headache, jaw claudication, fever, pain, and thickening of the temporal artery. The most feared complication is visual loss due to impairment of the ophthalmic artery and posterior ciliary arteries. GCA occurs predominantly in […]
Read More