FUO in a 56-year-old woman

A 56-year-old, obese woman who had been sexually inactive for 10 years presented at the hospital with high fevers, decreased appetite, nausea, vomiting, and weight loss. Following many diagnostic tests that revealed little, it was found that her estranged husband was being treated for Pneumocystis carinii pneumonia (PCP). The woman was tested for HIV and found to be positive. This is an example of the Centers for Disease Control and Prevention's (CDC) indication that 10 percent of reported AIDS cases occur in people over age 50, that diagnosis is often delayed in older age groups, and that anyone suffering from fever of an unknown origin should be tested for HIV. In such situations it is suggested that general practice include seeking behavioral information and offering HIV testing and counseling.     

Postpartum thyroiditis in a 20-year-old woman

POSTGRADUATE MEDICINE invites submission of brief case reports, especially those related to ambulatory medical care. Illustrations and references should be included only when essential.     

Epiploic appendagitis in a 24-year-old woman

Epiploic appendagitis is a very rare condition that results from acute inflammation of an appendix epiploica. We report a case involving a 24-year-old woman who presented to the emergency department with abdominal pain localized to the left lower quadrant. The patient was diagnosed with epiploic appendagitis, which was confirmed through findings obtained from a contrast-study computed tomography of the abdomen. The patient was subsequently taken to the operating room for a diagnostic laparoscopy due to persistent pain. Necrotic epiploic appendagitis was found on the descending colon, which was removed laparoscopically.     

Stress-related cardiomyopathy in a 31-year-old woman

Stress-related cardiomyopathy (SRC), initially referred to as Tako-Tsubo cardiomyopathy and later as apical ballooning syndrome, has been largely observed in postmenopausal women. It is frequently precipitated by a stressful event. This is a case report of a 31-year-old woman who experienced SRC immediately after a bilateral mastectomy.     

Myocardial infarction in a 25-year-old woman.

A 25-year-old woman presented with chest pain. Electrocardiogram (ECG) on admission was normal. When she had recurrent chest pain a second ECG showed marked ST elevation in the anteroseptal leads. Coronary angiography confirmed occlusion of the left anterior descending coronary artery. She was subsequently found to have a coagulation abnormality. The case illustrates several important points. Inquiring about risk factors in patients with chest pain should include a question about abnormal clotting. It is important to exclude significant pathology in patients who may appear 'histrionic': inspection of a patient's belongings and collateral history may be invaluable.     

Asymptomatic patent ductus arteriosus in a 41-year-old woman

Patent ductus arteriosus is a rare adult congenital heart disease, especially asymptomatic cases are uncommon in older ages. We report here the case of a 41-year-old woman, who was incidentally found to have a patent ductus arteriosus. The patient also was asymptomatic. For anatomical demonstration, computerized tomography angiography was performed and then surgical intervention was applied.