Case Presentation: A 75 year old African American male was diagnosed with metastatic prostate cancer and refused treatment with leuprorelin and radiation, and was eventually lost to follow up.  He represented to emergency department greater than 10 years after initial diagnosis with complaints of severe fatigue, shortness of breath, headache, and worsening bone pain.  Physical [...]

Case Presentation: A 33-year-old woman with a history of appendectomy, cholecystectomy and H. pylori presented with a two year history of episodic right lower quadrant abdominal pain associated with nausea, emesis and unintentional 40 pound weight loss. She had multiple emergency department visits and a prior extensive evaluation at an outside hospital, including CT of [...]

Case Presentation: A 42 year old male presented with fatigue, dyspnea on exertion, and bleeding gums for two weeks. Initial labs showed a white cell count of 96.1k/uL with blasts, Hgb 6.6 g/dL, and a platelet count of 64 k/uL. Bone marrow (BM) biopsy showed acute lymphoblastic leukemia (ALL). A lumbar puncture (LP) showed a [...]

Case Presentation: A 58 year-old man presented with a 3-month history of night sweats, chills and a 30 pound weight loss.  His temperature was 102°F with decreased breath sounds and dullness to percussion at the left lung base.   Labs were significant for a WBC 2.4 cells per µL with 22% monocytes and hemoglobin of 8.5 g/dl. CT [...]

Case Presentation: An 80 yo African-American female with past medical history of hypertension, uterine cancer s/p radiation and mild cognitive impairment presented to the hospital with fatigue and non-specific symptoms for 2 weeks. On examination, vital signs were within normal limits and no acute findings were noticed except impaired vision and mild cognitive impairment. Initial labs were [...]

Case Presentation: 53-yo Male with past medical history of poly-substance abuse presented with weakness, shortness of breath and productive cough for 1 month. He also reported low-grade fever, chills, fatigue, and weight loss of 30 to 40 pounds. He had 25-pack-year history of smoking. On examination, he had bronchial breath sounds in right upper lung [...]

Case Presentation: An 18 year old male with no past medical history presented with one month history of nausea and vomiting, 10 pound weight loss, and abdominal pain. Vital signs were normal and physical exam only remarkable for mild tenderness to palpation in the right upper quadrant. Admission labs were notable for leukocytosis (WBC 14) [...]

Case Presentation: A 21-year-old Hispanic male with no past medical history presented to our hospital with worsening abdominal pain for approximately two months.  He described the pain as initially intermittent but progressive and was not associated with eating food. In addition, he also complained of a diffuse maculo-papular rash involving the palms and soles that persisted [...]

Case Presentation: A 30 year old male with history of recently diagnosed AIDS presented with altered mental status, fevers and 3 witnessed tonic-clonic seizures. His family reported that he had been complaining of progressive headaches and photophobia for several weeks and that he was diagnosed with AIDS. He was admitted 1 month prior for rash [...]

Case Presentation: A 55 year old male with history of ulcerative colitis and iron deficiency anemia presented to the emergency department with a 1 week history of progressive swelling, tenderness and erythema of a circumscribed area of his anterior chest. Similar lesions erupted over right 4th finger and right ankle 2 days prior to presentation. [...]