IMAGES IN CLINICAL MEDICINE Minocycline-Induced Hyperpigmentation Aarti Maharaj, Michael Omar N Engl J Med 2026;394: e24 DOI: 10.1056/NEJMicm2513782 A 68-year-old woman with rosacea presented to the cardiology clinic with a 6-week history of dark patches on the skin of her arms and legs. Two weeks before the onset of the skin changes, she had started taking 100 mg daily of oral minocycline to treat rosacea. The dark patches, which had first appeared on ...

Teachable Moment  Pitfalls to Procalcitonin—Elevation in a Postvaccine Fever Virginia H. Sun, Esdras O. Rodriguez, Clement D. Lee JAMA Intern Med Published Online: April 13, 2026 doi: 10.1001/jamainternmed.2026.0673 A man in his mid-50s with end-stage kidney disease (ESKD) receiving peritoneal dialysis (PD) presented to the emergency department with fever, myalgias, and headaches 1 day after receiving COVID-19 and influenza vaccinations. He denied res...

IMAGES IN CLINICAL MEDICINE Massive Intravascular Hemolysis from Clostridium perfringens Bacteremia Ann Tran, Carol Lee N Engl J Med 2026;394: e19 DOI: 10.1056/NEJMicm2514135 A 73-year-old woman with type 2 diabetes presented to the emergency department with a 1-day history of malaise, dyspnea, and confusion. Vital signs and physical examination indicated shock. Serum laboratory samples were obtained, but they could not be processed owing to g...

CLINICAL DECISIONS Blood-Pressure Targets in Hypertension Management Christos P. Kotanidis, Paul K. Whelton, Clinton B. Wright N Engl J Med 2026;394:1026-1029 DOI: 10.1056/NEJMclde2505268 CASE VIGNETTE A Man with Hypertension Christos P. Kotanidis, M.D., D.Phil. A 75-year-old man comes to your primary care practice for a routine follow-up appointment. His medical history is notable for hypertension that is managed with...

CLINICAL DECISIONS Blood-Pressure Targets in Hypertension Management Christos P. Kotanidis, Paul K. Whelton, Clinton B. Wright N Engl J Med 2026;394:1026-1029 DOI: 10.1056/NEJMclde2505268 CASE VIGNETTE A Man with Hypertension Christos P. Kotanidis, M.D., D.Phil. A 75-year-old man comes to your primary care practice for a routine follow-up appointment. His medical history is notable for hypertension that is managed with...

CLINICAL DECISIONS Blood-Pressure Targets in Hypertension Management Christos P. Kotanidis, Paul K. Whelton, Clinton B. Wright N Engl J Med 2026;394:1026-1029 DOI: 10.1056/NEJMclde2505268 CASE VIGNETTE A Man with Hypertension Christos P. Kotanidis, M.D., D.Phil. A 75-year-old man comes to your primary care practice for a routine follow-up appointment. His medical history is notable for hypertension that is managed with ramipril and amlodipine. He i...

The Rational Clinical Examination  Does This Patient Have Volume Overload? The Rational Clinical Examination Benjamin Drum, Bryce La Course, Mark Kelly, et al JAMA Published Online: February 23, 2026 doi: 10.1001/jama.2026.0446 Key Points Question  Which physical examination, ultrasonographic techniques, and laboratory studies have the best evidence for determining volume overload in spontaneous...

When the heart goes to the wrong side Mabuchi, S., Minami, K. & Takeuchi, M When the heart goes to the wrong side. Intensive Care Med (2026). https://doi.org/10.1007/s00134-026-08321-9 Cardiac herniation is a rare but potentially serious complication that can occur when the pericardium is left unclosed after cardiac surgery, particularly following minimally invasive thoracotomy approaches (Fig. 1). Diagnosis is primarily based on postoperative imaging fin...

JOURNAL ARTICLE A 46-Year-Old With Persistent Altered Mental Status and Respiratory Failure Ann F Yang, Aesha Jobanputra, Thomas J Kirn, et al  Clinical Infectious Diseases, Volume 82, Issue 1, 15 January 2026, Pages 159–161, https://doi.org/10.1093/cid/ciaf439 Question: A 46-year-old undomiciled man with a past medical history of alcohol use disorder was found unresponsive and admitted for evaluation of altered mental status. He immigra...

JOURNAL ARTICLE A 46-Year-Old With Persistent Altered Mental Status and Respiratory Failure Ann F Yang, Aesha Jobanputra, Thomas J Kirn, et al  Clinical Infectious Diseases, Volume 82, Issue 1, 15 January 2026, Pages 159–161, https://doi.org/10.1093/cid/ciaf439 Question: A 46-year-old undomiciled man with a past medical history of alcohol use disorder was found unresponsive and admitted for evaluation of altered mental status. He immigrated from Mexico in 1...