Background: Neurogenic pulmonary edema (NPE) is a rare pulmonary edema that develops rapidly after an acute central nervous system injury. The mechanism by which neurological insult leads to pulmonary edema is not well understood. The clinical presentation of NPE varies widely and ranges from asymptomatic cases to fulminant cases. Clinical signs in pure NPE are usually those of acute pulmonary edema, without signs of left ventricular failure. Case Report: The author presents a case of NPE is a young female patient with a brief epileptic seizure in which NPE resolved within 48 hours. Patient had no respiratory symptoms but was initially placed on antibiotics because her chest x-ray showed bilateral lung patchy opacifications in a perihilar distribution suggestive of pulmonary edema and/or multifocal pneumonia. Antibiotics was discontinued when the pulmonary edema resolved. Conclusion: There is need for physicians to be aware of NPE to avoid unnecessary antibiotics in asymptomatic patients who present with bilateral pulmonary infiltrates following an epileptic seizure.

Hypothyroidism is characterized by a broad clinical spectrum ranging from asymptomatic or subclinical hypothyroidism to overt myxedema and multisystem failure. Pericardial effusion occurs frequently in myxedema but is rare in other stages of hypothyroidism because of the timeliness in which hypothyroidism is nowadays detected and treated. The author reports a case of progressively worsening pericardial effusion from refractory hypothyroidism secondary to autoimmune atrophic gastritis. The approach to managing pericardial effusion complicating refractory hypothyroidism is discussed.

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Mucormycosis is a life-threatening invasive fungal infection usually seen in immunocompromised patients and patients with poorly controlled diabetes mellitus with or without diabetic ketoacidosis. We present a rhino-orbito-cerebral mucormycosis (ROCM) case in a coronavirus disease 2019 (COVID-19) patient complicated by the optic nerve and optic tract ischemia with ischemic neuropathy. Both CT and MRI played an essential role in diagnosing ROCM and the accompanying complications in our patient.CT showed sinonasal sinusitis and MRI showed the sinusitis and its progression to ROCM. MRI also showed necrosis involving the bilateral orbits, basal ganglia, thalamus, internal capsule, hypothalamus, optic chiasm, optic nerves, olfactory bulbs, and skull base. ROCM associated with optic nerve ischemia is a rare but life-threatening complication of COVID-19, especially in patients with underlying diabetes and/or those treated with corticosteroids. Physicians should be aware of this complication as early diagnosis may improve the chances of survival in such patients.