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...

IMAGES IN CLINICAL MEDICINE Primary Cutaneous Blastomycosis Albert Alhatem, Kristin C. Smith N Engl J Med 2022; 386:e49DOI: 10.1056/NEJMicm2116178 A 53-year-old man presented to the dermatology clinic with a 4-month history of red, raised, itchy skin lesions on his left lower back and buttock. He had no known medical history and reported no constitutional or respiratory symptoms. He worked as a landscaper, often sustaining skin abrasions while trimming tre...

IMAGES IN CLINICAL MEDICINE Pneumatosis Intestinalis in Necrotizing Enterocolitis Lorraine Tong, Yu-Tang Chang N Engl J Med 2022; 386:1070DOI: 10.1056/NEJMicm2115830 An 11-day-old boy born at 39 weeks of gestation presented to the emergency department with watery diarrhea, bilious emesis, progressively worsening abdominal distention, and shock. There had been no complications during his birth, and he had been growing appropriately while receiving breast mi...

IMAGES IN CLINICAL MEDICINE Intestinal Tuberculosis Luis F. Oñate-Ocaña, Lizeth Pérez-Díaz N Engl J Med 2022; 386:e30DOI: 10.1056/NEJMicm2114345 A 36-year-old woman presented to the emergency department with a 1-day history of severe abdominal pain and a 2-week history of fever and cough. She had no known medical history and worked as a physician. On physical examination, diffuse, severe abdominal tenderness with rebound and guarding was observed. Computed...