A Case of Multiple Vein Thrombosis Following Pacemaker Implantation.

Pacemakers are implanted as part of the treatment process of conditions including symptomatic bradycardia and certain types of heart block. One complication associated with pacemaker implantation is upper extremity deep venous thrombosis (UEDVT), which can subsequently lead to pulmonary embolism, limb loss, or death. We present the case of an 88-year-old male who developed UEDVT in his left subclavian, axillary, brachial, and basilic veins shortly after dual chamber pacemaker implantation for treating symptomatic heart block. The patient received anticoagulation with intravenous heparin while inpatient but was switched to oral apixaban prior to discharge. This case highlights the importance of detecting and treating UEDVT in patients who recently underwent pacemaker placement.

A Case of Hand-Foot-and-Mouth Disease in an Adult Male.

Hand-foot-and-mouth disease (HFMD) is commonly seen in infants and children; less frequently, it may be seen in adults as well. The disease is usually associated with viral infections, including many variants of enteroviruses and coxsackieviruses. We discuss the case of a 39-year-old male who presented with constitutional symptoms, fever, and lesions on his hands, feet, and mouth. His children, who had been recently diagnosed with HFMD, were likely the source of his infection. A comprehensive history and physical examination enabled us to identify the lesions, some of which were faint and difficult to visualize. Viral panel testing indicated positive results for human rhinovirus/enterovirus. Treatment and testing associated with the patient's condition were supportive, largely based on the history and physical findings which helped us narrow down our differential diagnoses. Complete resolution of the symptoms within one to two weeks is generally expected in these patients.