A Very Uncommon Case of Myxedema Coma: Rediscovery of an Old Presentation.

Myxedema coma is an extreme manifestation of hypothyroidism. It is characterized by altered mental status and hypothermia. The most common precipitants of myxedema coma include discontinuation of thyroid supplements and infections. Therefore, the mainstay of treatment is IV glucocorticoids and IV levothyroxine. We describe a case of an 81-year-old woman with myxedema coma who developed acute cardiopulmonary failure with associated pericardial and pleural effusions, which are rare manifestations of myxedema coma.

Immunodeficiency: A Protective Factor for COVID-19?

Coronavirus disease 2019 (COVID-19) is an infection that involves the respiratory tract and is attributed to severe acute respiratory syndrome coronavirus 2. While most people develop mild or uncomplicated illness, approximately 15% develop a severe disease that requires oxygen support, and 5% develop a critical disease. While immunodeficiency is reported as a risk factor for COVID-19, we present a patient with idiopathic CD4+ lymphocytopenia who developed severe COVID-19 with an unexpected clinical course and complete recovery.

Acute Eosinophilic Pneumonia Secondary to Daptomycin.

Daptomycin is an antimicrobial agent with activity against gram-positive bacteria that is usually reserved for severe infections. Acute eosinophilic pneumonia (AEP) is an increasingly rare side effect that can manifest after its use. Our patient is a 79-year-old male who was admitted for a left total knee arthroplasty infection. After daptomycin was started, he developed AEP. The offending agent was stopped, the appropriate medical treatment was given, and his symptoms significantly improved. This case illustrates an uncommon side effect of daptomycin. Prompt medical recognition is paramount for medication discontinuation and adequate medical care.

Spontaneous pneumomediastinum: A collaborative sequelae between COVID-19 and self-inflicted lung injury - A case report and literature review.

Spontaneous pneumomediastinum is an infrequent complication of COVID-19. The mechanism is still unknown and thought to be related to patient self-inflicted lung injury. Our patient is a 49-year-old male who presented with shortness of breath and cough. A COVID-19 Polymerase Chain Reaction was positive. He required a high-flow nasal cannula, but he did not demand mechanical ventilation. Computed tomography angiography scan of the chest revealed pneumomediastinum. He was managed conservatively, and a complete recovery was achieved. This case highlights the emerging association of COVID-19, patient self-inflicted lung injury, and pneumomediastinum. Furthermore, spontaneous pneumomediastinum should be suspected even in patients who were not mechanically ventilated.

Pulmonary Septic Emboli due to Azygos Vein Septic Thrombosis.

The triad of extrapulmonary infection, contiguous septic vein thrombosis, and septic pulmonary embolism is a rare complex but associated with significant morbidity and mortality. Septic azygos vein thrombosis is extremely rare and potentially serious since it may also cause pulmonary emboli and sudden death. We report a case of a 32-year-old woman with history of IV drug abuse who presented with epidural abscess and methicillin-resistant S. aureus (MRSA) bacteremia. Later she developed signs of septic pulmonary embolism secondary to septic azygos vein thrombosis. With early diagnosis, appropriate antimicrobial therapy, and control of the infectious source, resolution of the illness can be expected for most patients with avoidance of potential complications.