Case Presentation: A 65-year-old male with a history of hypertension, hyperlipidemia, gout, chronic rhinosinusitis, and lumbar spinal stenosis with a recent lumbar laminectomy presented with fatigue, hemoptysis, weight loss, and a new purpuric rash with hemorrhagic bullae. On initial blood work, he was found to be in acute renal failure, suspected of being intrinsic due [...]

Case Presentation: A 65 year old male with myelodysplastic syndrome (SF3B1 mutation) on darbepoetin and luspatercept and a history of brain abscess secondary to dental infection with prior bilateral ethmoidectomies and maxillary antrectomies presented after a welfare check revealed altered living conditions and new slurred speech. On arrival, he was afebrile, bradycardic, and hemodynamically stable. [...]

Case Presentation: An 83 year old male with hypertension, chronic urinary retention, recurrent urinary tract infections, and a 2.9 cm bladder stone presented with three weeks of progressive suprapubic pain. He was afebrile (97.9°F), hemodynamically stable (BP 130/95 mmHg, HR 99), and had mild suprapubic tenderness to palpation on exam. Initial studies showed leukocytosis (white [...]

Case Presentation: A 50-year-old male with a history of poorly controlled type II diabetes (recent A1c: 11.2%), hypertension, and recurrent urinary symptoms presented with frequency, urgency, subjective fever, and dysuria one week after Foley catheter removal. The patient was first seen in the emergency department (ED) two weeks prior with dysuria, hematuria, retention with a [...]

Case Presentation: A 61-year-old male with past medical history of hypertension presented for three months of proximal muscle weakness. He had progressive weakness in his legs and shoulders to the point of wheelchair dependence. He also reported dysphagia to solids for two weeks. Workup was notable for anti-nuclear antibody (ANA) 1:1280, elevated aldolase levels, and [...]

Case Presentation: An 82-year-old man was admitted to our hospital for 3 months of progressive generalized abdominal pain, anorexia, and constipation. He had a medical history of bladder cancer and had undergone radical cystectomy and urostomy via ileal conduit. He had pelvic recurrence of disease 8 months prior to admission and started abdominopelvic radiation (60 [...]

Case Presentation: A 20-year-old man with no prior medical history presented to the emergency department with acute onset of bilateral lower-extremity edema, ankle pain, purpuric lesions, erythema, and episodes of palpitations. Further history revealed subjective fevers and conjunctivitis over the preceding three days, self-administration of over-the-counter corticosteroids, and a sexual encounter with a male partner [...]

Case Presentation: A 41-year-old male weightlifter with past medical history of hypertension, hyperlipidemia, anabolic steroid use, and obstructive sleep apnea presented to the emergency department due to acute onset chest pain, and shortness of breath while lifting weights. Initial work-up showed mildly elevated troponins and BNP 1399 pg/mL, but no ischemic changes. Left heart catheterization [...]

Case Presentation: A 32-year-old woman with no prior medical history presented with 3 days of severe diffuse abdominal pain, nausea, vomiting, obstipation, and abdominal distention. She reported no flatus and had recently started drinking a complex herbal tea mixture (>25 herbs) for constipation and improving energy. For over 10 years, she intermittently used unnamed herbal [...]

Case Presentation: A 46-year-old male with chronic polycythemia, recurrent DVTs (2015, 2016, 2021), and on long-term testosterone therapy presented with acute chest pain. Troponins were elevated (0.15 → 35.47 → 65.24 ng/mL). EKG showed inferior and lateral STEMI. Labs were notable for hemoglobin 19.5 g/dL, hematocrit 58%. Emergent left heart catheterization demonstrated 100% mid-circumflex occlusion, [...]