The 2019 coronavirus disease (COVID-19) can present with a wide variety of clinical manifestations, including a hypercoagulable state leading to both arterial and venous thrombosis. Portal vein thrombosis (PVT) in the setting of COVID-19 has rarely been reported in the medical literature. Pylephlebitis with concomitant liver abscess is a rare complication of intra-abdominal infection. Here, we present the case of a 49-year-old man who initially presented with intermittent fevers and generalized weakness of 1-month duration and was subsequently found to have COVID-19 infection, PVT, and Bacteroides fragilis bacteremia with associated pyogenic liver abscess. The patient was treated with intravenous antibiotics and oral anticoagulation with plan to follow up outpatient with gastroenterology in 3 months to ensure resolution of PVT and liver abscess.

Cerebral venous sinus thrombosis (CVST) is a rare etiology of stroke that results from inherited and/or acquired conditions, which can present in a variety of symptoms. CVST in the setting of the 2019 coronavirus disease (COVID-19) has rarely been observed. Herein, we present the case of a 32-year-old female with a recent history of COVID-19 subsequently found to have CVST involving bilateral transverse sinuses. Further workup demonstrated several hypercoagulable conditions, which were likely exacerbated by the viral infection. This case demonstrates an atypical outcome for young, COVID-19-positive patients, which emphasizes the importance of diligence when examining symptomatic patients with a history of COVID-19 infection. The patient was treated with apixaban therapy with radiographic resolution of bilateral CVST and improved vision.

This report describes the case of a 73-year-old female patient who presented with abdominal symptoms. A colonoscopy identified a cecal mass confirmed as mantle cell lymphoma (MCL). Imaging showed extensive lymph node involvement. The patient received rituximab, cyclophosphamide, hydroxydaunorubicin, vincristine, and prednisone (R-CHOP) chemotherapy, resulting in tumor reduction and adenopathy resolution. Despite a typically unfavorable prognosis associated with a high Ki-67 index, the patient responded well to chemotherapy and achieved a favorable outcome. This case highlights the importance of early detection, appropriate treatment which in our case was R-CHOP, and personalized management approaches in addressing MCL.

Atypical hemolytic uremic syndrome (aHUS) is a rare condition among thrombotic microangiopathies (TMA). Pregnancy is a known precipitating factor of complement mediated TMA. The occurrence of microangiopathic hemolytic anemia, thrombocytopenia and acute kidney injury presents diagnostic and therapeutic challenges. Diverse causes include hemolysis, elevated liver enzymes, and low platelets (HELLP syndrome) in pregnant women. In pregnancy or postpartum, the occurrence of aHUS is a critical complication requiring urgent diagnosis and treatment. aHUS is considered to be the result of the underlying condition, with the understanding that therapy is focused on the underlying condition. Five documented cases of pregnancy-associated aHUS treated with Eculizumab have been reported, making the condition extremely rare. We present the case of a pregnant woman with HELLP syndrome induced aHUS. The patient presented with evidence of dysregulation of the complement system and renal insufficiency. Since the initiation of Eculizumab, a C5 complement inhibitor, the development of renal insufficiency diminished and the patient became dialysis independent.