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NEJM—Images in Clinical Medicine

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https://www.readbyqxmd.com/read/28514617/scarlet-fever
#1
Alyson Brinker
A 20-year-old man presented to his primary care physician with a 3-day history of swollen tonsils, sore throat, fevers, chills, and rash. The nonpruritic rash had started on his abdomen, spread to his chest and back, and then appeared on his arms, legs, and face. He had no known allergies or..
May 18, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28514607/tuberous-sclerosis-complex
#2
Michele Marchini, Elisabetta Giglio
A 71-year-old man presented to the nephrology department for the evaluation of chronic kidney disease, which had developed during the past 20 years. The patient had received a diagnosis of tuberous sclerosis complex, or Bourneville’s disease, in his late 20s. The physical examination revealed..
May 18, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28490004/melanoma-of-the-foot
#3
Hui-Zi Gong, Jun Li
An 80-year-old man presented with a lesion on the left sole that had been increasing in size during the past 2 years. The lesion had become increasingly ulcerated, with intermittent bleeding. The physical examination revealed a well-defined, fleshy, reddish plaque measuring 2 cm in diameter with..
May 11, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28490003/binaural-tympanic-membrane-perforations-after-blast-injury
#4
Jeroen B van Rijswijk, Patrick Dubach
A 30-year-old man presented to the emergency department with new-onset hearing loss and tinnitus in both ears after a blast injury. While at a wedding that included celebratory fireworks, he had been standing near a sand-filled mortar when it accidentally ignited. Otoscopy revealed multiple..
May 11, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28467882/fluorescein-guidance-in-glioblastoma-resection
#5
David W Roberts, Jonathan Olson
A 55-year-old man presented to the emergency department with a 1-week history of severe headache. Magnetic resonance imaging of the brain with and without gadolinium-based contrast agent revealed a rim-enhancing mass (4.5 cm in diameter) in the right temporal lobe. At the time of surgery for tumor..
May 4, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28467872/traumatic-spondylolisthesis-of-the-axis
#6
Anis Khelifi, Faycel Saadaoui
A 25-year-old man presented to the emergency department with severe neck pain after he was involved in a high-speed collision between two vehicles. He had full strength in his arms and legs, normal sensation to light touch and pinprick, and no sphincter disorders. A lateral radiograph (Panel A)..
May 4, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28445673/extramammary-paget-s-disease
#7
Sarah H Mehrtens, Sriramulu Tharakaram
An 89-year-old man presented with a 1-year history of a nonhealing groin rash. The rash was not painful or pruritic. He had previously been treated empirically with oral and topical antibiotics, topical antifungal agents, and topical glucocorticoids without improvement. The physical examination..
April 27, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28445671/pyogenic-granuloma-of-the-conjunctiva
#8
Irene J Tan, Angus W Turner
A 30-year-old man presented with a pedunculated lesion on his right lower eyelid that had grown over a period of 3 days. Two weeks before presentation, a cyst had ruptured on the same eyelid. The new lesion started as a small lump on the bulbar conjunctiva and progressively increased in size until..
April 27, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28423304/candida-esophagitis
#9
Takeshi Kondo, Kazuhiko Terada
A 72-year-old man presented with a 2-week history of odynophagia (pain on swallowing). Sixteen months before the onset of this symptom, the patient had received a diagnosis of diffuse panbronchiolitis, and he had been receiving long-term treatment with macrolide antibiotics since then. He had not..
April 20, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28423297/osteopetrosis
#10
Udayshankar Yaga, Prashanth Panta
A 6-year-old girl was brought to the dentist by her parents, who reported that she had only a single tooth. Her medical history revealed that she was the child of consanguineous parents. She had partially impaired hearing and had lost her vision at 2 years of age. In addition, she had strabismus,..
April 20, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28402768/primary-hyperoxaluria
#11
Dapeng Jiang, Hongquan Geng
A 3-year-old boy presented to the pediatric urology clinic with a 6-month history of gross hematuria and intermittent abdominal pain. Urinalysis revealed red cells, white cells, and 3+ protein. The serum creatinine level was 0.9 mg per deciliter (80 μmol per liter; normal range in 3-year-old..
April 13, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28402761/dyskeratosis-congenita
#12
Daniel A Kelmenson, Michael Hanley
A 52-year-old man presented to the pulmonary clinic with a 2-month history of cough and dyspnea on exertion. He had a history of pancytopenia, although previous evaluation, including bone marrow biopsy, had not resulted in any diagnosis of the cause. His brother had died after undergoing bone..
April 13, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28379799/regression-of-coronary-atherosclerosis-with-medical-therapy
#13
Abhishek Keraliya, Ron Blankstein
A 42-year-old man with hyperlipidemia and a family history of coronary artery disease presented with a 4-month history of intermittent exertional chest pain. Myocardial perfusion imaging performed during exercise showed moderate ischemia in the distribution of the left circumflex coronary artery..
April 6, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28379795/gartner-s-duct-cyst
#14
Jacob P Hoogendam, Marieke Smink
A 29-year-old woman presented to an outpatient gynecology clinic 4 months after an uncomplicated vaginal delivery with a mass protruding from the vaginal canal. She reported no urinary tract symptoms or abnormal vaginal discharge. A physical examination revealed a smooth, nontender mass, 5 cm in..
April 6, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28355516/kaposi-s-sarcoma-of-the-oral-cavity
#15
Elizabeth Kennedy-LeJeune, Vince D Cataldo
A 33-year-old man presented to the emergency department with fatigue and with lesions in the oral cavity and on the skin. Physical examination revealed multiple, firm, nontender, violaceous plaques of the palate and gums. He had similar lesions on his face, chest wall, and legs. Laboratory studies..
March 30, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28355510/tumbu-fly-larvae
#16
John J Park, Jonathan Costello
A 46-year-old woman presented to the emergency department with a 10-day history of pain and swelling in her right arm. She had recently returned to the United Kingdom from the Ivory Coast. Examination revealed distinct areas of ulceration with surrounding erythema distal to her right elbow...
March 30, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28328345/incidental-finding-of-oleothorax
#17
Abhilash Koratala, Vikrampal Bhatti
An 86-year-old woman with hypertension who had been treated for pulmonary tuberculosis in the 1950s presented with burning chest and epigastric pain. She had no respiratory symptoms. After acute coronary syndrome was ruled out, she was treated for gastroesophageal reflux, which relieved her..
March 23, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28328332/fournier-s-gangrene
#18
Chih-Sheng Huang
A 46-year-old man with uncontrolled type 2 diabetes and alcoholic liver disease presented to the emergency department with painful swelling in the scrotum and perianal region. His temperature was 37.7°C, his pulse 130 beats per minute, and his blood pressure 97/61 mm Hg. The physical examination..
March 23, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28296615/protruding-iris-collarette
#19
Saiqun Li, Lingyi Liang
A 37-year-old woman presented to an ophthalmologist with itching and watering of her eyes. Examination revealed conjunctival papillary reaction and mild hyperemia, findings that were consistent with allergic conjunctivitis. Her visual acuity was 20/20 in both eyes. The intraocular pressure was..
March 16, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28296609/plasmacytomas-and-plasma-cell-leukemia
#20
Uqba Khan, Tarik Hadid
A 63-year-old man with IgG lambda multiple myeloma presented with progressive weakness and fatigue. He had received the diagnosis of IgG lambda multiple myeloma 4 years earlier and had been treated with several regimens. Physical examination revealed multiple exophytic subcutaneous lesions..
March 16, 2017: New England Journal of Medicine
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