Multiple Myeloma as a Potential Cause of Low Complements in Patients With Acute Kidney Injury.

Multiple myeloma (MM) is a plasma cell malignancy belonging to the class of monoclonal gammopathies that leads to end-organ damage myeloma events that encompass anemia, the presence of lytic bone lesions, hypercalcemia, and renal insufficiency. However, there are very few reported cases of patients with low complements in the context of MM and renal failure. Traditionally, low complements in glomerular disease are associated with conditions such as membranoproliferative glomerulonephritis, cryoglobulinemia, systemic lupus erythematous, and post-infectious glomerulonephritis. Despite its rarity, physicians should maintain a high degree of suspicion and consider MM as a potential cause of low complements in patients with renal injury. In this case report, we present a patient with a history of MM associated with acute kidney injury with hypocomplementemia, an atypical presentation of myeloma in MM.

End-Stage Achalasia With Megaesophagus Refractory to Two Heller Myotomies.

Achalasia is a motility disorder of the esophagus in which the lower esophageal sphincter fails to relax. Megaesophagus is a rare complication of achalasia characterized by severe dilatation of the esophagus, often indicative of end-stage achalasia. Typical presenting symptoms include dysphagia, nausea, vomiting, weight loss, and chest pain. The majority of patients with achalasia typically have excellent outcomes after surgical intervention with Heller myotomy. We discuss an interesting case of unsuccessful surgical intervention and hypothesize the reason for its failure in our patient.

Kocuria rosea Bacteremia in a Sickle Cell Patient: A Case Report.

Central line-associated bloodstream infections (CLABSI) are a significant risk factor for poor patient outcomes. It is important to correctly diagnose and treat these infections to ensure the best chance of recovery. Kocuria rosea is a novel bacteria that is native to the human flora and has been on the rise as a culprit in recent nosocomial infections. However, due to its characteristics, it is often misclassified by commonly used hospital tests. We present a case of a 55-year-old female with sickle cell disease who developed a K. rosea infection during her hospital course and was effectively diagnosed and treated. This case report aims to bring awareness to this unusual bacteria as a possible cause of inpatient infection and CLABSI. Further research should be conducted to determine the incidence of this bacteria and the best testing to be done for its proper recognition.