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...

Endgames Christmas 2022: Brain Stew Electrocardiogaffe Patricia McGettigan, Ian C Cooper, Jennifer H Martin, et al BMJ 2022; 379 doi: https://doi.org/10.1136/bmj-2022-074083 (Published 19 December 2022)Cite this as: BMJ 2022;379:e074083 Because a physician has possessed himself of an electrocardiograph, a polygraph, an x-ray machine, a blood pressure instrument, or some ingenious form of stethoscope, it does not at...

Endgames Christmas 2022: Brain Stew Electrocardiogaffe Patricia McGettigan, Ian C Cooper, Jennifer H Martin, et al BMJ 2022; 379 doi: https://doi.org/10.1136/bmj-2022-074083 (Published 19 December 2022)Cite this as: BMJ 2022;379:e074083 Because a physician has possessed himself of an electrocardiograph, a polygraph, an x-ray machine, a blood pressure instrument, or some ingenious form of stethoscope, it does not at all follow that he has become competent...

JAMA Diagnostic Test Interpretation  November 10, 2022 Peritoneal Fluid Analysis in Peritoneal Dialysis–Associated Peritonitis Jeffrey Perl, Ziv Harel, Sharon J. Nessim JAMA. Published online November 10, 2022. doi:10.1001/jama.2022.21289 Case A62-year-old woman undergoing peritoneal dialysis (PD) for kidney failure due to IgA nephropathy presented to the PD clinic with a 1-day history of severe abdominal pain...

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...

JAMA Diagnostic Test Interpretation  November 10, 2022 Peritoneal Fluid Analysis in Peritoneal Dialysis–Associated Peritonitis Jeffrey Perl, Ziv Harel, Sharon J. Nessim JAMA. Published online November 10, 2022. doi:10.1001/jama.2022.21289 Case A62-year-old woman undergoing peritoneal dialysis (PD) for kidney failure due to IgA nephropathy presented to the PD clinic with a 1-day history of severe abdominal pain and cloudy PD fluid. Seven da...

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...