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NEJM—Images in Clinical Medicine

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https://www.readbyqxmd.com/read/28199806/eosinophilic-otitis-media
#1
Hugo Lara-Sánchez, Luis A Vallejo
A 50-year-old man presented with a 6-month history of pain, intermittent otorrhea, and progressive hearing loss in both ears. He had a history of asthma, recurrent sinus disease with nasal polyps, and aspirin sensitivity. Otoendoscopy revealed polypoid masses in the external canals of both ears...
February 16, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28199804/gas-in-the-left-atrium-and-ventricle
#2
Mary Thomson, Fredy El Sakr
A 60-year-old man with coronary artery disease, ischemic cardiomyopathy with biventricular implantable cardioverter–defibrillator placement, and atrial fibrillation presented with chest pain and numbness in both arms. During his initial presentation, he suddenly collapsed and became unresponsive...
February 16, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28177872/persistent-pupillary-membrane
#3
Varada Gokhale, Sumita Agarkar
A 15-year-old boy presented with decreased vision in both eyes. His best corrected visual acuity, as determined with the use of the Snellen chart, was 20/20 in the right eye and 20/60 in the left eye, with anisometropic amblyopia in the left eye. A routine slit-lamp examination showed evidence of..
February 9, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28177861/disseminated-blastomycosis
#4
Anjum S Kaka, George A Sarosi
A 39-year-old man presented with acute hemoptysis and chills. Computed tomography (CT) of his chest showed an infiltrate in the right upper lobe (Panel A), and he was treated with levofloxacin. One month after this presentation, his 5-year-old son pulled on his left ring finger, which caused pain..
February 9, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28146660/calcific-pancreatitis-associated-with-alcohol-use
#5
Yub-Raj Sedhai, Dhruvan Patel
A 50-year-old man presented to the emergency department with sudden onset of hematemesis. He reported a 2-month history of epigastric pain and foul-smelling diarrhea. He had been drinking half a pint of vodka a day for 15 years. Physical examination revealed epigastric tenderness. Results of..
2, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28146657/actinic-granuloma
#6
Dong-Lai Ma, Sergio Vano-Galvan
A 50-year-old woman presented with an 18-month history of asymptomatic skin lesions on her forehead (Panel A) and the dorsum of her hands (Panels B and C). The lesions were well demarcated, erythematous, coalescing annular plaques with raised borders and slightly atrophic centers. Over time, the..
February 2, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28121510/radiation-induced-angiosarcoma-after-breast-cancer-treatment
#7
Jennifer K Plichta, Kevin Hughes
A 72-year-old woman presented with skin changes on her left breast; 5 years earlier, she had undergone lumpectomy and radiation therapy for breast cancer. Physical examination revealed an area of skin 10 cm in diameter, medial to the areola, that had an ecchymotic appearance (Panel A). The area..
January 26, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28121503/taenia-solium
#8
Cyriac A Philips, Amrish Sahney
A 48-year-old man presented with a 2-month history of abdominal discomfort and lethargy. Physical examination revealed pallor, and results from laboratory studies showed mild anemia (hemoglobin level, 9.2 g per deciliter [normal, 12 to 15 g per deciliter]). Colonoscopy revealed a proglottid from a..
January 26, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28099828/swirl-sign-intestinal-volvulus-after-roux-en-y-gastric-bypass
#9
Joseph Fernandez-Moure, Vadim Sherman
A 56-year-old man presented after a day and a half of midabdominal pain, nausea, and bilious emesis. The patient had undergone Roux-en-Y gastric bypass 7 years earlier. During the physical examination, tachycardia and tachypnea were noted. The abdominal examination showed a distended, tympanic..
January 19, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28099826/serrated-marine-nose
#10
Christoph Schlapbach, Parham Sendi
A 37-year-old woman who was receiving adalimumab for ankylosing spondylitis presented with a 6-week history of swelling and ulcerations with a hemorrhagic crust over her nose (Panels A and B). Serratia liquefaciens grew in biopsy samples obtained from the ulcers. A 3-week course of ciprofloxacin..
