Idiopathic Intracranial Hypertension in an Adolescent With Recent Human Immunodeficiency Virus (HIV) Diagnosis: A Challenging Etiological Dilemma.

Idiopathic intracranial hypertension (IIH) or benign intracranial hypertension affects the neuro-ophthalmological system and leads to elevated intracranial pressure. Elevated opening pressure during lumbar puncture is diagnostic of IIH. Here in, we present an interesting case of a 15-year-old girl, recently immigrated and with a high BMI, presenting with recurrent fever, abdominal issues, weight loss, and other symptoms, leading to a diagnosis of pelvic inflammatory disease (PID) and HIV infection. After treatment with antibiotics (doxycycline) and antiretroviral therapy, she developed IIH, manifesting as sudden-onset headache and vision problems. MRI and lumbar puncture confirmed the diagnosis. She responded well to acetazolamide and was discharged with continued medication and follow-up appointments. This case underscores the complexity of IIH development, especially in the setting of acute HIV infection and antibiotic treatment, highlighting the need for a comprehensive diagnostic approach and multidisciplinary management.

Idiopathic Fascicular Ventricular Tachycardia in a Pediatric Patient With Suicidal Ideation and Self-Injurious Behavior.

Idiopathic fascicular ventricular tachycardia (IFVT) is an arrhythmia that occurs in a structurally normal heart and may present with sudden onset in a healthy individual. We present the case of a 10-year-old female child, with no pertinent medical history, who complained of palpitations and shortness of breath, which was followed by suicidal ideations. On presentation to the ER, tachycardia was noted with other vital signs within normal limits. Labs were unremarkable. EKG showed wide-complex tachycardia with right bundle branch block and left superior axis, consistent with idiopathic left ventricular fascicular tachycardia. The echocardiogram showed normal cardiac structure. She was transferred to the cardiovascular care unit and intravenous verapamil was given with the resolution of symptoms and reversal of tachycardia. She remained hemodynamically stable and was subsequently discharged on oral verapamil. This case report is aimed at raising awareness of the different ways IFVT can manifest, aiding physicians to easily recognize the zebra among the horses.