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NEJM—Images in Clinical Medicine

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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
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
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
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
Luke Mountjoy, Daniel Kollmorgen
A 65-year-old man with type 2 diabetes and deterioration of glycemic control presented with a 2-to-3-month history of weight loss (7 to 8 kg), early satiety, and mild flank pain. Before the occurrence of these symptoms, a rash had developed over the course of 3 to 4 weeks. The rash involved the..
March 9, 2017: New England Journal of Medicine
Michael A Cardis, Helena B Pasieka
A 27-year-old woman with a history of genital herpes presented to the emergency department with painful, burning lesions on her left arm. On physical examination, grouped, coalescing pustules that had scalloped borders on an erythematous base and that were tender to palpation were seen on the left..
March 9, 2017: New England Journal of Medicine
Mehdi Afshar, Mosaad Alhussein
A 67-year-old man presented to the emergency department with neck swelling, dysphagia, and hoarseness that had started several hours after coronary angiography was performed. He had previously undergone heart transplantation owing to idiopathic dilated cardiomyopathy complicated by chronic kidney..
March 2, 2017: New England Journal of Medicine
Vladimir Ivashkin, Maria Zharkova
An 18-year-old woman presented with persistently elevated aminotransferase levels after varicella infection. She was taking no medications and did not drink alcohol. Physical examination revealed a low body-mass index (the weight in kilograms divided by the square of the height in meters) of 18, a..
March 2, 2017: New England Journal of Medicine
Chisato Akita, Yutaka Saikawa
A previously healthy 5-year-old boy presented with a 4-day history of nausea, vomiting, and intermittent abdominal pain. Physical findings were unremarkable except for mild periorbital edema. Laboratory studies revealed hypoproteinemia with an albumin level of 2.0 g per deciliter (normal range in..
February 23, 2017: New England Journal of Medicine
Ronaldo A Gismondi, Luiz F F de Souza
A 40-year-old man presented with a 3-month history of fever, weight loss, dyspnea, and cough. Physical examination revealed a tender, bulging anterior thoracic mass and a small ulcerative lesion that was inferomedial to the right nipple (Panel A). Computed tomographic scans showed a pleural..
February 23, 2017: New England Journal of Medicine
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
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
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
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
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..
February 2, 2017: New England Journal of Medicine
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
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
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
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
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
2017-01-20 05:30:18
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