September 11th 2025
Merck's CAPVAXIVE could cover approximately 78% of invasive pneumococcal disease cases in youth with chronic health conditions, vs other approved pneumococcal conjugate vaccines.
Cutaneous T-Cell Lymphoma in a 78-Year-Old Woman
September 14th 2005For several weeks, a 78-year-old woman had an intensely pruritic, diffuse, raised, slightly scaly, erythematous rash that persisted despite the use of several over-the-counter topical medications (such as hydrocortisone and clotrimazole cream). Since her last visit about 3 months earlier for a blood pressure reading, she had been well except for 2 episodes of night sweats. For several years, she had been taking levothyroxine and reserpine/hydrochlorothiazide; about 6 months ago, valsartan/hydrochlorothiazide had been prescribed.
Erythema Nodosum Erythema on Forearms and Legs of a 42-Year-Old Man
September 14th 2005A mildly painful, nonpruritic rash on the forearms and legs prompted a 42-year-old man to go to the emergency department (ED). The patient noted the rash when he awoke that morning. He had had joint pain and fever for the past 7 days and generalized malaise with chills that began about 3 days earlier. He had no significant medical history.
Unusual Presentation of Pneumocystis carinii Pneumonia
September 14th 2005A previously healthy 51-year-old man presented with weight loss and poor appetite of 2 months' duration. He was heterosexual and had many sexual partners. Except for a temperature of 38.3°C (100.9°F) and left basal rhonchi, results of physical examination were normal. A chest radiograph and CT scan, as seen here, showed large cavitary lesions in the lower left lobe.
Histoplasmosis-Induced Lung Calcification
September 14th 2005A 40-year-old man, originally an Ohio resident, underwent a chest x-ray study during medical clearance following surgery to repair a hernia. Although the patient had no pulmonary symptoms, the film showed multiple small, punctate calcifications in both lung fields.
Cyclospora cayetanensis and AIDS
A 32-year-old Hispanic woman with AIDS presented with a 1-month history of diarrhea; abdominal bloating and cramps; loss of appetite; and pronounced fatigue, malaise, and weight loss. She had no fever or chills and was not vomiting. Her CD4+ cell count was 12/µL. Results of a routine microscopic examination of stool for ova and parasites were negative; an acid-fast stain of stool demonstrated oocytes of Cyclospora cayetanensis measuring 8.8 mm in diameter (pictured, magnification ×1,000). This is about twice the size of the Cryptosporidium parvum oocyte, which typically is 4 to 5 mm.
Atypical Presentation of Visceral Leishmaniasis
September 14th 2005Fever occurring twice daily, accompanied by profuse sweating, anorexia, and malaise of 15 days' duration resulted in hospitalization of a 31-year-old woman. At this time, her temperature was 37.6°C (99.7°F); blood pressure, 110/70 mm Hg; pulse rate, 90 beats per minute; and respiratory rate, 18 breaths per minute. A palpable spleen was about 3 to 5 cm below the left subcostal margin. Neither lymphadenopathy nor hepatomegaly was noted.
Erythema Nodosum on Thighs and Anterior Tibial Areas of a 36-Year-Old Woman
September 14th 2005An otherwise healthy 36-year-old woman complained of multiple tender, hot, bright red nodules of acute onset on her thighs and anterior tibial areas. Antibiotics had been given for a suspected infection, but the rash persisted.
Secondary Syphilis From Boyfriend
September 14th 2005The widespread eruption of asymptomatic macules and flat, palpable, flesh-colored lesions prompted a 23-year-old woman to consult her physician. The lesions-some of which had dark centers-were concentrated on the patient's face, neck, and upper back; the palms, soles, anal mucosa, and genital areas were clear. The patient denied systemic symptoms. She was seronegative for HIV.
Purpuric Rash After Upper Respiratory Tract Infection
Two 7-year-olds show the purpuric rash of the lower body and legs that is typical of Henoch-Schönlein purpura. This disease is a vasculitis that chiefly affects small vessels of the skin, joints, gastrointestinal tract, and kidney.
Metastatic Squamous Cell Carcinoma
September 14th 2005Shortly after arriving from Puerto Rico, a 59-year-old man presented with right-sided frontal head pain and decreased vision in his right eye. He was concerned about a “sore” that first developed 9 months earlier on his head. The patient denied fever, chills, and syncope.