IMAGES IN CLINICAL MEDICINE Cerebral Cystic Echinococcosis Sumit Thakar, Akhil Sunil N Engl J Med 2023; 388:e10DOI: 10.1056/NEJMicm2208104 A previously healthy 14-year-old boy who lived on a farm presented with a 1-month history of episodic headaches associated with vomiting. Physical examination was notable for papilledema. Magnetic resonance imaging of the head showed a multiloculated cyst measuring 6.0 cm by 6.2 cm by 5.8 cm in the right temporoparietal...

IMAGES IN CLINICAL MEDICINE Cerebral Alveolar Echinococcosis Hu Ju, Chuanchuan Liu N Engl J Med 2023; 388:453DOI: 10.1056/NEJMicm2202196 A 17-year-old boy presented to the emergency department with a 3-week history of dizziness, headache, and weakness of the right leg. Neurologic examination was notable for 4/5 strength in the right lower leg. Computed tomography (CT) of the head revealed ring-enhancing lesions in the frontal lobe and basal ganglia on the ...

IMAGES IN CLINICAL MEDICINE Splenic Tuberculosis Chung-Yen Chen, Po-Jen Yang N Engl J Med January 21, 2023DOI: 10.1056/NEJMicm2206174 A 29-year-old man with human immunodeficiency virus (HIV) infection presented to the emergency department with a 2-week history of abdominal pain on the left side. Six months before presentation, he had received a diagnosis of HIV infection and non–drug-resistant pulmonary tuberculosis, for which antiretroviral and four-drug...

IMAGES IN CLINICAL MEDICINE Mercury Poisoning Yunying Feng, Fengdan Wan A previously healthy 25-year-old man presented to the general medicine clinic with a 3-month history of worsening fatigue, nausea, and dry cough. One week before the onset of his symptoms, he had injected 4 ml of elemental mercury intravenously as a folk remedy for tinea cruris. Conjunctival pallor was observed on physical examination. Laboratory studies showed a hemoglobin level of 6.5 g...

IMAGES IN CLINICAL MEDICINE Seat-Belt Sign and Seat-Belt Aorta Yuita Fukuyama, Tomokazu Motomura N Engl J Med November 5, 2022DOI: 10.1056/NEJMicm2204183 A 53-year-old woman presented to the emergency department with abdominal pain after being involved in a head-on motor vehicle collision in which she had been a driver and had been wearing a seat belt. Examination revealed decreased breath sounds in the right lung field, diffuse tenderness on palpation of the ...

IMAGES IN CLINICAL MEDICINE Foreign-Body Aspiration in a Child Katarzyna M. Saar, Christopher R. Grindle N Engl J Med 2022; 386:1741DOI: 10.1056/NEJMicm2115363 A healthy 12-month-old girl was brought to the emergency department with a 4-hour history of coughing and stridor. Four hours earlier, she had choked while eating. Her respiratory rate was 38 breaths per minute, and her oxygen saturation was 98% while she was breathing ambient air. On examination, s...

IMAGES IN CLINICAL MEDICINE Emphysematous Aortitis Edward C. Traver, Nina J. Gao N Engl J Med 2022; 386:1833DOI: 10.1056/NEJMicm2116075 A 74-year-old man with a history of end-stage kidney disease and coronary artery disease, as well as a 3-day history of anorexia and generalized weakness, was brought to the emergency department for evaluation of decreased responsiveness during hemodialysis. On examination, he appeared ill and provided only brief responses...

IMAGES IN CLINICAL MEDICINE Severe Subcutaneous Emphysema Sulakshan Rasiah, Max Whitchurch N Engl J Med 2022; 387:e18DOI: 10.1056/NEJMicm2200611 A 75-year-old man with chronic obstructive pulmonary disease underwent lung-volume–reduction surgery of the right upper lobe by means of video-assisted thoracoscopy. Postoperatively, a right apical pneumothorax and subcutaneous emphysema developed. The subcutaneous edema gradually worsened to extend from the pelvi...

Imaging in Intensive Care Medicine Published: 29 November 2021 Diffuse aspergillosis in a patient with SARS-CoV-2 pneumonia Giorgio Berlot, Ariella Tomasini, Rossana Bussani  Intensive Care Medicine volume 48, pages 609–610 (2022) A 59-year-old man with a severe pneumonia due to coronavirus disease 2019 (COVID-19) died in multiple organ failure caused by a postoperative septic shock subsequent to a hemicolectomy for a right colon infarction occurred two weeks ...

Rapid-Onset Cystic Bronchiectasis in a Mechanically Ventilated Patient with COVID-19 Michael Gilmartin ,  Ahmad Basirat ,  Conor Barry , et al Am J Respir Crit Care Med Vol 205, Iss 6, pp 721–722, Mar 15, 2022 A 40-year-old man presented to the ICU after intubation due to respiratory failure secondary to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonitis. Past medical history revealed a history of intravenous drug use (heroin). Early blood a...