Acute Corneal Hydrops in Keratoconus With Atopic DermatitisA 27-year-old Japanese man with a history of keratoconus (KC) and atopic dermatitis presented with sudden onset of decreased vision in his left eye. Best corrected visual acuity was 20/200 in the left eye. Slit-lamp examination and cross-sectional imaging with anterior segment optical coherence tomography revealed marked corneal stromal and epithelial edema with corneal protrusion in his left eye (Figure A). Thus, he was diagnosed with acute corneal hydrops. Pressure patching with an ophthalmic ointment improved the corneal edema gradually.
Daniel Alcides Carrión – Peruvian Hero and Medical MartyrWhen Daniel Alcides Carrión García died in Lima, Peru, in 1885 at the age of 28, he had never published a scientific paper and did not have a medical degree. Yet more than a century later, he is still considered a national medical hero in Peru, and his name is attached to a major Peruvian medical center near Lima, a province in the Andes mountains, as well as a University and the highest-altitude football stadium in the world – both in Cerro de Pasco, the small mountain city where he was born in 1857.
69-Year-Old Woman With Dyspnea and Cough Productive of White SputumA 69-year-old woman was admitted to our institution with progressive dyspnea and cough productive of white sputum. Three months earlier, the patient was hospitalized elsewhere for evaluation of fever, headache, and fatigue. Results of a right temporal artery biopsy were consistent with giant cell arteritis (GCA). She was treated with prednisone (50 mg/d) and initially improved, but after 6 weeks of therapy, she again experienced feelings of malaise. Her erythrocyte sedimentation rate (ESR) remained elevated at 75 mm/h.
65-Year-Old Woman With Shortness of Breath and Dark UrineA 65-year-old previously healthy woman presented to her primary care physician with a 6-week history of increasing dyspnea, accompanied by a dry cough, fatigue, malaise, and poor appetite. Before her initial presentation and the onset of the aforementioned symptoms, she had attributed her illness to an upper respiratory tract infection. She also reported a 1-week history of passing dark urine and had been treated empirically 2 weeks previously with a 3-day course of oral trimethoprim-sulfamethoxazole for presumptive urinary tract infection.
35-Year-Old Woman With Recurrent PalpitationsA 35-year-old woman presented to the outpatient clinic with a 2-week history of episodic palpitations. She noted that each episode was abrupt in onset and would last approximately 1 to 2 hours before abating gradually. She denied chest pain, shortness of breath, and light-headedness and had no history of similar symptoms.
22-Year-Old Woman With Severe Microcytic AnemiaA 22–year-old woman who had no notable previous medical history reported increasing fatigue during the past few months. Her mother noticed that she looked pale and suggested she visit her family physician. Her family and personal histories were noncontributory. Findings on physical examination were remarkable only for pallor. In particular, she had no hepatosplenomegaly or lymphadenopathy.