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NEJM—Images in Clinical Medicine

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https://www.readbyqxmd.com/read/28930513/intraocular-infection-with-a-trematode
#1
Pablo J Guzman-Salas, Juan C Serna-Ojeda
A 17-year-old boy from a rural town in Mexico presented to the hospital with a 3-week history of decreased visual acuity and pain in the right eye. He could see only hand motions. Intraocular pressure in the right eye was elevated at 30 mm Hg (reference range, 10 to 21 mm Hg). Slit-lamp examination..
September 21, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28930502/squamous-cell-carcinoma-of-the-mouth
#2
Tanay V Chaubal, Renjeet A Bapat
A 54-year-old woman presented to a dental clinic with a 1-year history of oral swelling and a sore mouth. She had regularly chewed loose-leaf tobacco, which she had placed on the floor of her mouth between the jaw and tongue, up to five times each day for more than 10 years. Intraoral examination..
September 21, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28902597/iridodonesis
#3
Dhaval Desai, A Jamil Tajik
A 65-year-old woman presented to a clinic to be evaluated for Marfan’s syndrome after her identical twin received a diagnosis of the disorder. Physical examination revealed iridodonesis, or "dancing" of the iris, which was elicited by rapid movement of the eye (see video). A 3/6 holodiastolic..
September 14, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28902582/marfan-s-syndrome-with-ectopia-lentis
#4
Jayanth Sridhar, Jonathan S Chang
A 41-year-old man presented with progressive loss of vision in both eyes that was worse in the right eye than in the left. There was no history of trauma. His uncorrected visual acuity was 6/200 in the right eye and 20/100 in the left eye. Slit-lamp examination revealed ectopia lentis in both eyes,..
September 14, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28877028/left-ventricular-free-wall-rupture
#5
Enrico Cerrato, Ferdinando Varbella
A 67-year-old man presented to the emergency department 12 hours after the onset of chest discomfort. An electrocardiogram showed ST-segment elevation in the inferior leads (II, III, and aVF). The patient was immediately transferred to the cardiac catheterization laboratory, where he had a cardiac..
September 7, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28877017/neobladder-stone
#6
Sabine Nguyen, Chester Choi
A 64-year-old man presented to the emergency department with a 3-day history of pain in the left flank and urinary retention. He had undergone radical cystectomy and orthotopic neobladder construction with intestinal segments more than a decade earlier because of invasive bladder cancer. Physical..
September 7, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28854093/sturge-weber-syndrome
#7
Shivang Desai, Charles Glasier
A 6-year-old girl was brought to the emergency department after the sudden onset of weakness in the left arm and leg. She also reported a 2-day history of pain in her right eye. No seizure activity had been witnessed. She had a nonpalpable red lesion on the right side of her face, and the..
August 31, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28854083/eosinophilic-bronchitis
#8
Yanhong Ren, Huaping Dai
A 43-year-old woman presented with an 8-month history of progressively worsening nonproductive cough. She had been treated with antibiotic agents for presumed bronchitis, but her cough continued to worsen. Her vital signs were normal, the pulmonary examination was notable for wheezing in both..
August 31, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28834489/venous-congestion-in-ischemic-bowel
#9
Wei-Lin Wang
A 57-year-old man with cirrhosis presented to the emergency department with acute abdominal pain that had been present for 1 day. On physical examination, his abdomen was tender to palpation over the epigastrium and lower abdomen, with rebound tenderness and guarding. Laboratory studies revealed a..
August 24, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28834481/sweet-s-syndrome-in-a-patient-with-rheumatoid-arthritis
#10
Zheng-Hao Huang, Hsiang-Cheng Chen
A 52-year-old woman with rheumatoid arthritis presented with a 1-month history of multiple painful, erythematous plaques on her palms and the fingers. One and a half years earlier, she had been treated with etanercept for 6 months. At the time of this presentation, her maintenance medications for..
