Immune thrombocytopenia (ITP) is a diagnosis of exclusion and can be challenging at times to make the diagnosis. We herein present a case of a 73-year-old male with a history of chronic ITP, who presented to the hospital with sepsis and developed thrombocytopenia. His thrombocytopenia did not improve with resolution of sepsis but improved with ITP treatment including immunoglobulins and steroids. Platelet-associated IgG antibody levels are inversely proportional to platelet counts. The antibody levels are increased in sepsis. We would like to highlight that other causes of thrombocytopenia should also be considered in sepsis.Brucellosis is a rare zoonotic infection with a low annual incidence in the United States. Infective endocarditis secondary to brucellosis involving native or prosthetic valves is contemplated to be an extremely rare entity. As Brucella can present with non-specific sign and symptoms, clinicians need to have a higher degree of suspicion of Brucella endocarditis in culture-negative endocarditis patients, particularly those who have a history of exposure to farm animals. Timely diagnosis with appropriate management using antibiotics can prevent valvular damage and restore the valve’s structural integrity. In this case report, we present a case of culture-negative, serology-proven Brucella endocarditis of native mitral valve, with an initial presentation of stroke that was successfully treated with combination antibiotic therapy.Inflammation is identified as a keystone of atherosclerosis. This review of the literature explores the unique anti-inflammatory effects of colchicine and summarizes the mechanisms of inflammation in acute coronary syndrome. It outlines other therapeutic strategies employed until now to target coronary inflammation and analyzes the role of colchicine in improving the outcomes of acute coronary syndrome. Despite the existence of guideline-directed medical therapy, there still remains a higher risk for recurrence due to continuous inflammation at remaining vascular sites. Several anti-inflammatory strategies have been employed, but they have not been shown to be beneficial. However, colchicine is becoming increasingly popular in tackling this problem. For this review, databases were searched for trials on the role of colchicine as an anti-inflammatory therapy in acute coronary syndrome.Delayed presentation of tracheal injury after thyroidectomy is a rare complication. We present the case of a 24-year-old male presenting with findings of tracheal injury 12 days after total thyroidectomy. Upon surgical exploration, multifocal, transmural tracheal injuries were identified. Repair was performed with a combination of acellular dermal matrix allograft, local-regional flaps, silicone stenting, and tracheostomy. Herein we also review published cases of delayed tracheal injury. Our findings suggest that delayed tracheal necrosis and rupture is an uncommon yet potentially devastating complication of thyroidectomy. Surgeons should maintain a low threshold to suspect such injuries when patients present with neck swelling and subcutaneous emphysema, even up to 40 days post-operatively. Complex injuries may require a multidisciplinary approach and an armamentarium of reconstructive techniques.Unresectable hepatocellular carcinoma has several different therapeutic options, including targeted agents as well as locoregional therapy. Yttrium-90 (Y90) radioembolization therapy is an established treatment for unresectable disease and has been compared to other locoregional options as well as different targeted therapies. Newer case series are also reporting a potential benefit to the addition of immunotherapy to Y90 radioembolization. Here we report a case of prolonged survival in a patient whose treatment course included Y90 radioembolization along with sorafenib and nivolumab.Coronavirus disease 2019 (COVID-19) has gained international attention as it poses a significant threat to global health. Currently, medical researchers are working to exhaust all strategies that may prove beneficial in combating this disease. Heat has been shown to destabilize other coronavirus strains in testing environments, and it has been hypothesized that heated air may destabilize viral pathogens in vivo as well. The present report describes the engineering of a micro-sauna prototype for the delivery of heated air. Concept formulation, process highlights, and the final prototype are all discussed. The prototype can deliver air heated to 80-90 degrees Celsius in a safe and tolerable manner. The goal of this technical report is to further encourage the study of heated air as a potential COVID-19 treatment.A typical presentation of a foreign body aspiration (FBA) in a child includes witnessed choking, respiratory distress, cyanosis, coughing, wheezing, diminished breath sounds, and/or altered mental status. Following an extensive literature review, we found pneumothorax occurring secondary to FBA is a rare occurrence and should elicit prompt treatment. This 17-month-old female was admitted for respiratory syncytial virus (RSV) bronchiolitis and developed a subsequent pneumothorax during her hospital stay, consequent to aspiration of a cashew fragment two weeks before presentation. In light of the National Institute of Allergy and Infectious Diseases (NIAID)-sponsored expert panel’s addended guidelines, published and endorsed by the American Academy of Pediatrics (AAP) in 2017, we highlight a potential complication of increasing encouragement of peanut consumption in children as young as four months.We are presenting a case of primary lymphedema (PL) complicated with a repeated need for thoracentesis and pericardiocentesis. Our patient is a 24-year-old male with primary lymphedema that is manifested in the left hand and right lower limb. The patient presented to the emergency department (ED) for recurrent right lower lobe cellulitis that had failed repeated attempts with outpatient