Case Presentation: A 54-year-old female with hypertension, type 2 diabetes, and morbid obesity with Roux-en-Y gastric bypass (RYGB) in 2009 presented to the hospital with abdominal pain and was found to have choledocolithiasis and acute cholecystitis. She was admitted to the surgery service and underwent ERCP and laparoscopic cholecystectomy. Her post-op course was complicated by [...]

Case Presentation: A 68 year old male with history of hemodialysis dependent chronic kidney disease, stroke and vascular dementia was transferred from a nursing home with increased lethargy and abdominal pain.  In the emergency department he was found to be febrile to 101.9°F and abdominal exam revealed involuntary guarding with diffuse pain to deep palpation.  [...]

Case Presentation: A 39 year old male with a history of congenital bicuspid aortic valve and ascending aortic aneurysm repair (1 year prior) presented with recurrent bilateral lower extremity edema (LEE). He first presented with LEE 3 months post-surgery.  Transthoracic echocardiogram (TTE) initially showed mild apical and inferior hypokinesis with a mildly dilated left atrium [...]

Case Presentation: A 53 year old Russian man with no significant past medical history initially presented to an ophthalmology clinic with two days of progressively worsening, near-total left visual field loss associated with a one-week duration of fever, chills, and cough. He was diagnosed with bacterial endophthalmitis. His vitreous fluid was sampled, and he was [...]

Case Presentation: A 66 year-old male with hypothyroidism was admitted for a COPD exacerbation, however his neurological exam was markedly abnormal. He had suffered multiple falls due to gait instability in years past, and recently experienced progressive symptoms of dizziness, slurred speech, tremors, and weakness. His symptoms were now so severe that he could no [...]

Case Presentation: A 74 year old, non-diabetic Singaporean male was hospitalized following 3 weeks of left iliac fossa pain.  Computed tomography showed marked mural thickening and enhancement of descending and sigmoid colon with extensive pericolic and omental fat stranding. Ill-defined pulmonary nodules were also seen. He was treated for colitis but deteriorated with shock and [...]

Case Presentation: Over one month our team (one of 14 in the division) saw 3 cases of Group B Streptococcus (GBS) bacteremia with musculoskeletal (MSK) complications. The first patient was a 65-year-old male admitted with 2 days of fever and right wrist tenosynovitis and shoulder pain. He had raised white cell count (WCC) of 15.16 [...]

Case Presentation: A 47-year-old woman presented to our facility.  Over four months, she had suffered an inexorable decline and multiple hospitalizations with fruitless searches for a diagnosis.  She had right-sided Bell’s palsy, progressive right-sided weakness, mastoiditis, vocal cord paralysis requiring intubation and tracheostomy, and severe dysphagia requiring a PEG tube.  All work up was negative [...]

Case Presentation: A 71 year old woman with a past medical history of type 2 diabetes mellitus, atrial fibrillation, hypothyroidism and hypertension presented for evaluation of one month history of right sided involuntary hyperkinetic movements. Physical exam was significant for lip smacking, distal choreic movements, and proximal ballistic swings of the right arm and leg. [...]

Case Presentation: 35 year old woman, diagnosed with biopsy proven sarcoidosis, developed a complex clinical course over time. She started experiencing recurrent watery diarrhea, accompanied with abdominal pain and generalized weakness. Physical exam revealed thin chronically unwell female, with BP of 115/76 | pulse 94 | temperature 97.7 °F (oral) | respiratory rate 16/minute | [...]