Case Presentation: A 17-year-old female with a past medical history of allergic rhinitis presents as transfer from an outside hospital for hemoptysis and chest pain. She reports three episodes of ¼ cup worth of bright red blood occurring within the last six months. No reported triggers and no history of trauma, smoking, vaping, lung or […]

Case Presentation: A 14-year-old male with autism spectrum disorder presented with history of 5 days of refusal to move and imbalance for 2 days, following diarrheal illness two weeks prior. On admission, he was tachycardic and hypertensive with dry mucous membranes. His neurologic exam was limited by agitation but demonstrated symmetric facies and 5/5 strength […]

Case Presentation: A 9 month old boy was brought to the emergency department for two day history of right arm edema and refusal to move his right arm. He began having rhinorrhea and cough earlier in the week then developed non-bloody diarrhea. During that time period he had fevers up to 102.5 that responded to […]

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 […]