Case Presentation: A 57-year-old woman with a history of morbid obesity, cholecystectomy, and prior choledocholithiasis with placement of biliary stents presented with nausea, vomiting, rigors, and fever with epigastric pain radiating to her back. Cardiopulmonary, neurological, and skin exams were unremarkable. Initial laboratory studies showed a white blood cell count of 10.7 x 10^3/µL, AST […]

Case Presentation: A 29-year-old female Jehovah’s Witness presented with three weeks of easy bruising in the absence of trauma. She also noticed heavier and prolonged menstrual flow associated with fatigue and dizziness. She denied medication use, febrile illnesses or neurologic symptoms. Vital signs were normal. Physical exam revealed multiple ecchymoses on bilateral upper and lower […]

Case Presentation: A 42-year-old female with a past medical history of hereditary angioedema, hypertension, and asthma presented to the emergency department with sudden onset weakness and numbness in the right upper and lower extremities, coupled with a posterior “pressure-like” headache. On presentation, she was non-febrile, hypertensive at 169/92 mmHg with a regular heart rate (80 […]

Case Presentation: An 80-year-old female with dementia presented with 4 months of intermittent confusion, hypoglycemia, and associated generalized weakness. Her symptoms resolved with eating. She had no diabetic medications at home. She was hospitalized 1 month prior for these symptoms; her blood glucose during that admission was 39 mg/dL, C-peptide was 6.9 ng/mL (reference range […]

Case Presentation: A 40-year-old male with a history of Psoriatic Arthritis (PsA), managed on weekly Etanercept, presented to our academic medical center with fevers and polyarthralgia. Two weeks prior, he presented to urgent care for fever, chills, arthralgias, and myalgias, where he was diagnosed with an acute viral syndrome. Two days later, he re-presented for […]

Case Presentation: A 55-year-old male with a remote history of intravenous drug use leading to aortic valve endocarditis and bioprosthetic aortic valve replacement, Bentall ascending aortic arch repair, and Micra leadless pacemaker placement, presented to his primary care physician with a petechial rash on his lower extremities. He noted several weeks of malaise and low-grade […]

Case Presentation: A 41-year-old male with a history of recurrent sinusitis, asthma, chronic nephrolithiasis, and open angle glaucoma from steroid use presented to the emergency department with new onset pleuritic chest pain and dyspnea. Over the last 10 years, he had experienced chronic sinusitis that was significantly decreasing his quality of life. The patient previously […]

Case Presentation: A 34-year-old man with a recent history of perforated appendicitis was admitted with a 2-week complaint of nausea, vomiting, abdominal pain and fever. His past history only included an appendectomy 6 months prior, with no history of intravenous drug use, prior diverticulitis, or biliary disease. On exam, he was febrile to 101.1°F, tachycardic, […]

Case Presentation: A 19-year-old female without medical history presented with two days of fever and nausea. Symptoms began abruptly while camping in Canada. She denied tick bites, sick contacts, injections, and trauma other than a cut from a clean razor while shaving. At Urgent Care, she was febrile to 104.9°F, tested negative for influenza and […]

Case Presentation: A 23-year-old female with a one-year history of intermittent back pain who presented to an outside hospital with acutely worsened low back pain, and new onset left leg weakness, constipation, and urinary retention. She did not have health insurance and was unable to seek proper medical care. She had been told her pain […]