Case Presentation: 61 year old Hispanic male with a history of end-stage renal disease receiving scheduled hemodialysis, type 2 diabetes presented with 2 months of progressive abdominal pain and distension, anorexia, and intermittent fevers. He had lived in Fresno, Ca for over 20 years. Five months prior, he was diagnosed and treated for COVID-19 pneumonia. [...]

Case Presentation: A 60-year-old male with chronic kidney disease 3a, hypertension (HTN) and type 2 diabetes was found unresponsive at work. The patient’s home medications were carvedilol, nifedipine, spironolactone and valsartan for his resistant HTN. Initial evaluation revealed undifferentiated shock with an inappropriately low heart rate of 40 beats per minute. Labs showed potassium of [...]

Case Presentation: A 67-year-old male presented with progressive bilateral upper extremity weakness, diplopia and neck pain of 1 week duration. Patient noted to have bilateral facial droop, weakness and areflexia of both upper extremities on physical exam. He reported having fevers and bloody diarrhea a few months prior to presentation. Magnetic resonance imaging (MRI) of [...]

Case Presentation: A 73 year-old man presented with 2 weeks of difficulty completing multi-step tasks, e.g., getting into a car. At baseline, he was independent in instrumental activities of daily living. He had no other symptoms; he denied headache, weakness, numbness, vision changes, confusion, fevers, chills or weight loss. His history included non-alcoholic steatohepatitis with [...]

Case Presentation: A 54-year-old female with a history of alcohol abuse and anxiety was admitted for 1 month of progressive altered mental status preceded by visual hallucinations. Over that time period, her symptoms rapidly progressed to agitation, dementia, and personality change. Physical symptoms included left elbow rigidity, startle myoclonus, and gait ataxia. Laboratory workup was [...]

Case Presentation: A 66-year-old female became noncompliant with home medications presented to the emergency room with altered mental status. She had an established diagnosis of decompensated cirrhosis on a recent discharge from hospital leading to metabolic encephalopathy. Five days into her hospital stay, the patient refused medications and nutrition leading to an IV saline treatment. [...]

Case Presentation: An 84-year-old Caucasian male with a history of hyperlipidemia presented to his primary care provider with a 6-week history of an erythematous rash with associated proximal limb weakness but without complaint of breathing or swallowing difficulties. Statin-induced rash with myopathy were suspected so his statin was stopped, and he was referred for skin [...]

Case Presentation: A 76-year-old male with past medical history of atrial fibrillation s/p ablation, recent pacemaker placement, heart failure with preserved ejection fraction (HFpEF), type 2 diabetes, leukemia, and colon cancer presented to the emergency department for weakness and dyspnea on exertion. Patient appeared volume overloaded with bilateral lower extremity edema with labs remarkable for [...]

Case Presentation: A 22-year-old male with no medical history presented to the emergency department with a 4-day history of fevers and odynophagia which progressively prevented intake of solids and liquids. He reported associated shortness of breath with pleuritic chest pain. He appeared nontoxic with sputum collecting in a bedside cup. He had a fever of [...]

Case Presentation: 72-year-old male with a history of prostate cancer status post prostatectomy, recent diagnosis of pansinusitis and multiple bilateral pulmonary lesions and a mass-like consolidation of the left upper lobe presented complaining of dyspnea. He was receiving treatment for sinusitis and pneumonia with plans for outpatient bronchoscopy to rule out malignancy. On presentation, the [...]