Acute Dacrocystitis

Case: A young woman with chronic nasolacrimal duct obstruction presents with 5 days of right sided swelling around her right eye. She was prescribed oral antibiotics by her primary care doctor, but symptoms worsened despite taking them. She denies systemic malaise, fevers, chills, rigors. She can see normally out of both eyes. No pain withContinue reading "Acute Dacrocystitis"

Pyogenic Flexor Tenosynovitis

Case: A middle-aged gentleman with a history of kidney transplant presented with a painful swollen right index finger. The pain and swelling started the day before. There was no preceding trauma to the finger. On exam, fusiform swelling of the digit, tenderness along the flexor tendon sheath, and extreme pain with passive extension of theContinue reading "Pyogenic Flexor Tenosynovitis"

Ulceroglandular Tularemia

Key Points: Tularemia is a rare, highly virulent zoonotic disease caused by Francicella tularensis.It is transmitted commonly through arthropods such as ticks and deer flies, as well as vertebrates such as rabbits.Tularemia occurs throughout North America, Europe, Asia, and the Middle EastThere are 6 major clinical forms of disease depending on route of entry. OverlappingContinue reading "Ulceroglandular Tularemia"

Cutaneous Disseminated Fusarium Skin Lesions

Vignette: A middle aged woman with MDS status post allogeneic stem cell transplant with delayed engraftment develops neutropenic fever with a new rash. She is empirically started on IV cefepime. Her preliminary workup is negative. Fevers persist and ID is consulted. On exam, you note erythematous lesions in varying stages of evolution, some of whichContinue reading "Cutaneous Disseminated Fusarium Skin Lesions"