ABSTRACTS FROM THE LOUSIANA ACP WITH WINNERS AT ANNUAL MEETING MARCH 2021.2.2 Each year medical students from the four medical schools and residents from the eight Internal Medicine training programs in Louisiana are invited to submit abstracts for the Annual American College of Physicians (ACP) Meeting of the Louisiana Chapter. The content of these abstracts includes clinical case vignettes or research activities. The abstracts have all identifying features removed (i.e., names, institutional affiliations, etc.) before being sent to physician judges. This year a total of 119 abstracts were submitted for the meeting. Each judge scores each abstract independently and then the scores from all judges are averaged and ranked. This year we are excited to be able to publish the three most highly ranked abstracts presented at this year’s competition that were selected for oral presentations. An additional 20 abstracts are published online at https://online.flippingbook.com/view/88196473/5/. All abstracts were presented at the Associates Meeting held virtually due to the COVID-19 pandemic onMarch 13, 2021. We would like to thank the Journal of the Louisiana State Medical Society and appreciate its efforts to publicize the hard work of these trainees.
Shane Sanne, DO, FACP Chair, Louisiana Associates Liaison Committee
Lee S. Engel, MD, PhD, FACP Past Governor, Louisiana Chapter ACP
Angela Johnson, MD, FACP Governor, Louisiana Chapter ACP
NOT THE EXPECTED DIPLOCOCCI: A RARE CASE OF GONOCOCCAL INFECTIVE ENDOCARDITIS J Dubuc, D Montgomery, S Vignes Department of Internal Medicine, LSU Health Sciences Center, New Orleans, Louisiana INTRODUCTION Neisseria gonorrhoeae is a gram-negative diplococci bacteria responsible for over 80 million cases of urethritis in men and women every year. Infections rarely spread to distant sites such as skin, brain, joints, and even heart valves. Gonococcal endocarditis has been described in the literature fewer than 150 times, yet it portends a 19% mortality with 50% of cases requiring surgical intervention.
CASE A 56-year-old Caucasian man with a history of nephrolithiasis, coronary artery disease, and hypertension presented to the emergency department for 5 months duration of chest pain, fever, and chills. The chest pain was described as sternal intermittent aching pain with associated fevers, night sweats and rigors. The patient denied penile lesions, dysuria, and urethral discharge. Other pertinent history includes recent multiple laser lithotripsy procedures to treat nephrolithiasis. Temperature upon arrival to the emergency department was 100.1oF, physical examwas remarkable for a grade II/VI holosystolic murmur at the left mid-sternal border. Labs remarkable for WBC 8.4 10^3/uL ESR 77 mm/hr , CRP 9.7 mg/dL , and BNP 166 pg/mL On trans-thoracic echocardiogram a highly mobile 3.3x1.7cm vegetation on the septal leaflet of the tricuspid valve was visualized resulting in severe tricuspid regurgitation. On hospital day #2, blood cultures resulted positive for Neisseria gonorrhoeae . Empiric antibiotics were changed
16 J LA MED SOC | VOL 173 | WINTER 2021
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