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1 Introduction Intrathoracic kidney (ITK) is a rare congenital condition where the kidney is located above the diaphragm and enters the posterior mediastinum

The chemically synthesized peptide variants exhibit antimicrobial activities against bacteria and fungi

Patients should be instructed to stop the medication and seek urgent medical care for severe or persistent abdominal pain (especially if radiating to the back), right upper quadrant pain with fever, inability to maintain adequate fluid intake for more than 24 hours, or decreased urine output

Documented side effects are usually mild to moderate: Injection-site pain, redness, or bruising Flushing Increased heart rate Nausea or gastrointestinal upset Headache Urinary changes or a fishy body odor at higher choline doses Because these are compounded products, sterile technique, pharmacy sourcing, and formulation verification matter

Carey Nease MD