Case Presentation: A five year old male presents to the emergency department with abdominal pain and emesis. Labs were significant for hyponatremia, elevated alkaline phosphatase, mild hyperproteinemia, and leukocytosis with neutrophilia. Urinalysis showed ketones present. A plain film of the kidneys, ureter, and bladder showed distension of the transverse colon and stool in the rectum. […]

Case Presentation: A previously healthy 13-year-old girl presented with chronic abdominal discomfort, significant weight loss (11 kg over 8 months), and hyponatremia in the setting of decreased oral intake. Initial evaluation revealed elevated inflammatory markers, iron deficiency anemia (IDA), and thickened bowel walls on abdominal ultrasound. Then, computed tomography revealed a small bowel obstruction secondary […]

Case Presentation: A 12 month old female with a prior episode of hyperkalemia in the setting of diarrheal illness presented to the Emergency Department with four days of non-bloody, non-bilious vomiting and three days of non-bloody loose stools. Initial outpatient evaluation included normal abdominal ultrasound and serum potassium of 7.1 mEq/L. Patient was admitted for […]

Case Presentation: A 17-year-old African American male with a past medical history of pulmonary embolism (PE) and morbid obesity presented to the hospital for right shoulder pain and dyspnea. On admission, his physical exam findings were most consistent with cellulitis, and he was started on IV vancomycin and PO clindamycin for MRSA and MSSA coverage […]

Case Presentation: Although infrequent, systemic loxoscelism can occur following a brown recluse spider bite and result in dermal necrosis, hemolytic anemia, DIC and renal failure. We present a case of an eight year old male who developed Hemophagocytic Lympho-Histiocytosis (HLH) secondary to systemic loxoscelism. The patient presented with gross hematuria, abdominal pain, and fever. The […]

Case Presentation: A 5 month old boy born at 39 weeks presented with vomiting and lethargy. On the day of presentation, the patient took his morning bottle but refused baby food, then had an episode of non-bilious emesis. Over the course of the day the patient was less interactive and sleeping more. The last bottle was […]

Case Presentation: A seventeen year-old male was admitted for two weeks of intractable nausea and vomiting in the setting of daily marijuana use over the last two years. Symptoms were associated with weight loss (9 kg over 2 weeks) and temporarily improved with frequent hot showers (Figure 1). Despite the use of commonly effective antiemetic […]

Case Presentation: An 18-year-old man presented with 2 weeks of fever, non-productive cough, and sore throat, as well as nausea, emesis, and unintentional weight loss of ~5kg. He was an undocumented immigrant but had not traveled outside of the country in the past 18 months and reported no sick contacts. He worked in landscaping but […]

Case Presentation: Hyperbaric oxygen therapy (HBOT) has been considered a promising modality of treatment for inflammatory bowel disease (IBD) wound treatment. Over the past decade, there has been a rising number of case reports in the adult population demonstrating its safety and efficacy, and a 2021 systematic review found that HBOT was safe and well […]

Case Presentation: A 25-day old, full term male, presented to the ED with one day of decreased oral intake and a rectal temperature of 39.2ºC.In the ED, the patient was febrile to 38.6 ºC and had mottled skin with an otherwise unremarkable physical examination. Initial workup included CBC with a WBC of 3.6 10^3/uL, ANC […]