antibiotic therapy. The patient was admitted to the intensive care unit due to signs of cardiac tamponade that were discovered on the physical examination. Pericardial tamponade was confirmed by echocardiography. The patient underwent thoracentesis and multiple pericardiocenteses and required a pericardial window. Pericardial and pleural fluids appeared milky and biochemical analysis was consistent with chylopericardium and chylothorax.While the pulmonary and pancreatic involvement of cystic fibrosis (CF) is commonly described and therefore best studied, the cutaneous manifestations are frequently underdiagnosed, despite being important markers of disease severity. We report a case of antineutrophil cytoplasmic antibody-negative cutaneous vasculitis in a 15-year-old female CF patient in tandem with infection and subsequent colonization by Burkholderia cepacia complex (BCC). The flares of cutaneous vasculitis is associated closely with an infective exacerbation of CF and improved upon treatment of the infective exacerbation. We further discuss how the appearance of BCC colonization and cutaneous vasculitis affected both lung function and lung parenchyma by tracking spirometry and imaging changes over the subsequent four years.Limb shaking is a paroxysmal involuntary hyperkinetic movement that may be a presentation of severe unilateral steno-occlusive carotid disease. This unusual form of transient ischemic attack (TIA) is often misdiagnosed as focal motor seizures, especially with frequent repetition. We present a case of 67-year-old man with severe unilateral carotid stenosis leading to frequent left arm shaking TIAs. Initial work-up did not reveal any abnormalities, and anticonvulsant was started. He readmitted again after few days with left side mild hemiparesis. Cerebrovascular evaluation showed recent watershed infarction with significant stenosis in the ipsilateral internal carotid artery (ICA). The patient underwent stenting of the right ICA with weakness improvement and no more limb-shaking TIA on follow-up. In conclusion, early recognition of limb-shaking TIAs and differentiating it from focal motor seizures can facilitate identification of pre-occlusive carotid stenosis, allowing for appropriate interventions to prevent further TIAs or disabling stroke.Valacyclovir is a well-tolerated antiviral drug. Thrombotic thrombocytopenic purpura is a rare adverse effect of valacyclovir therapy. Mostly, it has been reported in clinical trials and case reports in patients with high dose or low dose therapy in immunocompromised patients. Herein we write a case report of the immunocompetent patient, who was taking very low dose valacyclovir therapy for his recurrent genital herpes. This case emphasizes the role of low dose (1000 mg/day) valacyclovir therapy causing thrombotic thrombocytopenic purpura in an immunocompetent patient with no other explainable trigger.Brucellosis is a form of zoonotic infection caused by various Brucella organisms. It most commonly presents as a case of pyrexia of unknown origin, alongside symptoms such as night sweats, malaise, arthralgias, and myalgias. This report describes the case of a man who presented with pyrexia of unknown origin for one month; he was diagnosed to be a case of brucellosis after enteric fever was ruled out. Investigations were ordered as it was a differential diagnosis with high clinical suspicion due to the presenting complaint and potential exposure of tainted consumable products. The systemic disease was determined to be brucellosis following blood results demonstrating positive antibody titers, and the suspicion of exposure due to widespread inadequacies in sterilization of food products.Loeffler endocarditis is relatively under-recognized and can impose a diagnostic challenge. We present a case of Loeffler endocarditis where eosinophilia was associated with parasitosis. This case highlights the importance of clinical clues in a patient with restrictive cardiomyopathy, and appropriate ancillary testing which helps guide further management.Aim To study ground-glass opacities (GGO) not only from the coronavirus 2019 (COVID-19) pneumonia” perspective but also as a radiological presentation of other pathologies with comparable features. Methods We enrolled 33 patients admitted to Policlinico Universitario G. B. Rossi who underwent non-contrast-enhanced (NCE) or contrast-enhanced (CE) chest computed tomography (CT) between March 12 and April 12. All patients with CT-detected ground-glass opacity (GGO) were included. All patients resulted as COVID-19 negative at the reverse transcription-polymerase chain reaction (RT-PCR) assay. We studied the different pathologies underlying GGO features neoplastic diseases and non-neoplastic diseases (viral pneumonias, interstitial pneumonias, and cardiopulmonary diseases) in order to avoid pitfalls and to reach the correct diagnosis. Results All CT scans detected GGOs. Symptomatic patients were 25/33 (75.7%). At the clinical presentation, they reported fever and dry cough; in six out of 25 cases, dyspnea was also reported (24%). Thirty-three (33; 100%) showed GGO at CT 15/33 (45.45%) presented pure GGO, and 18/33 (54.54%) showed GGO with consolidation. The RT-PCR assay was negative in 100%. We investigated other potential underlying diseases to explain imaging features neoplastic causes (8/33, 24.24%) and non-neoplastic causes, in particular, infectious pneumonias (16/33, 48,48 %, viral and fungal), interstitial pneumonias (4/33, 12,12%), and cardio-pulmonary disease (5/33, 15,15%). Conclusions GGO remains a diagnostic challenge. Although CT represents a fundamental diagnostic tool because of its sensitivity, it still needs to be integrated with clinical data to achieve the best clinical management. In the presence of typical imaging features (e.g. GGO and consolidation), the radiologist should focus on the pandemic and manage a suspect patient as COVID-19 positive until proven to be negative.