Case Presentation: A 40 year‐old male presents with fever, severe fatigue, intermittent myalgias, migratory polyarticular pain and 18 kg unintentional weight loss over 4 months. He has no prior illnesses, and his social history is notable for remote IV drug abuse 7 years ago. Prior HIV testing, PPD placement, and hepatitis serologies were negative. Physical [...]

Case Presentation: A 25 year‐old Yemini man presented with three months of progressively worsening jaundice. The patient had no past medical history and physical exam was negative for stigmata of chronic liver disease. Laboratories were significant for a transaminitis (1000 U/L, ratio 1:1) and a predominantly direct hyperbilirubinemia (total 30 mg/dL) with relative preservation of [...]

Case Presentation: A 65‐year‐old Caucasian male smoker with a past medical history of coronary artery disease, diabetes mellitus, hypertension and dyslipidemia, presented to the emergency department with the complaint of sudden onset right testicular pain of one hour’s duration. It was intermittent, sharp, non‐ radiating, associated with painful, spasmodic micturition. He denied any history of [...]

Case Presentation: A 70 year old Caucasian women is admitted with a 2 week history of extremely painful large violaceous, indurated plaques on her inner thighs bilaterally. She has a past medical history of hypertension, diabetes mellitus, and chronic kidney disease not on dialysis, peripheral arterial disease, hypothyroidism and rheumatoid arthritis. Five months prior she [...]

Case Presentation: A 61year old female with hypertension treated with olmesartan and recently diagnosed stroke was admitted for a one month history of recurrent non‐bloody emesis and watery diarrhea. Her symptoms started 1 month prior after a camping trip. Since then she has had watery diarrhea 5 times/day and clear emesis resulting in a 15 [...]

Case Presentation: 60yo F with PMHx of Hepatitis C presented with shortness of breath for 2 days, associated with chest tightness and lightheadedness. Further questioning revealed she had 2 days of bloody stools, hematuria, and minor nose bleeds. Physical examination was remarkable for dried blood in the nares, pale conjunctiva, and a flow murmur. Rectal [...]

Case Presentation: A 62 year‐old woman with a history of persistent endometrial adenocarcinoma undergoing conservative treatment with megestrol presented with two episodes of vaginal bleeding and nausea. Initial vital signs and physical exam were unremarkable. Preliminary laboratory results were notable for a hematocrit of 22.2%, platelets 10,000/UL, and a creatinine of 1.99 mg/dL. Prior to [...]

Case Presentation: A 42‐year old man who uses intravenous heroin daily presented with sudden onset, excruciating and left‐sided pleuritic chest pain along with shortness of breath. He had a fever of 104 degrees Fahrenheit and a pulse oximetry reading of 84% on room air. He had clear lung fields, absence of cardiac murmurs and a [...]

Case Presentation: A 48‐year‐old man presented with two weeks of progressive fatigue, nausea, and malaise. He reported subjective fevers, as well as progressive yellowing of his skin. He had no previous medical problems or prescription drug use. There was no history of intravenous drug use, blood transfusions or heavy alcohol use. He was an ill [...]

Case Presentation: A 44 yo male, well except for diabetes and hypertension, presented to an outside hospital with 2‐3 weeks of headache and gait instability. Head CT was normal, and he was sent home. The HA persisted for the next week and he began to experience photophobia and confusion. He again went to an OSH [...]