January 19, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28076713/fibromuscular-dysplasia-of-the-brachial-artery
#11
Mistyann-Blue Miller, Demetrio R Flores
A 68-year-old woman presented with exertional dyspnea and chest pain, symptoms that suggested unstable angina. She had undergone coronary-artery bypass grafting 5 years earlier. Vascular examination revealed palpable radial pulses on both sides of the body. The results of Allen’s test, conducted..
12, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28076706/circinate-balanitis
#12
Ana Pulido-Perez, Ricardo Suarez-Fernandez
A 37-year-old man presented to the emergency department with a 7-day history of genital lesions. He also had weight loss (approximately 4 kg), fatigue, and back pain but no gastrointestinal symptoms. Two months before presentation, he had had dysuria and urethral discharge, both of which resolved..
January 12, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28052229/gastric-cancer-in-chest-radiograph
#13
Jorge L Polo, Juan C Porres
A 90-year-old man presented with a 1-month history of progressive edema in both legs and several episodes of malaise and dizziness that were associated with hypoglycemia. On examination, a nontender epigastric mass was palpated. A plain radiograph of the chest showed a round, irregular opacity..
January 5, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28052220/acromioclavicular-joint-separation
#14
M Enes Kayaalp, Ali Seker
A 30-year-old man visited the emergency department after a fall that had resulted from a loss of balance while he was walking that day. The patient recalled that he had sustained the impact of the fall on his left shoulder. On examination, his vital signs were normal, but a palpable posterior..
January 5, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28029928/infected-urachal-cyst
#15
Nicholas Potisek, James Weihe
A 19-month-old girl with a history of myelomeningocele and Chiari malformation type II presented with abdominal pain. The initial abdominal examination was normal; however, within 24 hours, the umbilicus became protuberant and erythematous (Panel A). The white-cell count was elevated, with a large..
29, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/28029917/disseminated-cysticercosis
#16
Qiang Meng, Lingchun Liu
A 23-year-old woman presented with a 1-month history of headache, vomiting, recurrent episodes of syncope, weight gain, and leg pain. A physical examination revealed several subcutaneous nodules on the patient’s face and trunk. Exophthalmos, fundal hemorrhage, neck rigidity, and a hypertrophic..
December 29, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/28002703/uterine-rupture-with-protruded-legs-in-a-large-amniocele
#17
Pierre-Emmanuel Bouet, Charlyne Herondelle
A 33-year-old asymptomatic woman (gravida 6, para 5) presented at 22 weeks of gestation with a large herniation of the amniotic sac through the left uterine wall that was detected by routine ultrasonography. She had had five previous cesarean sections through a transverse incision of the lower..
December 22, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/28002702/acute-rheumatic-fever-with-erythema-marginatum
#18
Makoto Saito, Shuji Hatakeyama
A previously healthy 36-year-old man presented with a 1-month history of fever and pain in both shoulders and knees, which had been preceded by a sore throat 2 weeks before the onset of fever. Laboratory studies were notable for a white-cell count of 13,800 per cubic millimeter (85% neutrophils), a..
December 22, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27974038/african-trypanosomiasis
#19
Judy A Streit, Eiyu Matsumoto
A previously healthy 60-year-old woman presented with a 2-to-3-day history of fevers, chills, myalgias, headache, and two pruritic areas on her back. She had returned 3 days earlier from a 2-week trip to Botswana and Zimbabwe that had included canoeing and camping. She had received vaccines before..
December 15, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27974033/patellar-fracture-with-sleeve-avulsion
#20
Rachel A Lindor, James Homme
A 9-year-old girl presented with knee pain and inability to extend her leg after landing on her flexed right knee while jumping on a trampoline. Physical examination revealed superior displacement of the patella (Panel A), and a radiograph showed a fracture of the patella at the inferior pole..
December 15, 2016: New England Journal of Medicine
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