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NEJM—Images in Clinical Medicine

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https://www.readbyqxmd.com/read/28723340/severe-plantar-warts-in-an-immunocompromised-patient
#1
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
#2
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
https://www.readbyqxmd.com/read/28700852/mobile-aortic-thrombi
#3
Ville Sallinen, Pirkka Vikatmaa
An 85-year-old woman with essential thrombocytosis, coronary artery disease, and a remote history of venous thromboembolism presented with abdominal pain, fever, vomiting, and diarrhea. Physical examination revealed tenderness and guarding in the lower abdomen. Laboratory results showed a..
July 13, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28700851/salt-and-pepper-skin-changes
#4
Mariah Giberson, Alain Brassard
A 31-year-old man with an 8-month history of progressive shortness of breath and skin changes presented to the emergency department. Examination of the skin revealed areas of depigmentation with relative sparing of the perifollicular areas and preservation of pigmentation over the veins. A biopsy..
July 13, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28679101/cerebral-cavernous-malformations
#5
Ithamar Ganmore, Anat Achiron
A 59-year-old man presented to an outpatient clinic with a 1-year history of progressively worsening headaches. Neurologic examination was normal; skin examination revealed multiple hyperkeratotic papules and bluish, nodular skin lesions. Magnetic resonance imaging of the brain revealed numerous..
July 6, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28679097/unmasking-ptosis-in-both-eyes
#6
Sunil Kumar, Vijay K Sharma
A 27-year-old woman presented to a tertiary care center with a 1-month history of a drooping left eyelid that worsened in the afternoon. She reported no other neurologic symptoms, such as diplopia, weakness, numbness, fatigability of limbs, or disturbed speech or swallowing. Her pupils were equal,..
July 6, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28657879/achenbach-s-syndrome
#7
Yu Yamamoto, Sayaka Yamamoto
A previously healthy 66-year-old woman presented with sudden-onset pain and bruising in her right middle finger. She had had a similar episode 3 weeks earlier, which had resolved spontaneously within a few days. She did not take any regular medication and reported that she had not had any recent..
June 29, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28657877/eye-injury-from-a-firecracker
#8
Parul C Gupta, Jagat Ram
A 44-year-old man presented to the emergency department with pain and decreased vision in both eyes after an injury sustained while lighting a firecracker. He was unable to perceive light in the right eye and had reduced visual acuity of 20/80 in the left eye. He received a diagnosis of globe..
June 29, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28636863/coronary-artery-vasospasm
#9
Takeshi Kondo, Kazuhiko Terada
A 52-year-old man who had a history of 34 pack-years of smoking presented to our primary care clinic with a 1-month history of episodic chest pain. The episodes occurred once every night while the patient was at rest, lasted for 15 minutes, and resolved without intervention. Sublingual..
June 22, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28636862/perirenal-extramedullary-hematopoiesis
#10
Ying-Nan Cheng, I-Wen Ting
A 69-year-old woman with chronic kidney disease and myelofibrosis presented to the emergency department with a 2-day history of dyspnea and general weakness. The patient had a hemoglobin level of 7.2 g per deciliter (reference range, 11.1 to 15.0), hyperkalemia, and a serum creatinine level of 6.7..
June 22, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28614692/seesaw-nystagmus
#11
K V S Hari Kumar, Pratima Singh
A 52-year-old man presented to the emergency department with a 1-year history of generalized headache, diminished vision, and abnormal eye movements. Examination of the fundus revealed disk pallor. His pupillary reflexes were normal, but there was reduced visual acuity (20/120) in both eyes and..
June 15, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28614685/strongyloides-stercoralis-hyperinfection
#12
Heidi H McDonald, Milton Moore
A 47-year-old man who had lived in Laos and was taking prednisone for dermatomyositis presented with a 4-day history of abdominal pain, fever, melena, and hemoptysis and a 2-week history of rash. One month before presentation, he had been hospitalized and treated with high-dose glucocorticoids for..
June 15, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28591532/mondor-s-disease
#13
Arun A Vijayalakshmi, Shrutiraaj Anand
A 53-year-old man with hypertension and diabetes mellitus presented with a 4-day history of dull, aching pain in his right nipple. He said that he had not had any fever, trauma, or discharge from the nipple. Physical examination revealed a tender subcutaneous cord that began below the right..
June 8, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28591531/large-arachnoid-cyst
#14
Jennifer de Longpre
A 27-year-old man presented to the emergency department after a first seizure. He reported that during the previous 3 years, he had had frequent headaches and falls. Magnetic resonance imaging of the brain revealed an arachnoid cyst, measuring 12.3 cm by 16.5 cm by 7.9 cm, with mass effect on the..
June 8, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28564574/evolution-of-purpura-fulminans
#15
Tamae Kugai, Hidenori Nakagawa
A previously healthy 3-year-old boy presented to a children’s hospital with fever and vomiting. On physical examination, he had small purpura on his legs (Panel A) that spread to his face, abdomen, and limbs during the ensuing 3 hours. Treatment with broad-spectrum antibiotic agents was initiated..
June 1, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28564573/dysphagia-after-occipitocervical-fusion
#16
Jaetaek Hong, Seonghoon Lim
A 64-year-old man presented with difficulty in swallowing immediately after he had undergone an operation to fuse the occiput to the cervical spine to correct atlantoaxial subluxation. Panel A shows a preoperative lateral plain radiograph, and Panel B, a postoperative radiograph. A..
June 1, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28538123/galloping-heart
#17
Binh An P Phan, Philip Chung
A 62-year-old man with a long-standing history of uncontrolled hypertension presented to the emergency department with chest pain. His blood pressure was 168/103 mm Hg. The left ventricular point of maximal impulse (PMI) was visible and prominent at the midclavicular line in the fifth intercostal..
May 25, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28538120/auer-rods
#18
Sarah W Gordon, Geoffrey W Krystal
A 69-year-old man was referred to our medical center for the evaluation and treatment of neutropenia and anemia. The complete blood count showed a white-cell count of 1000 per microliter (reference range, 4800 to 10,800 per microliter), with 10% neutrophils (absolute neutrophil count, 100) and a..
May 25, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28514617/scarlet-fever
#19
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
#20
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
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