Case Presentation: Hypotension in the hospital setting is a common finding with a broad differential diagnosis.  The workup includes evaluation for cardiac and infectious etiologies, among others.  We present an infrequent cause of hypotension to demonstrate the importance of manually measuring blood pressure.  A 62 year-old woman with impaired fasting glucose and hyperlipidemia was admitted [...]

Case Presentation: The patient is a 31-year-old lady with a history of sickle cell disease and a chronic left lower extremity DVT. She presented to the hospital for an elective thrombolysis procedure for treatment of post-phlebitic syndrome. The patient had thrombolysis for 72 hours per protocol, but was unsuccessful.  On the day after procedure,  the [...]

Case Presentation: A 65 year old African American male with a past medical history of non-obstructive CAD and chronic hepatitis C with cirrhosis presented to the emergency room with one episode of hematochezia.  Vital signs on presentation were significant for BP 104/61 and HR 103. A digital rectal exam revealed bright red blood. Labs were [...]

Case Presentation: A 40-year-old man initially presented with a headache and was admitted for hypertensive emergency. He rapidly developed altered mental status, acute kidney injury, fever, and weakness. After 12 days of supportive care, he was transferred to our institution. On arrival, the patient was unable to provide a history but his family reported he [...]

Case Presentation: A 41 year-old African-American woman with recently diagnosed pericarditis presented actively seizing with fixed gaze deviation to the right. When levetiracetam and lorazepam did not break seizure activity, she required sedation with propofol and intubation. Within 2 days she was successfully extubated, but began to develop a fever, confusion, agitation and visual hallucinations. [...]

Case Presentation: A 31-year-old female with history of generalized anxiety disorder (GAD), morbid obesity, and eight weeks status-post sleeve gastrectomy presented with 50-pound weight loss and mental status changes. Other symptoms included nausea, vomiting, and poor oral intake. Days to weeks prior to admission she developed generalized weakness, gait disturbance, diplopia, vertigo, and slowed mentation [...]

Case Presentation:   A 29-year-old African-American female presented with two weeks of left neck swelling and fever. Over four months, she had noted fatigue, cough, night sweats, and an unintentional 12-pound weight loss. Two empiric courses of antibiotics effected no clinical change. She had no toxic habits and was sexually active with one male partner. [...]

Case Presentation: A 90 year old female, with diabetes mellitus type 2, hypertension and osteoporosis presented to our emergency room with altered mental status for 5 days. The patient had been treated for jaw osteonecrosis over the past 6 months which included multiple debridements and IV antibiotics. She was started on IV ertapenem 1g daily [...]

Case Presentation: A 57-year old man presented with a painful rash for 3 weeks. He had no medical history besides a 10-year history of a generalized intermittent rash, which had never been this extensive or painful. One month prior to presentation, he was treated for cellulitis with amoxicillin-clavulanate and trimethoprim-sulfamethoxazole. Days later, diffuse erythema and [...]

Case Presentation: A 71 year-old woman with a past medical history of hypertension was admitted with generalized fatigue, weakness, and decreased concentration and memory for a week and a half. During this time, she also had fevers, sweats, anorexia and nausea. She was originally admitted to an outside hospital after falling and losing consciousness, diagnosed [...]