- N Engl J Med 2022; 387:833-838
A 3-year-old boy presented with abdominal pain and vomiting. He had associated chills without fever, nonbloody and nonbilious emesis, constipation, reduced urinary output, and a decreased activity level.
- N Engl J Med 2022; 387:832-832
A 32-year-old man with daily nitrous oxide inhalant use presented with an inability to walk. MRI of the whole spine revealed hyperintensities in the posterior spinal cord on T2-weighted images.
In comatose patients after out-of-hospital cardiac arrest, the incidence of death or severe disability was similar regardless of whether a restrictive or a liberal oxygenation strategy was used.
In a randomized, placebo-controlled trial, patients with acute decompensated heart failure and volume overload who received intravenous acetazolamide plus a loop diuretic had a higher incidence of decongestion.
This trial showed no significant difference in the percentage of patients who died or had severe disability or coma when higher or lower blood-pressure targets were used after an out-of-hospital cardiac arrest.
- N Engl J Med 2022; 387:640-640
An 86-year-old woman presented with acute pain on the right side of her abdomen. Computed tomography revealed a distended gallbladder outside the gallbladder fossa and swirling of the cystic artery and duct.
- N Engl J Med 2022; 387:641-650
A 25-year-old woman was evaluated for worsening headaches, photophobia, nausea, vomiting, and blurred vision. MRI revealed hydrocephalus and leptomeningeal enhancement. CSF analysis revealed neutrophilic pleocytosis.
- N Engl J Med 2022; 387:491-493
A shortage of contrast material has made weighing value an urgent aspect of imaging decisions and provided a stark example of the consequences of low-value imaging for public health and health equity.
- N Engl J Med 2022; 387:506-513
Removal of small, asymptomatic kidney stones during surgery to remove ureteral or contralateral stones resulted in less relapse than nonremoval and in similar numbers of subsequent emergency department visits.
- N Engl J Med 2022; 387:562-563
Asymptomatic kidney stones are often noted on imaging studies that are performed to screen for stones or when a patient presents with symptomatic stones. Patients frequently ask two questions about the asymptomatic stones: “Will my stones ever become symptomatic?” and “How do we get those stones to come out before...
- N Engl J Med 2022; 387:547-556
A 31-year-old man was admitted with perianal and penile ulcers, rectal pain, and vesiculopustular rash. He had first noticed itchy white “bumps” around the anus 9 days earlier. A diagnostic test was performed.
- N Engl J Med 2022; 387:451-451
A 68-year-old woman living in Japan presented with a 5-day history of rash and fevers. She had been bitten by a tick 1 week earlier. Examination revealed a petechial rash and eschar on the ankle.
- N Engl J Med 2022; 387:356-365
A 49-year-old man with a family history of diabetes was evaluated because of hypoglycemia. Two hours earlier, he had been found on the floor, obtunded and making nonpurposeful movements. A diagnostic test was performed.
- N Engl J Med 2022; 387:260-260
A 26-year-old woman presented with sore throat, pain while swallowing, shortness of breath, and fever. Marked swelling of the posterior oropharynx was observed on physical examination, and CT of the neck was performed.
- N Engl J Med 2022; 387:e5
A 78-year-old man with type 2 diabetes presented with hemiballism of the left arm and leg (shown in a video). Evaluation revealed hyperglycemia and an area of increased density in the right basal ganglia on imaging.
- N Engl J Med 2022; 387:e4
A 46-year-old man presented with tinnitus and dizziness after a backward fall from a 2-m height. CT imaging showed fractures of the occipital and right temporal bones with pneumolabyrinth and pneumocochlea.
- N Engl J Med 2022; 387:167-167
A 30-year-old man presented with a morbilliform rash and fever after taking an antimicrobial agent. Facial edema, eosinophilia, and elevated liver-enzyme levels developed later.
- N Engl J Med 2022; 387:168-176
A 17-year-old girl was admitted because of prolonged fever and cough. She had an elevated creatinine level and a low hemoglobin level. A diagnostic test was performed.