Background: Symptomatic venous thromboembolism (VTE) occurs in about 1% of patients within 3 months after admission to a medicine ward.1,2 The 9th Edition American College of Chest Physicians Guidelines recommends the use of pharmacologic VTE prophylaxis in acutely ill hospitalized medical patients at increased risk of thrombosis and suggests against its use in low risk [...]

Case Presentation: A 13-year-old female with Aicardi syndrome and treatment-resistant epilepsy presented to the emergency department with several weeks of diarrhea and vomiting. Her review of symptoms was negative for recent fevers, chills, shortness of breath, cough, sick contacts, or respiratory distress. Physical exam was notable for intermittent discomfort with palpation in the right upper [...]

Case Presentation: 62-year-old Caucasian female with no significant medical history presented with complaint of worsening generalized weakness, difficulty with word finding, blurred vision, left arm and leg weakness ongoing for 3-4 weeks. 3 weeks ago she was discharged from an outside hospital after evaluation for similar complaints. Since discharge had worsening weakness, and decided to [...]

Case Presentation: A 68-year-old man with a history of cryptogenic cirrhosis and hepatocellular carcinoma status post liver transplant with donor positive for cytomegalovirus (CMV), and recent treated CMV reactivation, was transferred from a nearby hospital with acute hypoxic respiratory failure requiring intubation secondary to Pneumocystis jirovecii pneumonia (PJP) identified on bronchoalveolar lavage. He was treated [...]

Case Presentation: A 34 year old male with a medical history of polysubstance abuse and hypothyroidism presented from subacute rehab after a combined thoracolumbar and sacral fixation surgery with worsening generalized weakness. The patient described deconditioning with increased difficulty standing despite 3-4 hours of daily physical therapy. Other acute symptoms included insomnia and mood swings. [...]

Case Presentation: A 60-year-old female with a history of ulcerative colitis, hypertension and paternal history of Huntington’s disease was diagnosed with mild COVID 19 infection in September 2021. Three weeks later, she started noticing that she was clumsy, and dropping things. She then started having jerky, spasmodic, involuntary movements of her head, upper extremities, and [...]

Case Presentation: Central Adrenal Insufficiency (CAI) is a rare and often late diagnosis due to nonspecific signs, such as fatigue, hyponatremia, electrolyte abnormalities and fever of unknown origin (FUO). CAI suspicion arises in patients with pituitary tumors, cranial irradiation, surgery, injury, infection, exogenous glucocorticoid withdrawal, and less commonly known, opioid use disorder. A 31-year-old male [...]

Case Presentation: A 56-year-old man with active polysubstance use disorder including daily intranasal heroin and cocaine use and previous abdominal surgery was admitted with a week of abdominal pain and constipation. His last bowel movement was one week prior to admission, though he did report ongoing flatus without nausea or vomiting. The abdomen was diffusely [...]

Case Presentation: Anti-melanoma differentiation-associated gene 5 dermatomyositis (MDA5-DM) is a subset of amyopathic dermatomyositis that may present with oral ulcerations, painful palmar papules, arthritis, and panniculitis.1 Unique characteristics of MDA5-DM versus other types of dermatomyositis include a higher incidence of interstitial lung disease (ILD), lower incidence of myositis, and a higher rate of morality. MDA5-DM [...]

Case Presentation: A healthy 32-year-old male presented with fever and myalgia followed by multiple episodes of vomiting and diarrhea for the past few days. On admission, patient had a fever of 101F, tachycardia of 118, blood pressure of 118/66 mmHg. His oxygen saturation was 100% on room air. Physical exam was unremarkable. COVID-19 test was [...]