August 24, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28813228/acute-ocular-graft-versus-host-disease
#11
Regine Braun, Ernst Holler
A 21-year-old man with refractory acute myeloid leukemia presented with itching and tearing in both eyes 1 month after receiving a hematopoietic stem-cell transplant from an HLA-mismatched, unrelated donor. Three weeks after transplantation, he received a diagnosis of grade 4 acute..
August 17, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28813215/eczema-herpeticum
#12
Giuseppe Micali, Francesco Lacarrubba
An 8-year-old girl with atopic dermatitis presented with a 3-day history of a diffuse eruption of pruritic, umbilicated, erythematous vesicles with erosion and crusting on the flexor surfaces of the legs (Panel A) and arms. Her parents reported that eczematous lesions had previously occurred in..
August 17, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28792883/left-middle-lobe-pneumonia
#13
Ling Yuan Kong, Yves Longtin
A 34-year-old man presented to the emergency department with a 5-day history of fever, cough, and dyspnea. He had received a diagnosis of situs inversus when he was 2 years of age, after a chest radiograph had been obtained in order to evaluate a cough. Physical examination was notable for heart..
August 10, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28792866/insulin-mediated-lipohypertrophy
#14
Rajanshu Verma
A 76-year-old man with hypertension, chronic kidney disease, and a 15-year history of type 2 diabetes mellitus was admitted to the hospital with pneumonia. Two painless, rubbery, hyperpigmented masses were noted near the umbilical area. The patient reported that for the preceding 10 years he had..
August 10, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28767354/xanthomas-in-familial-hypercholesterolemia
#15
Amitabh Poonia, Priya Giridhara
A 13-year-old boy presented to a primary care clinic with skin lesions on his buttocks, elbow, and knees (Panels A, B, and C). The lesions were initially noted when he was 5 years of age, but no medical care was sought until similar lesions were apparent in his younger brother several years later..
August 3, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28767353/crusted-scabies
#16
Marta Elosua-González, Elena García-Zamora
A 71-year-old man with cirrhosis presented to the emergency department with severe diffuse pruritus. Three months earlier, he had presented with erythematous and scaly skin on the scalp and hands. Two skin scrapings had not revealed mites, and he was treated with oral and topical glucocorticoids...
August 3, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28745996/nystagmus-from-wernicke-s-encephalopathy
#17
Pria Anand, Daniel R Gold
A 28-year-old woman presented to the emergency department with vertigo, confusion, and falls 2 weeks after a surgical abortion at 11 weeks of gestation. Her pregnancy had been complicated by persistent hyperemesis gravidarum. An examination revealed spontaneous upbeat nystagmus (Video 1),..
July 27, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28745992/cholelithiasis
#18
Yang-Yuan Chen, Cheng-Che Chen
A 60-year-old man with cirrhosis and a remote history of colon cancer, for which he had undergone a hemicolectomy, presented to the emergency department with a fever. He reported no diarrhea, vomiting, or abdominal pain. His temperature was 38.5°C. There was no tenderness to palpation across his..
July 27, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28723340/severe-plantar-warts-in-an-immunocompromised-patient
#19
Gehaan F D'Souza, James E Zins
A 25-year-old woman who had undergone orthotopic heart transplantation presented to a plastic surgery clinic with a 4-year history of extensive warts on both feet (Panel A). The lesions had first developed 7 years after the cardiac transplantation and resulted in considerable pain, swelling, and..
July 20, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28723339/bronchoscopic-removal-of-an-obstructing-broncholith
#20
Kathryn Williams, Karen Swanson
A 68-year-old woman presented to the emergency department with a 3-day history of worsening shortness of breath, wheezing, dry cough, fevers, and chills. Her oxygen saturation was 96% while she was breathing ambient air. Pulmonary examination revealed crackles in the left lower lobe. Computed..
July 20, 2017: New England Journal of Medicine
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