Case Presentation: A 70-year-old male with a history of metastatic renal cell carcinoma (RCC) on cabozantinib and nivolumab presented with an extensive, blistering skin rash. He initially noted faint erythema and blisters over his right elbow a week ago which spread to his arms, hands and feet. His oncologist had prescribed high dose prednisone, however [...]

Case Presentation: A 19-year-old female presented with 1 month of worsening abdominal pain, 3 weeks of fevers / chills, 1 week of nausea/vomiting, and 4 days of rash. Her abdominal pain was intermittent, stabbing, diffuse, and worsening in severity. She also had daily chills and fevers (maximum temperature of 38.9 °C). Her emesis was non-bilious [...]

Case Presentation: A 90 year old Caucasian female with history of complicated diverticulitis s/p partial colectomy and Waldenstrom’s Macroglobulinemia (last treatment with Cyclophosphamide and Dexamethasone 1 week prior to presentation) was admitted with 2 day history of crampy lower abdominal pain, bloody streaked diarrhea, vomiting, and subjective chills. Physical examination elicited tachycardia and diffuse abdominal [...]

Case Presentation: A 23-year-old male with past medical history significant for recovered COVID 19 pneumonia one year prior presented to the Emergency Department with a chief complaint of shortness of breath with exertion that was gradually worsening. He endorsed increased weakness, fatigue, and pallor over a similar time span. The onset was two weeks prior. [...]

Case Presentation: A 54-year-old man with a past medical history of intravenous drug use and morbid obesity presented with worsening bilateral lower leg pain and swelling. The patient reported chronic bilateral leg edema after a car accident a year before and started noticing skin changes with multiple bumps on his legs for several months. He [...]

Case Presentation: Immune checkpoint inhibitors have evolved into the conventional therapy regimen for many cancer types. The major categories of immune checkpoint inhibitors include monoclonal antibodies against cytotoxic T lymphocyte antigen (CTLA-4), programmed cell death protein-1 (PD-1) and programmed cell death ligand molecules (PD-L1). Pembrolizumab has been implicated in causing hepatitis Discussion: An 89-year-old Caucasian [...]

Case Presentation: A 35-year-old female dog groomer with a history of an ovarian cyst presented as a direct admission from the Gastroenterology clinic due to worsening upper abdominal pain and weight loss for 2 months. An abdominal CT obtained two weeks prior showed a large left liver lobe mass measuring 6.3 x 4.6 cm. On [...]

Case Presentation: Implanted central venous port catheters (ports) are widely used for chemotherapy, total parenteral nutrition and blood monitoring. If placed in the subclavian vein, up to 15% of patients who receive implanted ports have immediate complications, including venous injury, pneumothorax and pneumomediastinum. Long-term ports are associated with delayed complications, including thrombosis, occurring in 1.9-21.5% [...]

Background: High rates of venous thromboembolism (VTE) have been reported with coronavirus disease 2019 (Covid-19). However, studies have predominantly focused on hospitalized patients. The risk of VTE in outpatients with Covid-19 is less known. Methods: We conducted an observational study of adults (age ≥18 years) enrolled in two large, integrated healthcare delivery systems serving >9 [...]

Background: The diagnostic process is dynamic – as additional information becomes available and diagnostic uncertainty is addressed, diagnosis evolves. An accurate and updated problem list in the electronic health record (EHR) should reflect modifications and refinement of the working diagnosis (1). Anecdotally, this does not happen: many providers do not the update problem list or [...]