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All critical-care Cases

Empyema suspected due to leukocytosis on chest x-ray

elderly lady with increasing shortness of breath over the last week. WBC 24k


Pulmonary tuberculosis on chest x-ray

male aged 60 years with prolonged cough and fever. Unfortunately he didn't survive.


Acute myocardial injury on EKG

EMS reaponds to a private residence for an approx 85-year-old male complains of CP. Pain started last night at 19:00, ...


Meningitis Cerebrospinal fluid

This is cloudy #csf in an elderly lady who came in with #sepsis and multilobar #pneumonia. She was growing #strep ...


T12 burst with paraplegia

Chronic pain pt involved in moderate speed MVC. Restrained driver. C/o inability to feel legs or move them. T12 burst ...


Klebsiella pneumonia on CT

50's alcoholic male and #Critically-ill-patient with #klebsiella PNA. Respiratory failure and septic shock at time of CT in image 1. ...


S1Q3T3 and tachycardia of pumlmoary embolism on ECG

45 yo obese male, had 2 weeks of seated computer training for work now in ER with shortness of breath. ...


3D print of severe facial trauma

severe facial trauma due to a deployed recalled automobile airbag. The maxilla was basically completely destroyed. #3DPrinting


Strategies for lip biting in patients with a brain injury

3 solutions to the lip-biting problem in this young patient with bad brain injury. Image #1 is a scissor clamp, ...


Blue Rubber Bleb Nevus Syndrome

21 yr old male lorry driver admitted via emergency to ICU with PR bleeding and haematuria. He had developed progressing ...


Pneumothorax on x-ray

2/2. Update on precious case of #Pneumothorax . Obviously this is s/p chest tube placement in the ER, then the ...


Diabetic ketoacidosis lab values

Female in her 40s w/ poorly controlled diabetes mellitus. Non compliant. Weakness x 1 week w/ nausea and vomiting. Serum ...


Inferior ST elevation MI on ECG

53 year old male with chest pain that woke him from sleep. Patient went to PCP day prior and got ...


Heparin-induced thrombocytopenia

Female 71 years old with mediastinal neoplasm infiltrating the superior vena cava and right atrium (histology: thymoma type A). Clinical ...


Fracture of the anterior and posterior column of the acetabulum 3D reconstruction

both column acetabular #


Diaphragmatic tear pre and post repair on chest x-ray

65yr female admitted into ICU post multitrauma mainly chest . She had weaning failures and failed extubations. She was found ...


Right ventricular strain pattern on ECG with pulmonary embolism

Severe right ventricular strain with new atrial fibrillation (+ clear chest X-ray and hypoxemia) = massive pulmonary embolism. Echo showed ...


Doctors Without Borders in Afghanistan

@DrsWithoutBorder medical staff provide emergency treatment to patients and wounded colleagues in an improvised area of MSF's trauma centre in ...


Tension pneumothorax bilaterally on chest x-ray

Bilateral Spontaneous #Tension-pneumothorax #Pneumothorax - patient walked in to the ED! Sorry about the poor quality image.


Post-conversion ECG

Update to 30s Female 30 weeks pregnant. Patient responsive to IV fluid bolus. Initiated procainamide 1gram IV infusion @25mg/min. Patient ...


Equipment graveyards

#GMHStories Equipment graveyards are a common site for northern Ghana hospitals. When equipment breaks down, there is no proper way ...


Microprocessor hydraulic knee prosthesis

18 year old male with L AKA above knee amputation after a traumatic work accident at a farm being run ...


Staphylococcal scalded skin syndrome

posting this for a colleague. started with high fever over 104 it wasn't resolving with Tylenol and Motrin the next ...


Left temporal epidural hematoma on CT

Head trauma & sequela: 52yoM bike accident presented in coma with dilated left pupil, intubated. CT shows left temporal epidural ...



Fluconazole is an Azole antifungal drug, which decreases ergosterol synthesis & interferes w/ fungal cell membrane formation. Beware QTc prolongation, ...


Meningioma 5cm posterior fossa compressing brain stem

52 yo F presented after PCP tested and MRI. Patient has had HA for years but that last 3 mo ...


Clot removed from the left M1 segment of the Middle cerebral artery

80yo F presents to the ED aphasic and right sided paralysis. CT confirms left M1 clot. Pt sent to Cath ...


Ventricular tachycardia on ECG

~70s M c/o Chx pain x45 mins around 0300. Arrived to find pt in V tach with pulses, BP over ...


metastatic ovarian cancer with peritoneal carcinomatosis, malignant ascites.

This week’s case is a 40 year old Haitian woman presents with loss of appetite and weight loss. Physical exam ...


Diffuse subendocardial ischemia on ECG

it's been a while figure1! Posting from a colleague of mine, 68 yoF 4 hour hx of central chest pain ...

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