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Case Report of Unusual Facial Swelling in an 8-Month-Old

Amanda E Mulcrone, MD*, Zobiya Z Momin, MD^ and Corrie E Chumpitazi, MD, MS*

DOI: https://doi.org/10.21980/J8M06F Issue 6:3[mrp_rating_result]
Facial ultrasound revealed local inflammatory changes such as increased echogenicity and heterogeneity in the soft tissues of the right cheek, suggestive of soft tissue edema. There was evidence of a prominent right parotid gland with increased heterogeneity suggestive of a traumatic injury. Additionally, facial ultrasound demonstrated a 6mm ill-defined anechoic collection within the right cheek without increased doppler flow (green arrow), thought to represent a focal area of edema instead of an abscess.
PediatricsRenal/ElectrolytesVisual EM
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Auricular Perichondritis after a “High Ear Piercing:” A Case Report

Diego Federico Craik Tobar, MD* and Adeola Adekunbi Kosoko, MD*

DOI: https://doi.org/10.21980/J8WH16 Issue 6:2[mrp_rating_result]
On physical examination, there was erythema, swelling, warmth, and general exquisite tenderness of the superior aspect of the left pinna (the outer ear) but excluding the ear canal, lobe, tragus, and crus. There was no facial involvement. There was no fluctuance about the ear and no drainage of fluid. The preauricular lymph nodes were enlarged and tender, but the anterior cervical lymph nodes were not tender. There was no mastoid tenderness, protrusion of the ear, or interruption of the postauricular crease.
ENTInfectious DiseaseVisual EM
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Case Report of Thrombotic Thrombocytopenic Purpura in a Previously Healthy Adult

Jessica L Sea, PhD*, Stephen F Gassner, MD, MPH* and Jonathan Smart, MD*

DOI: https://doi.org/10.21980/J8VK9M Issue 6:1[mrp_rating_result]
The physical exam revealed globalized pallor of his skin as well as conjunctival pallor. Mucous membranes were found to be dry and pale with dried gingival hemorrhages apparent between teeth (image). Additionally, mild hepatosplenomegaly was noted. While in the ED, the patient’s urine was dark reddish-brown, which he then reported had been similarly discolored for the past 7 days.
Hematology/OncologyVisual EM
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A Case Report of Posterior Communicating Artery Aneurysm Presenting as Cranial Nerve 3 Palsy in a Young Female Patient with Migraines

Colin Danko, MD* and Dustin Williams, MD*

DOI: https://doi.org/10.21980/J8QW83 Issue 6:1[mrp_rating_result]
Physical exam revealed a right pupil that was dilated compared to the left pupil, though both pupils were reactive. The patient also had impaired medial gaze on the right and ptosis of the right eyelid. Exam was otherwise unremarkable.
NeurologyVisual EM
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Case Report of COVID-19 Positive Male with Late-Onset Full Body Maculopapular Rash

Sarah Harirforoosh, MD*, Jessica Hoffmann, MD^ and Emily Bernal†

DOI: https://doi.org/10.21980/J86W72 Issue 6:1[mrp_rating_result]
The images demonstrate a diffuse, flat, maculopapular exanthema along the torso, bilateral upper and lower extremities, and neck without edema consistent with reported cutaneous manifestations of COVID-19. There are no surrounding bullae, vesicles, or draining. On palpation, there was blanching of the rash. Sensation to light touch was intact in all extremities. The findings were also apparent on the face with no mucosal involvement.
DermatologyInfectious DiseaseVisual EM
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Case Report of Spontaneous Thyroid Hemorrhage Following LMA Insertion

Gregory Podolej, MD* and Gary Bhagat, MD*

DOI: https://doi.org/10.21980/J8XP8W Issue 5:3[mrp_rating_result]
Two photographs of patients neck, both showcasing no obvious erythema, bruising, or swelling which is noteworthy because there is potential for airway compromise but there was nothing visible to indicate that on exam. CTA of neck showing thyroid nodule and potential thyroid hemorrhage (outlined in orange) on the left without evidence of airway compromise at the time of CT scan. Official read by attending radiologist states there is a “heterogeneous left thyroid nodule measuring 3 cm. Findings are suggestive of multinodular goiter with possible acute hemorrhage. Adjacent tract of soft tissue stranding in the anterior left neck with mild adjacent fascial thickening. This could represent small amount of hemorrhage or could be inflammatory.”
EndocrineVisual EM
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Ascending Thoracic Aortic Dissection: A Case Report of Rapid Detection Via Emergency Echocardiography with Suprasternal Notch Views

Brandon Backlund, MD*, Anastasia Kendrick-Adey, MD*, Rachel Harper, MD* and Martin Makela, MD*

DOI: https://doi.org/10.21980/J8WW6WIssue 5:2[mrp_rating_result]
Video of parasternal long-axis bedside transthoracic echocardiogram: The initial images showed grossly normal left ventricular function, and no pericardial effusion or evidence of cardiac tamponade. However, the proximal aorta beyond the aortic valve was poorly-visualized in this window.
Cardiology/VascularUltrasoundVisual EM
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Case Report: Acute Supraglottitis

Jamie Robin Chu, MD* and Jonathan G Rogg, MD, MBA^

DOI: https://doi.org/10.21980/J8006V Issue 5:1[mrp_rating_result]
On arrival, radiographs of the neck soft tissues were obtained, which showed a markedly enlarged epiglottic shadow (red arrow) concerning for epiglottitis. A computed tomography scan of the neck soft tissues with contrast was then obtained which revealed edematous mucosal thickening of the oropharynx (blue arrow) and supraglottic larynx (green arrow) including the epiglottis (purple arrow) concerning for acute infectious pharyngitis and supraglottic laryngitis with severe narrowing of the supraglottic laryngeal lumen, as well as associated extensive inflammation and edema of the superficial and deep left neck spaces. The patient’s white blood cell count was elevated to 25.7x109/L with 87% neutrophils. Her rapid strep test was positive. Otolaryngology was consulted and performed a bedside flexible laryngoscopy which showed significant edema of the epiglottis (orange arrow), vocal cords (white arrow), and arytenoids (black arrow), left greater than right. Based on the findings and concern for impending respiratory failure, the patient received an awake fiberoptic intubation by anesthesia at the bedside.
Infectious DiseaseENTVisual EM