Case Presentation: A 34 year-old woman with no significant past medical or psychiatric history presented to our emergency department (ED) with concern for catatonia. Two months prior, the patient developed sudden onset of bizarre behavior, aggression, and psychosis leading to a one-month admission at an outside psychiatric hospital. She did not improve clinically despite treatment [...]

Case Presentation: A 44-year-old paraplegic male with chronic indwelling foley, chronic thoracic back pain, non-occlusive DVT, anemia, insomnia, and depression who presented with a three week history of abdominal pain, bilateral flank pain, chills, and fever was admitted for ESBL UTI. Hospital course was complicated by hypoglycemia and thrombocytosis due to exogenous testosterone use. During [...]

Case Presentation: A 41-year-old male with a history of intravenous drug use presented with status epilepticus. His seizures were preceded by episodic catatonia, hallucinations, and paranoia over the last two months. He was intubated and admitted to the ICU for evaluation of acute encephalopathy and seizures. Collateral history revealed absence of fevers or headache, and [...]

Case Presentation: Pulmonary renal syndrome is a condition characterized by diffuse alveolar hemorrhage and rapidly progressive glomerulonephritis. It is often associated with vasculitides, but rarely Type I cryoglobulinemic vasculitis. When presenting in the setting of rare comorbidities, it can be confused with pneumonia and acute kidney injury. This patient was a 66-year-old male with a [...]

Case Presentation: A 21-year-old female with prior history of aseptic meningitis presented to the emergency department with progressively worsening headaches and drowsiness for 4 days. On physical examination, she was oriented only to herself but otherwise had no focal neurological deficits or nuchal rigidity. Kernig and Brudzinski sign were negative. Labs were unremarkable, except for mildly [...]

Case Presentation: A 74 year old lady with past medical history of urothelial cancer on pembrolizumab, atrial fibrillation on warfarin, systemic hypertension, diabetes mellitus and stroke presented from an outside hospital to the urology service with complaints of abdominal pain, fever and altered mental status. Her vitals on presentation were within normal limits with physical [...]

Case Presentation: A 56-year-old female with a history of scleroderma, Sjogren’s syndrome, GERD, cirrhosis, HTN presented with abdominal pain for 3 days. She reported nausea without emesis, decreased oral intake, and no bowel movements or passing gas during this time. She denied fevers, night sweats, diarrhea, gastrointestinal bleeding, recent travel, swimming in lakes/rivers, ingesting unclean [...]

Case Presentation: A 51-year-old female with no past medical history presented with a rash that developed a week ago which started on her right calf and then progressed all over her body. She was on ibuprofen for right knee pain for the 3 weeks before her presentation. Vital signs were normal. Laboratory tests revealed leukocytosis, [...]

Case Presentation: A 40-year-old female presented to the emergency department with 4 days of unsteady gait, somnolence, and confusion. Her history included atrial fibrillation, depression, and Degos disease complicated by chronic malabsorption, pain, and jejunal perforations s/p ileocecectomy with total parenteral nutrition (TPN) dependence. She did not drink alcohol. Additional history revealed she switched to [...]

Case Presentation: A 68-year-old female with hypertension and type 2 diabetes presented with diffuse abdominal pain for 2 weeks. Surgical history was remarkable for TAH & BSO. Family history was notable for colon cancer in her father. A physical exam showed abdominal distention, tenderness, and a palpable indurated periumbilical and right flank mass. Vitals were [...]