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Aspirin-exacerbated respiratory disease (AERD) consists of a triad of asthma, chronic rhinosinusitis with nasal polyposis, and a hypersensitivity reaction to aspirin consisting of nasal congestion and broncho-constriction. This disease presents a conundrum in cardiac patients undergoing percutaneous catheterization intervention (PCI) who might require stent deployment due to the need for aspirin as part of the dual antiplatelet therapy required if a stent is placed. Here, we present the case of a patient who underwent a coronary angiogram showing two-vessel disease but had to undergo aspirin desensitization first before planned PCI as he had a history of severe aspirin allergy in the past., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Landa et al.)

Sapovirus causes acute gastroenteritis (AGE) which manifests as severe diarrhea and vomiting. It is most often seen in, but not limited to, children and toddlers but can occur in people of all ages. It is typically more prevalent in low to middle-income countries but has also been reported in progressive countries such as the United States. Due to the universal use of reverse transcriptase-polymerase chain reaction (RT-PCR) testing, the reported incidence of sapovirus has continued to grow as the culprit agent in both AGE outbreaks and isolated cases. Its symptoms resemble what is seen with rotavirus but with a milder clinical course. This discussion explores the dire implications of a relatively understated pathogen. Here, we present a rare case of a 20-year-old woman who presented with septic shock secondary to severe gastroenteritis as a result of sapovirus infection., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Landa et al.)

An aortic dissection is a life-threatening event that requires urgent evaluation. A dissection is defined as a tear in the innermost layer of the aortic wall forming a true and false lumen. This is normally diagnosed with a CT with contrast when clinical suspicion is present. Deciding whether urgent surgical intervention is required is key, as it may determine the survival of the patient. The treatment of type A aortic dissection involves emergent open-heart surgery. Medical treatment and clinical follow-up are recommended for uncomplicated type B dissections. In this report, we present a case of an extensive type B aortic dissection in an asymptomatic patient who required immediate surgical intervention., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Landa et al.)

Varicella zoster is one of the common causes of aseptic meningitis, typically seen in immunosuppressed individuals and rarely in the immunocompetent. The varicella zoster virus (VZV) infection is normally associated with a dermatomal rash in the abdomen with spread to the back. The small prevalence of VZV in immunocompetent individuals may be due to lack of recognition; thus, it is always important to keep it in mind when meningitis is in the differential. Here, we present a case of varicella zoster meningitis in an immunocompetent adult presenting with slurred speech, dizziness, and episodes of confusion., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Landa et al.)

Thrombocytopenia is a common clinical condition, and drug-induced immune thrombocytopenia (DITP) should be considered in hospitalized patients with severe thrombocytopenia who are exposed to new medications. The potential mechanism is described to be drug-triggered antibody-mediated platelet destruction causing petechiae and mucosal bleeding. Severe form of DITP can be refractory to systemic steroids and even intravenous immunoglobulin administration. Such cases usually require splenectomy for definitive treatment. A number of substances including medications, herbal remedies, and even food items have been identified with a definitive or probable causal role in DITP. However, it is rarely reported from locally administered medications such as local anesthetic drugs. We present a unique case of severe DITP from lidocaine that resulted in refractory DITP requiring splenectomy for definitive treatment., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2020, Muhammad et al.)

Spontaneous coronary artery dissection (SCAD) is one of the rarest causes of acute coronary syndromes, which include myocardial infarction (MI), stable and unstable angina, cardiogenic shock, and sudden death. The course of the disease, its etiology, prevalence, prognosis, and treatment remain ill-defined. Adding to the complexity is the fact that patients may lack typical risk factors for coronary heart disease. Herein, we report a case of a 42-year-old woman with vitamin B12 deficiency, who presented with chest pain; electrocardiography (ECG) findings were consistent with the acute anterior wall MI. Cardiac catheterization was done, which showed a very large left anterior descending (LAD) artery dissection., Competing Interests: The authors have declared that no competing interests exist.