Case Presentation: A 71 year old male with a history of COPD, Hypothyroidism and Stage IIIA Lung Cancer status post wedge resection and prior treatment with chemotherapy and radiation currently on Pembrolizumab who presented with a two week history of fatigue. He denied any recent steroid use. Physical exam revealed hypotension and blood pressures dropping [...]

Case Presentation: A 69 year old male patient who at baseline was fully functional, presented with new-onset, progressive left lower extremity (LLE) weakness for 8 days. Patient’s weakness began with difficulty sitting to standing and progressed to inability to climb stairs, requiring a cane and then wheelchair in a span of 5 days. He had [...]

Case Presentation: A 49-year-old female with Adult-onset Still’s disease on prednisone 40 mg daily for three months presented to ED with right leg weakness and intractable headache for one week. CT head was unrevealing. LP showed an opening pressure of 29.5cmH2O, 97 WBCs (88% lymphocytes), 36 RBCs, protein of 56mg/dL, and glucose of 46mg/dL. CSF [...]

Case Presentation: A 50yo Pacific Islander male with history of ESRD due to DM s/p DDRT (2018) on immunosuppression (tacrolimus, MMF, prednisone), HTN, and type II DM presented with 10 days of fever of undetermined etiology, headache, neck stiffness, nausea, and vomiting. Patient had several ER visits prior to admission, where he was started on [...]

Case Presentation: A 61-year-old man with a history of hypertension and type 2 diabetes mellitus developed tingling, numbness, and burning pain in his feet and calves. He was prescribed gabapentin for presumed diabetic neuropathy but had no relief. Five years later, on a routine MRI of the spine for chronic low back pain, multiple sclerotic [...]

Case Presentation: A 47-year-old woman with schizoaffective disorder and hypertension (HTN) was admitted to the psychiatry ward after found wandering her town. She was hypertensive and tachycardic. Psychiatric exam noted disorganization and appearance of responding to internal stimuli. Lisinopril was resumed for HTN. On hospital day (HD) 16, Medicine was consulted for persistent HTN, which [...]

Case Presentation: A 44-year-old gentleman with a history of traumatic brain injury and schizophrenia presented to our emergency department after reporting chest pain at his group home. He had been started on clozapine 2 weeks prior. This had been titrated up to 100 mg daily, five days prior to presentation. Due to his underlying cognitive [...]

Case Presentation: A 36-year-old previously healthy female presented to the emergency department with one-day history of decreased visual acuity and spontaneous contractions of her right fourth and fifth digits. Review of systems was positive for a month history of dyspnea on exertion, hives, mild edema of ankles, wrists, hands, lips and eyes, as well as [...]

Case Presentation: An uninsured, homeless 26-year-old male with no past medical history presented with two weeks of progressive left eye vision loss described as a central enlarging black spot progressing to complete vison loss. Three months prior, he describes a painless, penile bump and a skin rash which started on his hands and feet. He [...]

Case Presentation: A 24-year-old woman with no medical history presented with eight weeks of nausea, vomiting, and fevers. Six weeks prior to admission she had a positive monospot test, positive EBV IgG, and negative EBV IgM. Two weeks prior, she developed cyclical fevers, night sweats, and weight loss. She presented to the ED due to [...]