Case Presentation: A 42-year-old female with past medical history of systemic lupus erythematosus (SLE) presented to the emergency department with two days of severe polyarthritis in her left wrist, right knee, and lower back. On admission, physical exam was notable for joint swelling and limited range of motion in the wrists, elbows, and knees. Bilateral [...]

Case Presentation: A 55-year-old female with hypertension presented to the Emergency Department with bilateral lower extremity rash. Five days prior, she developed fatigue and small red spots on her distal legs which progressed to pruritic, raised, palpable lesions. Over-the-counter steroid cream reduced the pruritus, but the rash spread proximally, prompting presentation. She was hypertensive with [...]

Case Presentation: A 49-year-old male with a history of hypertrophic cardiomyopathy(HOCM), hypertension, hyperlipidemia, peripheral vascular disease, deep vein thrombosis, type II diabetes mellitus, chronic kidney disease stage 3b, and early-onset cataracts presented with chest tightness and shortness of breath of one-day duration. Vitals included blood pressure 222/72mmhg and tachycardia (110/min). Physical exam notable for short [...]

Case Presentation: A 50-year-old male with a history of smoking and current vape use presented with bilateral flank pain, chills, and dysuria. Two days earlier, he had been seen at an urgent care center, where urinalysis showed hematuria without infection, and a CT scan of the abdomen and pelvis was unremarkable. He was also diagnosed [...]

Case Presentation: A 70-year-old Spanish speaking female was admitted to the hospital with unstable angina. Chart review confirmed that the patient was followed in the cardiology clinic for months for unstable angina and found to have elevated coronary calcium score. Cardiac catheterization was not offered to the patient due to concerns around compliance with dual [...]

Case Presentation: A 69-year-old male with a complex medical history including coronary artery disease, abdominal aortic aneurysm, and polyarthralgia was hospitalized for treatment of lower extremity necrotizing fasciitis and refractory ulcers. During hospitalization, the patient developed intermittent melena. Upper endoscopy was unremarkable. Contrast-enhanced CT revealed biliary dilation with evidence of blood in the biliary system [...]

Case Presentation: A previously healthy53-year-old male, who had undergone dental treatment one week before, was transfered to our hospital with the symptoms of acute-onset cephalgia and right homonymous hemianopia. Upon physical examination, cardiac auscultation revealed a pan-systolic murmur (Levine 2/6), with maximal intensity at the apex. Laboratory analyses revealed leukocytosis with a white blood cell [...]

Case Presentation: A 75-year-old female with a history of Crohn’s disease with known sigmoid colon stricture presented to the Emergency Department with severe abdominal pain; CT abdomen pelvis without contrast revealed pneumoperitoneum, ascites, and a likely perforated colon. She was emergently taken to the OR and subsequently underwent exploratory laparotomy with rectosigmoid colon resection, end [...]

Case Presentation: Microscopic polyangiitis (MPA) is a rare form of small-vessel vasculitis strongly associated with antineutrophil cytoplasmic antibodies (ANCA), particularly myeloperoxidase (MPO-ANCA). While the kidneys are the most commonly affected organ, MPA can also present with pulmonary involvement, manifesting as interstitial lung disease (ILD). This presentation is particularly challenging to diagnose in older adults, as [...]

Case Presentation: A 36-year-old female with history of recurrent pleural effusion presented with worsening shortness of breath. One year prior, she was treated for presumed aspiration pneumonia after a moderate left pleural effusion and left lower lobe consolidation were noted on imaging. Initial ultrasound-guided thoracentesis revealed transudative pleural fluid, resolving her symptoms. Despite repeated therapeutic [...]