Case Presentation: A 42-year-old male with a history of intravenous (IV) drug abuse presented with four weeks of skin lesions on his bilateral dorsal forearms and one week of associated right-hand swelling and anesthesia. Prior to the development of the skin wounds, the patient had been frequently injecting fentanyl into the veins of both forearms; […]

Case Presentation: A 44-year-old man with no significant medical history was referred from our ophthalmology clinic with clinical concern for optic neuritis. One week earlier, he noted acute onset of left eye discomfort and blurred vision which evolved to central vision loss and brightness desaturation, accompanied by new headaches. Initial exam and lab work were […]

Case Presentation: A 58-year-old Nigerian American man with a history of pancreatic neuroendocrine tumor with metastases to the liver and spleen, developed large volume hematemesis while traveling in Nigeria, requiring stabilization at a local hospital. He received 13 units of blood and an upper endoscopy revealed gastric varices. Two weeks later, he presented to our […]

Case Presentation: A 55-year-old woman presented with abdominal pain and intractable nausea without constitutional symptoms. Abdominal CT showed duodenal obstruction and hydronephrosis. She underwent two EGD/EUS with benign duodenal and celiac lymph node biopsies. Small bowel follow-through revealed near complete obstruction at the level of the duodenum. Abdominal MRI demonstrated a soft tissue mass-like density […]

Case Presentation: A 53-year-old male with no prior medical history presented to our institution with a 6-day history of fever and lumbar pain. He denied experiencing a sore throat. Upon examination, conjunctival icterus was observed. No dental caries were detected in the oral cavity. Laboratory analysis revealed an elevated inflammatory response, characterized by a white […]

Case Presentation: A 54-year-old male with known human immunodeficiency virus (HIV) presented to the emergency room with three weeks of progressive lower abdominal pain, nausea, chills, and a 15-lb weight loss. The patient had no diarrhea, dysuria, urinary frequency, or penile discharge. He had no recent sexual activity. He was diagnosed with HIV four years […]

Case Presentation: We present a case series of three patients who developed secondary B-cell acute lymphoblastic leukemia (B-ALL) after multiple myeloma (MM) treatment. Case 1: A 71-year-old male with a four-year history of standard-risk kappa MM presented with weakness, fever, cough, and pancytopenia. His MM had initially been treated with six cycles of lenalidomide (R), […]

Case Presentation: We detail the hospital course of a 44-year-old man with HIV, inconsistent treatment adherence, and suspected pulmonary tuberculosis (TB). Referred due to miliary lesions on CT scan post-positive QuantiFERON test, weight loss prompted further investigation. The patient, with a CD4 count of 290 cells/μL, had a history of HAART non-adherence, yet no prior […]

Case Presentation: A 55-year-old female with a history of renal cell carcinoma treated with left-nephrectomy and Pembrolizumab-immunotherapy presents with complaints of weakness, orthostatic hypotension, nausea, and vomiting with food aversion. She had been admitted with similar complaints 9 times since her left nephrectomy, each time having received full workups including extensive sub-specialty evaluations including cardiology, […]

Case Presentation: A 63-year-old man with a history of atopy recently started on dupilumab presented to a hospital in Central Appalachia with 1-week of flu-like symptoms, rigors, and right upper abdomen pain. He was hypoxic with SpO2 75% on room air, febrile to 103.3°F, tachycardic to 105 bpm. He was placed on 2 L nasal […]