Case Presentation: We present the case of a 61-year-old female with past medical history of cirrhosis and heart failure status post ICD placement who presented with acute kidney injury and intermittent fevers. She denied recent history of cat bite/scratch, but she had been exposed to a cat with fleas. During her admission, her creatinine peaked [...]

Case Presentation: Systemic Lupus Erythematous (SLE) is an autoimmune condition with a broad variety of clinical presentations. Ascites is a rare feature of SLE, only present in approximately 10% of patients1. Possible causes include serositis, pancreatitis, nephritis, and nephrotic syndrome, constrictive pericarditis and peritoneal inflammation secondary to vasculitis. Though there are documented cases of ascites [...]

Case Presentation: 3 years after liver transplantation, a 53-year-old female on tacrolimus had 4 months of jaundice, abdominal pain, and vomiting with transaminitis and hyperbilirubinemia. At an outside transplant center, two liver biopsies showed cholestasis and inflammation; removal of choledocholithiasis and placement of a biliary stent for an anastomotic stricture resulted in no improvement. She [...]

Case Presentation: A 56-year-old male with stage IV small cell lung cancer and liver metastasis presented with abdominal pain, nausea, vomiting, shaking, increased thirst, urinary frequency, and palpitations. He had recently completed cycle 3 of carboplatin, etoposide, and atezolizumab. On exam, he was afebrile, pulse 124, BP 132/80. Labs revealed WBC 15.3 (post-Neulasta), lactate 4, [...]

Case Presentation: A 47-year-old female with a history of HR+/HER2- breast cancer status post chemotherapy and radiation, currently on exemestane, and bilateral carpal tunnel syndrome, presented with pain and swelling in her left hand, fingers, wrist, and both knees for five days. She reported difficulty walking due to the pain. She denied any trauma, intravenous [...]

Case Presentation: A 22-year-old female with severe persistent asthma presented with rapidly progressive dyspnea and near-silent chest following a rhinovirus-triggered upper respiratory infection. EMS and ED records described escalating work of breathing, SpO₂ 89%, HR ~130s, and profound hypercapnic respiratory failure with initial pH ~7.19 and pCO₂ >60 mmHg, later falling to pH 6.94 with [...]

Case Presentation: A 21-year-old man with well-controlled ulcerative colitis (UC) on mesalamine and chronic vaping presented with rapidly progressive ischemia of all digits. Symptoms began after an upper-respiratory illness followed by abdominal pain and hematochezia. Evaluation revealed normal platelets, elevated inflammatory markers, preserved renal function with mild proteinuria and microscopic hematuria, increased reticulocyte count, rising [...]

Case Presentation: A 48-year-old man with a history of asthma and chronic cigar use presented with a two-year history of progressive dyspnea that acutely worsened with fever, nonproductive cough, and pleuritic chest pain. He had no known immunodeficiency or prior immunosuppressant exposure. CT chest revealed multiple small pulmonary nodules, severe emphysematous changes, and a left [...]

Case Presentation: Takotsubo cardiomyopathy, or stress-induced cardiomyopathy, typically presents with apical ballooning and is often precipitated by emotional or physical stress. We present a rare variant with mid-ventricular hypokinesis in the absence of an identifiable stressor or recent triggering medication.A 66-year-old woman with hypertension, prediabetes, hyperlipidemia, and marginal zone B-cell lymphoma (treated with rituximab, last [...]

Case Presentation: Bullous pemphigoid (BP) is an autoimmune subepidermal blistering disorder caused by autoantibodies targeting hemidesmosomal proteins BP180 and BP230 at the dermal–epidermal junction. Although classically idiopathic, BP can be drug-induced. Agents including diuretics, antibiotics, DPP-4 inhibitors, and more recently, GLP-1 receptor agonists, have been implicated. We report a case of tirzepatide-induced bullous pemphigoid, an [...]