Case Presentation: A 38-year-old female presented to the emergency department with profuse vomiting, fever, chills, lightheadedness, dizziness, and the inability to tolerate oral intake. She had been in her usual state of health until two hours after returning from a doctor’s appointment where she received methylene blue intravenously. Past history included hypothyroidism, postural orthostatic tachycardia [...]

Case Presentation: A 72 y/o African American male with PMHx of HTN, IDDM, CAD, ESLD 2/2 Hepatitis C in remission with portal hypertension and hepatocellular carcinoma s/p radioembolization presented after a fall at home. He had generalized weakness for 3 weeks with worsening over last 3 days. His ROS significant for diarrhea from lactulose and [...]

Case Presentation: A 83-year-old female with PMH of hypertension, type II diabetes mellitus, and prior tobacco use initially presented to the ED for generalized weakness. Initial exam was notable for hypertension and slowly healing wound on her right leg s/p mechanical fall several weeks prior. Her labs revealed hyperglycemia with serum glucose > 500 in [...]

Case Presentation: A 62-year-old female presented with a two-week history of exertional dyspnea, orthopnea, lower extremity edema, and headaches. She had puffy hands, diffuse joint pain, and skin thickening which limited range of motion of her wrists, elbows, ankles, and knees. She was hypertensive with rales and moderate edema to the knees bilaterally. BNP and [...]

Case Presentation: A 90-year-old man with chronic kidney disease and benign prostatic hyperplasia presented with a 4-month history of persistent mucous diarrhea, abdominal pain, and a few episodes of enterorrhagia. On exam, vital signs were normal except for hypotension. He was in mild acute distress but alert and oriented. He had dry mucous membranes and [...]

Case Presentation: A 41-year-old male with a past medical history of hypertension and occasional alcohol use presented to our facility for progressively worsening shortness of breath and flu-like symptoms of six days duration. The patient was started on oseltamivir at an urgent care two days prior to presentation. On evaluation, the patient was diaphoretic and [...]

Case Presentation: A 74-year-old Hispanic male patient with a history of monoclonal gammopathy of undetermined significance presented with worsening right upper extremity (RUE) motor weakness for the last few months. This was present in an ulnar nerve distribution with muscle wasting in the hypothenar and fourth and fifth metacarpal areas. Blood work was notable for [...]

Case Presentation: A 32-year-old man with AIDS (CD4 count 45) presented to the emergency department for altered mental status. More specifically, he reported 5 days of severe bitemporal headache, fatigue, memory disturbance, blurry vision, dizziness, and subjective fevers. His review of systems was also positive for acute-on-chronic diarrhea and a diffuse rash. Given his diagnosis [...]

Case Presentation: A 66-year-old man with history of atrial fibrillation, heart failure, hepatocellular carcinoma (HCC), bipolar disorder, and gout presented with lightheadedness and a syncopal episode with tremulousness and confusion. His reported medications included apixaban, carvedilol, risperidone, and allopurinol. Vitals were notable for tachycardia but otherwise normal. Physical exam was notable for irregularly irregular heart [...]

Case Presentation: An 80-year-old female was admitted with sudden right-sided weakness, expressive aphasia and left partial loss of vision. She denied preceding temporal tenderness, jaw claudication, headaches, history of tick bites, and new rashes. While her weakness and aphasia resolved within an hour, her vision impairment persisted. Initial CT and MRI scans showed no acute [...]