Case Presentation: A previously healthy 54-year-old man presented with three days of fever, right upper-quadrant abdominal (RUQ) pain, and non-bloody diarrhea after returning from a trip to Massachusetts. He worked in an outdoor occupation with frequent interstate travel. Initial evaluation showed a temperature of 37.8 °C, mild RUQ tenderness, hemoglobin 13.8 g/dL, WBC 2.47 × [...]

Case Presentation: An 87-year-old woman presented with generalized malaise 3 days after starting Trimethoprim-Sulfamethoxazole (TMP-SMX) for treatment of a UTI. Admission vitals were within normal limits and examination was benign with a baseline mental status. Labs on arrival were notable for sodium of 120mmol/L, serum osmolality of 253mOsm/kg, potassium 4.3mmol/L, bicarbonate 18mmol/L, urine sodium of [...]

Case Presentation: A 39-year-old previously healthy woman presented with left periorbital pain and rash, followed by progressive paresthesia in the left upper and lower extremities. She was initially diagnosed with preseptal cellulitis and discharged on cephalexin, but returned four days later with worsening paresthesia. She had recently traveled to Pennsylvania and Upstate New York, but [...]

Case Presentation: A 50-year-old previously healthy man presented with three weeks of progressive low back pain following a recent tooth extraction. Symptoms progressed to bilateral lower extremity weakness, perineal numbness, and night sweats. He was afebrile and normotensive. Examination revealed lumbar midline and paraspinal tenderness, bilateral proximal 4/5 lower extremity strength, and positive straight-leg-raise test [...]

Case Presentation: A 63-year-old woman with hypertension and essential thrombocytosis presented with transient left eye vision loss. Imaging revealed a left parietal stroke, moderate stenosis of the left internal carotid artery (ICA), and diffuse intracranial atherosclerosis. She was discharged on dual antiplatelet therapy. One week later, she presented with complete left eye vision loss and [...]

Case Presentation: A 52-year-old man with pulmonary sarcoidosis and epilepsy was admitted with paranoia and disorganized behavior. Exam was only notable for agitation. Labs were unremarkable, and he was admitted to psychiatry service. The patient was diagnosed with neurosarcoidosis four years prior after presenting with seizures. MRI at that time showed frontotemporal and leptomeningeal enhancement. [...]

Case Presentation: An 81-year-old man with neurocognitive disorder, diabetes, hypertension, autoimmune sclerosing pancreatitis, and treated pulmonary tuberculosis presented with acute, painful right-sided neck swelling. On admission, he was afebrile and normotensive. Exam was notable for large, tender cervical mass without buccal lesions, and auscultation demonstrated decreased breath sounds over the right lung field. Labs revealed [...]

Case Presentation: A 67-year-old man with remote smoking history presented with acute onset hemoptysis and progressive shortness of breath. On presentation, he was tachycardic to 108 bpm, normotensive and hypoxemic to 88% on room air. Physical examination revealed diffuse bilateral crackles without wheezing. Initial laboratory studies showed Hb 9.8 g/dL and normal platelet count and [...]

Case Presentation: A 26-year-old male with depression and anxiety on fluoxetine 30 mg daily and daily cannabis use was admitted to the ED for intractable vomiting and was presumed to have cannabinoid hyperemesis syndrome (CHS), consistent with multiple prior admissions. On arrival his vitals included BP 151/98, HR 98, RR 20, Temp 97.3F, and SpO2 [...]

Case Presentation: A 61-year-old man with type 2 diabetes, autonomic neuropathy, prior right partial hallux amputation, right third metatarsal head resection, and previous right ring finger I&D presented with two weeks of swelling, erythema, drainage, and distal numbness of the right second finger. He has a longstanding finger chewing habit and had recently completed a [...]