Small Cell Lung Carcinoma in a Young Non-Smoking Male: An Unusual Presentation with Extensive Thoracic DiseaseHossam Salameh¹, Momen Zetawi¹, Mohammed AbuBaha¹, Mutaz Abu-Awwad¹ Mohammed B. Abboushi², Hanood Abu Ras³, Wafa Khalifah³, Dr. Ali Suleiman⁴, Osama Salameh⁵¹ Department of Medicine, An-Najah National University, Nablus, State of Palestine ² Department of Internal Medicine, An-Najah National University Hospital, Nablus, State of Palestine ³ Department of Pathology, An-Najah National University Hospital, Nablus, State of Palestine ⁴ Department of Radiology, An-Watani Hospital, Nablus, State of Palestine ⁵ An-Watani Hospital, Nablus, State of Palestine

A document by Mohanad Jaber. Click on the document to view its contents.

not-yet-known not-yet-known not-yet-known unknown Key Clinical Message This case highlights an atypical presentation of Community-acquired Methicillin-resistant Staphylococcus aureus (CA-MRSA) cavitary pneumonia in an immunocompetent host, complicated by the ”skip phenomenon”: a pattern of intermittent negative blood cultures that may obscure persistent bacteremia. Its PVL-mediated severity and diagnostic challenges underscore the need for heightened clinical suspicion, repeated cultures, and early, targeted intervention.

The background of Takotsubo cardiomyopathy is classically associated with identifiable emotional stress; however, there is a significant number of cases that meet the diagnostic criteria without any identifiable antecedent stress. While the literature reports cases of Takotsubo cardiomyopathy triggered by various factors such as emotional stress or physical stress, our case highlights a unique association between steroid and Takotsubo Cardiomyopathy (TCM). In this instance, we present a rare case involving a 72-year-old family patient with a medical history significant for immune thrombocytopenia (ITP) and coronary artery disease status post-stent placement in the left anterior descending artery 16 years ago in 2009. The patient presented with cardiac chest pain, and while cardiac catheterization ruled out coronary artery disease, the left ventricle gram strongly suggested Takotsubo cardiomyopathy, a diagnosis later confirmed by a surface echocardiogram. Interestingly, the patient denied recent catastrophic events causing stress but revealed that the patient was taking 40mg of dexamethasone for five days for ITP management.