Case Presentation: A 74-year-old man with a medical history of hepatitis C cirrhosis post-treatment was evaluated after he was found to have hepatocellular carcinoma on abdominal MRI. The carcinoma occupied almost the entire right hepatic lobe with macrovascular invasion without evidence of metastatic disease. The initial alpha-fetoprotein level exceeded 2000 nanograms per milliliter. Subsequently, the [...]

Case Presentation: A 65-year-old female with a history of focal epilepsy and carotid stenosis with recent endarterectomy presented with four weeks of abrupt aphasia, right sided weakness and several days of altered mental status and unusual left-hand movements. Since the endarterectomy one month prior to presentation, her family reported cognitive decline, memory loss and increased [...]

Case Presentation: A 32-year-old man with AIDS (CD4 count 45) presented to the emergency department for altered mental status. More specifically, he reported 5 days of severe bitemporal headache, fatigue, memory disturbance, blurry vision, dizziness, and subjective fevers. His review of systems was also positive for acute-on-chronic diarrhea and a diffuse rash. Given his diagnosis [...]

Case Presentation: 47 year old male with left temporal meningioma s/p resection, and recent immigration from India presented with fevers and worsening encephalopathy. CTH was unremarkable however MRI showed leptomeningeal hemispheric, brain stem, and cord signal with perivascular enhancement concerning for CNS TB however included a broad differential. He was started on empiric antibiotics for [...]

Case Presentation: A 35-year-old woman with no significant medical history presented with severe headache, neck pain, photophobia, fevers, nausea, vomiting, and petechial rash for 5 days. She had recently attended a large outdoor wedding in rural Iowa. On exam her vital signs were within normal limits and neurologic exam was without focal deficits or meningeal [...]

Case Presentation: A 56-year-old female with stage IIB T2N0M0, grade 3, and triple negative breast cancer, was treated with lumpectomy and neoadjuvant chemoimmunotherapy (dose-dense doxorubicin and cyclophosphamide followed by carboplatin/paclitaxel/pembrolizumab). This resulted in near-complete remission. However, evidence of residual disease was found and she was started on pembrolizumab and capecitabine for 3 months. She presented [...]

Case Presentation: A female patient in her 70s, with a history notable for hypothyroidism who initially presented to an outside hospital with complaints of left-hand paresthesia, numbness, and dizziness. She underwent an extensive work up for CVA with no acute findings on non-contrast MRI brain or cervical spine. During her hospital course she developed worsening [...]

Case Presentation: Our 28-year-old female patient with a history of acute myeloid leukemia (AML) and allogeneic peripheral blood stem cell transplant presented to the Emergency Department (ED) for the evaluation of intermittent confusion and word-finding difficulty for one week. The patient’s vitals on admission were within normal limits. A physical examination was significant for diffuse [...]