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A diagnosis at hand
A 45-year-old man was found unconscious on the sidewalk and brought to the Emergency Department. He could not provide anamnestic information, but the hospital electronic archive revealed he was homeless and had a history of excessive alcohol consumption (250–300 g daily intake). He suffered from depressive disorder and had attempted suicide 9 years before by caustic ingestion, which led to total gastrectomy and esophagojejunal anastomosis. Physical examination revealed a Glasgow Coma Scale score of 8 with no focal neurological signs.A man with arthralgias and skin lesions
A healthy 43-year-old man presented to the Emergency Department with a one-week history of fever, low back pain and arthralgias mainly localized in the right knee. Physical examination revealed painful swelling of the left hand and lower limb (Fig. 1A), non-tender haemorrhagic macular lesions on the soles (Fig. 1B) and signs of right knee arthritis (Fig. 1C). Laboratory tests showed aspecific neutrophilic leukocytosis. A computed tomography of the lumbar region demonstrated a paravertebral mass located at L4-L5 level, which was consistent with spondylodiscitis associated with soft tissue involvement.
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