Cor triatriatum is a rare, congenital heart defect. When diagnosis does not occur in infancy, primary symptoms in an older patient may mimic reactive airway disease. We report a case of cor triatriatum in an older child, previously diagnosed with asthma, presenting to an emergency department with a chief complaint of wheezing. Initial treatment with bronchodilators and corticosteroids was unsuccessful, prompting thorough evaluation. Subsequent imaging diagnosed cor triatriatum sinister. When presentations consistent with common conditions, such as asthma, do not respond appropriately to classic intervention, emergency physicians must be prepared to consider alternative and rare diagnosis.

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Introduction: Patients with naturally occurring, impaired cell-mediated immunity secondary to age and pregnancy are known to be at risk of developing severe and invasive Listeria monocytogenes infections. Immunosuppressant medications, particularly infliximab, are also known to increase this risk. Case Report: We present the case of a seven-year-old female on infliximab who was diagnosed with culture positive L. monocytogenes meningitis after a negative cerebral spinal fluid polymerase chain reaction (PCR). Conclusion: Patients receiving infliximab who display signs of central nervous system infection should be suspected to have L. monocytogenes as an infecting agent, and empiric addition of ampicillin to their antibiotic regimen should be considered, with substitution of trimethoprim-sulfamethoxazole in cases of penicillin allergy, regardless of initial PCR results.

Case study of a patient (pt) presenting with positional loss of muscle tone and deep tendon reflex (DTR) of the left lower extremity (LLE). MRI identified lumbar spinal stenosis but failed to identify other disease processes accounting for the motor deficit. We hypothesized that an increase in sedentary lifestyle related to the stay at home order for the 2020 COVID-19 pandemic, superimposed on generalized deconditioning resulting in postural disturbance, led to anatomic dysfunction sufficient to block motor signals to the LLE. Conservative management including positioning, stretching, and manual therapy allowed the pt to demonstrate a return of active movement of the LLE against gravity in all major joints. This treatment protocol is presented as a novel, conservative approach to restoring functionality in a pt with a rare symptom of spinal stenosis: Functional monoplegia of a lower extremity. This case report additionally discusses the suspected functional impact of the COVID-19 stay at home order on the geriatric population.