Imaging in Intensive Care Medicine Published: 19 January 2026 Portal venous gas on point-of-care ultrasound van Gastel, L., de Kok, L. Intensive Care Med(2026). https://doi.org/10.1007/s00134-025-08232-1 Abdominal computed tomography (CT) confirmed the presence of portal venous gas and pneumatosis intestinalis in the ileum and ascending colon, with patent mesenteric arteries (Fig. 1, panel A, B and C respectively). Non-occlusive mesenteric ischem...

Imaging in Intensive Care Medicine Ghost cells in Clostridium perfringens liver abscess with massive hemolysis Yoshihiro Nagai, Seiya Nishiyama, Tadashi Kamio, et al Intensive Care Med 2025 https://doi.org/10.1007/s00134-025-08227-y Clostridium perfringens produces phospholipase C, the systemic dissemination of which can lead to severe intravascular hemolysis. Erythrocytes whose cell membranes are lysed lose hemoglobin, and the resulting small, me...

Acute respiratory failure unmasking an unexpected disease Loïc Velten, Anaïs Curtiaud, Antoine Studer, et al Intensive Care Med (2025). https://doi.org/10.1007/s00134-025-08093-8 Relapsing polychondritis (RP) is a rare, immune-mediated disease characterized by recurrent inflammation of cartilaginous structures, including the auricles, nasal cartilage, peripheral joints, and respiratory tract (Fig. 1). It affects both men and women, typically presenting around...

CLINICAL DECISIONS Simplify or Stratify? The Debate over Medical School Grading Systems Harleen Marwah, Abhinav Suri, Clarence H. Braddock III, et al N Engl J Med 2025;393:2268-2270 CASE VIGNETTE A Medical School Evaluating the Grading System Harleen Marwah, M.D. You have recently been named the dean in charge of preclinical curriculum for your medical school. There is debate among the faculty and students in your school regarding the approach to grad...

IMAGES IN CLINICAL MEDICINE Complete Heart Block Detected by Consumer-Facing Digital Health Technologies James E. Ip N Engl J Med 2025;393:2254 DOI: 10.1056/NEJMicm2510111 A 70-year-old man with hypertension and coronary artery disease presented to the emergency department with a several-hour history of shortness of breath and a slow heart rate. On the day of presentation, his commercial mattress — which included a ballistocardiographic monitoring featu...

Imaging in Intensive Care Medicine Serum sickness: a mimic of septic shock Takafumi Todaka Intensive Care Med Published: 17 September 2025 https://doi.org/10.1007/s00134-025-08118-2 Serum sickness typically manifests 7–14 days after exposure to heterologous proteins, such as antivenoms, some vaccines, and immune-modulating agents (e.g., rituximab and infliximab). Most cases resolve with withdrawal of the offending agent; however, severe systemic involve...

JAMA Insights  How to Communicate Medical Numbers Brian J. Zikmund-Fisher, Alistair Thorpe, Angela Fagerlin JAMA 2025;334;(16):1474-1475 doi:10.1001/jama.2025.13655 Health care professionals often use numbers to guide decisions, monitor patient health, and communicate information. Although nonnumeric conversations may be recommended for some situations (eg, many cancer screening decisions),1 providing numerical information...

JAMA Insights  Recurrent Clostridioides difficile Infections Joffrey van Prehn, Ed J. Kuijper, Erik R. Dubberke JAMA Published Online: October 20, 2025 doi: 10.1001/jama.2025.18089 Clostridioides difficile is a gram-positive spore-forming anaerobic bacterium that can produce toxins. After ingestion of C difficile spores, which can be found in health care institutions and homes of healthy people, the intestines can bec...

IMAGES IN CLINICAL MEDICINE Uremic Frost Muzamil Ahmad Wani, Zeeza Hussain Shah N Engl J Med 2025;393:1327 DOI: 10.1056/NEJMicm2507714 A 52-year-old woman with hypertension presented to the hospital with a 1-month history of fatigue, as well as 6 days of vomiting and 1 day of confusion. Over the past 20 years, she had not received regular treatment for hypertension. Physical examination was notable for pallor of the conjunctiva and o...

Imaging in Intensive Care Medicine Hypervirulent Klebsiella pneumoniae: watch the eyes Yan Wang, He Zhou, Meiling Ding, et al Intensive Care Med (2025). https://doi.org/10.1007/s00134-025-08109-3 Imaging studies (Fig. 1, Panels A–E) revealed a solitary lung abscess, a large hepatic abscess, and endophthalmitis characterized by flocculent vitreous opacities. Liver puncture drainage was performed. Microbiological cultures (Panel F) from blood, liver aspi...