A Case Report of Catastrophic Antiphospholipid Syndrome with Libman-Sacks Presenting as Interstitial Pneumonia

A Case Report of Catastrophic Antiphospholipid Syndrome with Libman-Sacks Presenting as Interstitial Pneumonia Chassidy Sumler Martin, MS, Rocco Cannistraro, MD Antiphospholipid syndrome (APS) is an autoimmune condition characterized by vascular thromboses and a positive antiphospholipid antibody. Catastrophic antiphospholipid syndrome (CAPS) is a rare disease that often results in death. CAPS is the most severe form of APS, which can develop in a short period of time and occurs in less than 1% of people with APS. CAPS involves multiple organs simultaneously with diffuse microvascular and macrovascular involvement. Here, we present a case of catastrophic antiphospholipid syndrome presenting as interstitial pneumonia that rapidly progressed to acute renal failure, acute ischemic cerebral infarcts, cardiac valvular vegetations, and heart failure. This case report aims to bring awareness of prompt medical suspicion and treatment of CAPS in hopes of improving disease outcomes

Adult Intestinal Botulism: A Rare Presentation in an Immunocompromised Patient With Short Bowel Syndrome

The cholinergic heat-labile neurotoxin produced by Clostridium species is primarily responsible for the clinical manifestations of botulism. The classic phenotypic presentation of botulism consists of subacute descending flaccid paralysis with intact sensory function. Traditionally, it is classified into 3 main forms (foodborne, wound-related, and infantile) on the basis of primary site of toxin entry into the human nervous system. Toxemia is the common pathophysiology in all forms of botulism. Adult intestinal toxemia botulism is an extremely rare form of the disease with pathogenesis similar to that of infant-type botulism. Symptomatic adults usually have an anatomic abnormality in the gastrointestinal tract leading to changes in normal gut flora. The current case is an addition to the growing literature on this unusual clinical variant of botulism