Hantavirus Pulmonary Syndrome

Imaging Gross Pathology Micro Pathology Treatment A 25-year-old male woodcutter, residing in S. Korea, is admitted to the ER in a state of shock and massive epistaxis. The patient had been complaining of fever, malaise, headache, myalgias, back pain, abdominal pain, nausea, and vomiting for the past week he also complained of extremely reduced urine output. Careful history revealed that before he fell ill, he and his friend were cutting wood in the forest when they accidentally disturbed a...

Pelvic Inflammatory Disease

Imaging Gross Pathology Micro Pathology Treatment A 30-year-old woman presents to the ER with an abrupt-onset high fever, vomiting, profuse diarrhea, severe muscle aches, and disorientation. One day ago she developed an extensive skin rash all over her body. Her husband says she used a vaginal sponge for VS fever tachycardia hypotension. PE extremely toxic-looking drowsy but responding to verbal commands extensive scarlatiniform rash seen involving entire body pharyngeal, conjunctival, and...

St Louis Encephalitis

ID CC The case of a 12-year-old boy who died of a progressive degenerative neurologic disease was discusscd at an autopsy meeting. HPI The child had been developing normally up to 10 years of age, when his teachers noted a progressive deterioration in intellect and personality this was followed by the development of seizures akin to myoclonus, signs of pyramidal and extrapyramidal disease, and finally a state of decerebrate rigidity. The child died seven months after the onset of symptoms. His...

Pinworm Infection

ID CC -A- 30-year-old hospitalized male presents with profuse watery diarrhea with mucus, crampy periumbilical abdominal pain, nausea, and vomiting. HPI He has been receiving oral ampicillin for five days for a lower respiratory tract infection. PE VS fever tachycardia. PE dehydration abdominal distention diffuse rebound tenderness reduced bowel sounds. Labs CBC leukocytosis (15.000 uL) with predominantly polymorphonuclear leukocytosis. Fecal staining reveals few RBCs and leukocytes (< 10...

Acute Prostatitis

ID CC A 65-year-old male complains of recurrent burning, urgency, and frequency of micturition together with vague lower abdominal, lumbar, and perineal pain. HPI He also complains of a mucoid urethral discharge. He was previously diagnosed via ultrasound with benign prostatic hypertrophy but does not report any severe symptoms of prostatism his medical history reveals frequent UTIs due to E. coli. VS stable no fever. PE rectal exam reveals enlarged, nodular prostate biopsy obtained to rule out...

Scabies

Imaging Gross Pathology Micro Pathology Treatment A 15'day-old infant is brought by his mother to the pediatric emergency room in a state of marked muscle rigidity and spasm. The mother is illiterate and did not receive any prenatal care the delivery was conducted at home and, according to her, was uneventful and full term. The child did not receive any immunizations directed questioning reveals that he has been crying excessively for the past two weeks and has not been feeding normally....

Severe Combined Immunodeficiency Syndrome Scid

Imaging Gross Pathology Micro Pathology Treatment A 10-year-old male complains of generalized weakness, faintness on exertion, and occasional epigastric pain His mother has noticed that he often eats soil and other inedible things ( PICA). Pallor puffy face and dependent edema. CBC microcytic, hypochromic anemia eosinophilia. Low serum iron and ferritin elevated scrum transferrin reduced bone marrow hemosiderin hypoproteinemia stool exam revealed eggs of Ancylostoma duodenaU (ovoid eggs with...

Parvovirus B1 9 Aplastic Crisis

A 34-year-old male presents to his primary care physician with a hard, red, painless swelling on his left mandible that has slowly been growing over the past few weeks and has now begun to drain pus. The patient recently had a tooth extraction. No acute distress no other significant findings. Gram stain of exudate reveals branching gram-positive filaments and characteristic sulfur granules non-acid-fast and anaerobic (distinguishes actinomyces from Nocardid). Sinus tracts from region of...

Proctocolitis

Imaging Gross Pathology Micro Pathology A 35-year-old male presents with high fever, inalaise, headache, and a hacking cough productive of a small amount of mucoid sputum. He has two pet parrots at home who have recently shown signs of illness. VS fever bradycardia. PF. auscultation of chest reveals crepitant rales over both lower lung fields splenomegaly with mild hepatomegaly noted multiple purpuric macules seen over abdomen ( HORDER's SPOTS). Greater than fourfold rise in complement-fixing...

Herpangina

Labs Imaging Gross Pathology Micro Pathology A 60-year-old male presents with swelling and a vesicular skin eruption on the left side of his face. The patient reports that before the rash developed, he had severe radiating pain on the left side of his face. He also recalls having suffered an attack of chickenpox during his childhood. Unilateral vesicular rash accompanied in places by suppuration, bleeding, and small pitted scars over left forehead, nasal bridge, including tip (indicating...

Chronic Prostatitis

A 28-year-old man comes to the ER with gradually worsening and now severe scrotal swelling and pain radiating to the inguinal area. The patient has no significant medical history. He reports pain on urination due to concomitant urethritis and notes that he is sexually active with multiple partners. He also notes that the pain is greater on standing and walking and is relieved by rest and elevation of the legs. VS normal. PE scrotal edema and erythema right epididymis enlarged and tender...

Otitis Externa

Imaging Gross Pathology Micro Pathology Treatment A 9-year-old male is admitted for an evaluation of a suspected underlying immune deficiency. He has been hospitalized and treated several times for recurrent life-threatening septicemia due to S. pneumoniae, meningococcus, and H. influenzae. Careful history reveals that a few years ago he underwent an emergency splenectomy following traumatic splcnic rupture in a motor vehicle accident. Left paramedian postsurgical scar seen on abdomen. Reduced...