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...

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...

Imaging in Intensive Care Medicine "Air in the water"—the hydropoint sign Eleni Soilemezi, Petros Morfesis, Vassiliki Birmpa, et al Intensive Care Med 2025; 51: 1721–1723 A 30-year-old female patient was admitted in ICU due to community-acquired pneumonia causing bilateral lung infiltrations and severe hypoxemia requiring mechanical ventilation. An episode of rapid desaturation (SpO2 87% despite increased FiO2 to 100%) triggered a new lung ultrasound assessmen...

IMAGES IN CLINICAL MEDICINE Snowman Sign in Pituitary Macroadenoma Yuwei Zhou, Wei Weng N Engl J Med 2025;393:699 DOI: 10.1056/NEJMicm2503820 A previously healthy 47-year-old woman presented to the neurology clinic with a 1-month history of worsening headaches associated with blurry vision, galactorrhea, and irregular menstrual cycles. Physical examination was notable for reduced visual acuity of 20/50 in both eyes, with normal visual fields and extraoc...

IMAGES IN CLINICAL MEDICINE Incarcerated Femoral Hernia Pratyaksha Rana, Hit Jivani N Engl J Med 2025;393: e2 DOI: 10.1056/NEJMicm2500535 A 77-year-old woman presented to the emergency department with a 2-day history of abdominal pain, nausea, and vomiting. On physical examination, abdominal distention with tenderness was present in the left lower quadrant. Computed tomography of the abdomen revealed herniation of a loop of ileum on the left side (Panel...

IMAGES IN CLINICAL MEDICINE Diffuse Alveolar Hemorrhage in ANCA-Associated Vasculitis Irene S. Lee N Engl J Med 2025;393:72 DOI: 10.1056/NEJMicm2416576 A 57-year-old man with hypertension presented to the emergency department with a 2-week history of worsening shortness of breath. His oxygen saturation was 68% while he was breathing ambient air. He was confused and unable to speak. Physical examination was notable for diffuse crackles in both lungs. Tra...

IMAGES IN CLINICAL MEDICINE Round Pneumonia Jhon Camacho-Cruz, Daniela Guerrero-Sanchez N Engl J Med 2025;392: e39 A previously healthy 4-year-old girl who was up to date on routine vaccinations presented to the emergency department with a 3-day history of dry cough and fever. On physical examination, intercostal retractions and decreased breath sounds over the left lung were observed. Laboratory studies were notable for neutrophilic leukocytosis. A chest ...

JAMA Insights  March 17, 2025 Point-of-Care Ultrasound in Sepsis and Septic Shock Timothy B. Kaselitz, Christopher W. Seymour JAMA. Published online March 17, 2025. doi:10.1001/jama.2025.1983 Point-of-care ultrasound (POCUS) is a portable imaging tool used to guide clinicians in the rapid assessment of patients at the bedside. Because POCUS is noninvasive, radiation sparing, inexpensive, and allows for repeat examinations with evolving clinic...