Case Presentation: An 83-years-old female with hypothyroidism, diabetes type 2, hypertension and atrial fibrillation presented with two-week progressively worsening right-sided ptosis, dysphagia, dry mouth, generalized weakness and recurrent falls. She denied chest pain, dizziness, palpitations, syncope or seizure history. She was treating stage IV metastatic gastric adenocarcinoma intestinal type diagnosed 4 months before admission with [...]

Case Presentation: A 39-year-old male post-splenectomy due to hereditary spherocytosis presented with syncope, fatigue, fever and dark urine. He had associated tachycardia and fever. Physical exam was unremarkable. Labs showed an elevated lactate, creatinine, bilirubin, transaminases, and markedly elevated D-dimer. CBC was normal. He received IV fluid resuscitation and IV Rocephin. The patient subsequently desaturated [...]

Case Presentation: A 43-year-old male from Guatemala with a history of alcohol abuse, brief incarceration and nephrolithiasis presented to the emergency room with abdominal pain and bloody diarrhea. He was found to have a psoas abscess and subsequently underwent radiologic aspiration and drainage of the lesion. Given the unusual intraosseous features on imaging, the patient [...]

Case Presentation: Patient was a 26-year-old female with history of methamphetamine abuse, previous C trachomatis infection, and heart failure with reduced ejection fraction who presented via EMS for acute hypoxic respiratory failure and unresponsiveness and was intubated in ED. Initial vitals include systolic blood pressure of 80, undetectable diastolic blood pressure, heart rate of 168 [...]

Case Presentation: A 63-year-old male was admitted to the hospital for dizziness secondary to heart failure exacerbation and incidentally found to have thrombocytopenia of 141,000 on admission. Over the next 72 hours, the patient’s platelet count decreased by over 50% to 51,000 while all other cell lines remained stable. The patient had not received any [...]

Case Presentation: A 54-year-old woman with type 2 diabetes mellitus with hyperglycemia and hypertension presented to our hospital with new fevers, nausea, vomiting.Four days prior, the patient was found to have a diabetic foot infection and started on trimethoprim/sulfamethoxazole (TMP-SMX) and metronidazole as an outpatient. At this time, her sodium was 133, corrected to 139 [...]

Case Presentation: Acquired hemophilia A is a rare disorder related to autoantibodies against factor VIII (Fc VIII) and reduced Fc VIII/VIII inhibitors causing bleeding. The incidence is 1 to 1.5 per million a year with 78 years as a median. Diagnosis is crucial due to the mortality can include spontaneous hemorrhages into skin, muscles, soft [...]

Case Presentation: A 46-year-old healthy man presented with bilateral limb swelling, shortness of breath, fatigue, and orthopnea for one week. A transthoracic echocardiogram revealed a decreased ejection fraction (35-40%), severe pulmonary hypertension, diffuse hypokinesis, and significantly increased left ventricular wall thickness. Notably, he had presented with similar symptoms seven months earlier. At that time, he [...]

Case Presentation: A 53-year-old male with a complex medical history including hypertension, diabetes, peripheral vascular disease, abdominal aortic aneurysm, and non-small cell lung cancer presented with persistent headaches, dizziness, and an unsteady gait. Initial CT scan revealed a left cerebellar mass with fourth ventricle effacement, prompting transfer to our intensive care unit for urgent neurosurgical [...]

Case Presentation: A 73-year-old male with a past medical history of hypertension and benign prostatic hyperplasia presented to the emergency department (ED) with acute onset generalized weakness, nausea, emesis, diarrhea, fever, and dyspnea approximately 2.5 hours after taking a combination pill of losartan-hydrochlorothiazide (HCTZ). The patient reported that he had been prescribed losartan-HCTZ 50-12.5 mg [...]