Case Presentation: We report the case of an 80-year-old woman with known Graves disease who presented to a community hospital with atrial fibrillation with rapid ventricular response and congestive symptoms following a respiratory infection. Despite aggressive initial medical therapy which included beta-blockade, high-dose methimazole, corticosteroids, and cholestyramine, the patient demonstrated persistent tachyarrhythmia and clinical instability. [...]

Case Presentation: An 83-year-old Japanese man with hypertension presented with painful oral ulcers localized to the left side. He later developed a sore throat, dysphagia, and hoarseness, prompting admission. He was referred to the otolaryngology department, where laryngoscopy revealed ulcers confined to the left oropharynx and partial paralysis of the left vocal cord (Fig. 1). [...]

Case Presentation: We present a case of a 54-year-old male with history of severe Aortic Insufficiency s/p Bioprosthetic aortic valve replacement (February, 2025), Chronic kidney disease, Congestive Heart Failure with reduced EF (30-35%), and Severe periodontal disease who presented with progressive fatigue, dyspnea and worsening leg edema concerning for prosthetic valve endocarditis (PVE). Transesophageal Echocardiogram [...]

Case Presentation: A 46 year-old man with paraplegia from a gunshot wound to the spine complicated by neurogenic bladder with bilateral nephrostomy tubes, CKD III, and recurrent urinary tract infections, presents to the emergency department with gradual decrease of urine output from the right nephrostomy tube over the preceding one to two weeks. He also [...]

Case Presentation: The patient is a 70-year-old woman with history of Streptococcus agalactiae native valve infectious endocarditis (IE) complicated by multifocal thalamic infarcts with subsequent porcine mitral valve repair 7 months prior who presented to an outside hospital for generalized weakness and fatigue. On day 4 of admission, she developed a fever and was found [...]

Case Presentation: The patient is a 54 year old male with multifactorial chylomicronemia syndrome (MFCS), one prior episode of pancreatitis, hemochromatosis, cirrhosis, and alcohol use disorder (last drink 2 days prior to admission) who presented with a 2 week history of abdominal pain, chest pain, and malaise. Outpatient blood work one day prior to presentation [...]

Case Presentation: 61-year-old female with history of asthma, hypothyroidism and migraines presented with 6 weeks of intractable headache, nausea and metallic taste. Provoking factors included standing upright and Valsalva maneuvers. Palliation occurred with lying flat. Anti-inflammatories, butalbital-acetaminophen-caffeine and triptans were ineffective outpatient. In the emergency department, IV fluids, ketorolac, diphenhydramine, metoclopramide, magnesium, ketamine and fentanyl [...]

Case Presentation: Our patient is a 73-year-old male with past medical history including monoclonal gammopathy of undetermined significance (MGUS), inflammatory symmetric arthritis, relapsing chondritis, bilateral episcleritis/scleritis, sinusitis, bilateral deep vein thromboses and recurrent pleural effusions. This was refractory to methotrexate, infliximab, rituximab, tofacitinib, and abatacept. He had not tolerated cyclophosphamide, tocilizumab, or sarilumab due to [...]

Case Presentation: Rectus sheath hematoma is a rare cause of abdominal pain. Most are associated with anticoagulant use or trauma. Spontaneous rectus sheath hematoma after coughing or increase in intra-abdominal pressure is rare. Patients’ presentation can mimic other intra-abdominal pathology making it challenging to diagnose without a thorough history, physical examination, and diagnostic imaging. A [...]

Case Presentation: A 61-year-old man with a history of GERD, tobacco, and alcohol use presented to our hospital with a week-long exacerbation of subacute abdominal pain and constipation. He had presented multiple times in recent months to outside hospitals with similar symptoms. CT and MRI scans showed a small bowel obstruction (SBO) with a transition [...]