Case Presentation: This is a case of a 58-year-old male with history of urethral stricture s/p dilation who presented with progressive dyspnea, nonproductive cough and fever. Chest x-ray revealed bilateral diffuse opacification concerning for pneumonia, CTA showed no PE. The patient was initiated on levofloxacin for Pneumonia, heparin infusion for NSTEMI and was admitted to […]

Case Presentation: Patients presenting with melena are often found to have an upper gastrointestinal source: melenic stool on exam has a likelihood ratio of 25 for upper gastrointestinal bleed (1). But what if repeated endoscopies are unimpressive? Mr. S is a 75 year old male with a history of atrial fibrillation on apixaban for three […]

Case Presentation: An 84-year-old woman with a medical history of asthma and hypertension presented with generalized weakness and poor oral intake. Initial vital signs showed heart rate of 108 beats/minute, blood pressure 146/77 mmHg, temperature of 105.5 F and respiratory rate of 15 breaths/minute. Admission labs showed a leukocytosis (78.56 K/uL cells) with blasts, thrombocytopenia […]

Case Presentation: A 43-year-old woman with general anxiety disorder and benzodiazepine abuse was brought to the emergency department by her husband with nausea, diarrhea, agitation, and altered mental status. She also endorsed restlessness and muscle tension. Examination revealed an agitated, disoriented woman with three days of amnesia. Vitals signs were within normal limits. Drug and […]

Case Presentation: A 20-year-old female with systemic lupus erythematosus and end stage renal disease (ESRD) secondary to lupus nephritis on hemodialysis via left upper extremity arteriovenous graft presented to the emergency department for pain, erythema, and swelling of the right inferior breast. She was initially treated for cellulitis with resolution of erythema and warmth of […]

Case Presentation: A 78-year-old female with a medical history of deep vein thrombosis, ovarian cancer status post resection and currently in the TESARO trial (receiving Dostarlimab and Niraparib or placebo; last dose was 3 months ago) presented to the emergency department from her outpatient provider due to inability to obtain a blood pressure reading in […]

Case Presentation: A 62-year-old woman with a history of diabetes mellitus, hypertension, and hypothyroidism presented with a severe headache which was posterior, waxing and waning in nature, and associated with nausea and vomiting. The headache started suddenly five days earlier and had awoken her from sleep. At that time she had presented to the emergency […]

Case Presentation: Hepatitis B is a viral infection that attacks the liver and can cause both acute and chronic disease. The WHO estimates 1.5 million new infections each year. Most people remain asymptomatic. However, some people have acute illness that lasts several weeks, which can be complicated by acute liver failure. Glucose-6-phosphate dehydrogenase (G6PD) deficiency […]

Case Presentation: A previously healthy 18-year-old male presented with a loculated pleural effusion. 10 days prior, the patient had sudden, acute, left sided anterior wall chest pain and shortness of breath. He reported night sweats, but no other symptoms. He was initially treated with doxycycline in the outpatient setting. Despite antibiotics, the symptoms worsened, and […]

Case Presentation: A previously healthy 27-year-old man presented with one week of generalized weakness and lightheadedness upon standing. He works in construction (installing fireplaces) but had been unable to work during the last week due to symptoms. On presentation, he was tachycardic with HR 120; vital signs were otherwise normal. Exam was notable for significant […]