An Unusual Cause of Shortness of Breath: Primary Tracheal Basal Cell Adenocarcinoma.

A rare case of basal cell adenocarcinoma of the salivary gland tissue in the trachea can be difficult to differentiate from basal cell adenomacarcinoma.

A rare cause of altered mental status and fever in a young military recruit in Puerto Rico.

Heat stroke (HS) is a medical emergency characterized by increased core body temperature with associated systemic inflammatory response leading to a syndrome of multi-organ damage in which encephalopathy predominates. We describe a case of a 29 year old male recruit presenting with altered mental status during military training in Puerto Rico. Associated symptoms included high grade fever, dizziness, nausea, vomiting, blurred vision and profuse sweating followed by loss of consciousness. Upon arrival to medical evaluation the patient was found with dry skin and depressed Glasgow Coma Score. Initial laboratories, clinical evolution of symptoms and imaging studies were consistent with the diagnosis of HS. Patient was managed with mechanical ventilatory support, intravenous fluids and external cooling measures. He was later discharged home without any neurological sequelae. To our knowledge this is the first documented case of HS in Puerto Rico.