Case Presentation: A 74-year-old man presented to our rural hospital for evaluation of three days of right flank and abdominal pain with constipation. Initial examination and workup were unremarkable, and the patient was discharged on laxative therapy. Two days later, the patient returned with worsening abdominal discomfort, constipation, and a painful rash to the right [...]

Case Presentation: A 50 year old female with history of type 1 diabetes mellitus, alcohol use disorder, and mood disorder was found down and unresponsive. She was intubated in the ED and admitted to the ICU for further management. Initial laboratory data was concerning for diabetic ketoacidosis, with a pH of 6.8, glucose 794 mg/dL, [...]

Case Presentation: A 66-year-old female presented to the ED with generalized weakness, tremor, diplopia, and slurred speech. The patient’s medical history included TIA, hyperlipidemia, metabolic syndrome, anemia, BPPV, fibromyalgia, syringomyelia, DDD and depression. Notably, this patient was diagnosed with bilateral neuropathy two months prior and self-reportedly experienced gait abnormalities one month prior. Initial exam findings [...]

Case Presentation: A 46-year-old female with history of rheumatoid arthritis and asthma presented with chest and back pain to an outside facility and was evaluated for acute coronary syndrome and cholecystitis. Patient’s absolute eosinophil count (AEC) was 1.76 at that time. Patient was re-admitted with altered mental status and vomiting. Her AEC was 41. Strongyloides [...]

Case Presentation: A 26-year-old woman with systemic lupus erythematosus (SLE) of ten years (status post renal transplant complicated by secondary acute rejection) presented to the Emergency Department with a week and a half of bilateral lower extremity edema and nausea. The patient’s lower extremity edema began nine days prior to admission and was slowly worsening. [...]

Case Presentation: A 69yo man was seen in preop clinic before cystoprostatectomy for a very large bladder tumor that had excellent radiographic response to pembrolizumab. His recent history was notable for an episode of witnessed syncope 5 weeks prior attributed to dehydration in the setting of baseline, long-standing intermittent episodes of SVT. Outpatient ECHO and [...]

Case Presentation: We present the case of a 64-year-old male with a history of pulmonary embolism status post IVC filter, and recent viral constrictive pericarditis with exudative pericardial effusion requiring pericardiocentesis and bilateral pleural effusions requiring chest tubes, who was admitted for dyspnea, cyanosis, and confusion. Vitals were blood pressure 78/51, heart rate 60, respiratory [...]

Case Presentation: 29 year old female presented with 3 days of low grade fever, chills, dyspnea, cough, nausea, headaches, night sweats and myalgias. She also had intermittent fatigue and dyspnea with exertion for the past 3 years. No sick contacts, recent travel, antibiotic use, or weight loss. Medical history included type 1 diabetes, depression, and [...]

Case Presentation: A 73-year-old man presented to his PCP after noticing new onset jaundice. He endorsed 6 weeks of decreased appetite, intermittent abdominal pain and 7-pound weight loss. Lab analysis demonstrated a cholestatic pattern of liver injury and elevated CA 19-9. CT abdomen revealed an infiltrative soft tissue mass originating from the head of the [...]

Case Presentation: A 26-year-old female with PMH migraines presented to the ED with a 3-day history of headaches unlike her migraine headache. The headache was located in the occipital region, pressure-like, not alleviated by acetaminophen, and was associated with blurred vision, left ear throbbing, and neck pain. She also reported recent head trauma. She denied [...]