Case Presentation: A 78 year old female with history of previous cholecystitis s/p cholecystectomy in 1950s complicated by recurrent choledocholithiasis and cholangitis presented with a 1 day history of chills, epigastric abdominal pain, nausea and vomiting. Patient had recurrent episodes almost yearly, characterized by these symptoms. Similar to prior episodes, labs were indicative of biliary […]

Case Presentation: A 81 year old Asian woman with past medical history of diabetes, hypertension, coronary artery disease, and arthritis presented with fever and five days of worsening neck stiffness and pain, worsened by neck movement. Laboratory examination revealed mild leukocytosis, CRP 28 and ESR 114. Broad spectrum antibiotics were started for possible meningitis. Lumbar […]

Case Presentation: KW is a 64 year old female with chronic obstructive pulmonary disease and hypertension who presented with progressive dyspnea in the setting of cardiac tamponade, but with persistent hypoxic respiratory failure despite pericardiocentesis. One week after initial presentation, a test returned positive for p-ANCA with anti-myeloperoxidase (anti-MPO) by immunofluorescence and ELISA. Lupus anticoagulant […]

Case Presentation: A 23 year-old man with schizophrenia presented to the emergency department complaining of nausea, vomiting, headache, and subjective fever, followed by acute onset of right lower quadrant abdominal pain. His medications included chlorpromazine and benztropine. Vital signs: temperature 39 degrees C, pulse 155, respirations 18, and blood pressure 116/58. Admission exam was remarkable […]

Purpose: To recognize Strongyloides stercoralis hyperinfection as a fatal cause of diffuse alveolar hemorrhage (DAH) in immunocompromised individuals. Case Presentation: A 47-year-old Hispanic female with MPO-ANCA-positive pauci-immune RPGN status post plasma exchange now well controlled on Cytoxan and prednisone presented with dysphagia, nausea, abdominal pain, and dyspnea on exertion for the preceding three days and […]

Case Presentation: A 34-year old male with no past medical history presented to the emergency room with 1 day of low back pain associated with fever and chills.  He reported the pain as constant and 10/10 in severity, partially relieved by ibuprofen. He denied any trauma. There was no loss of bowel or bladder function […]

Case Presentation:  A 66-year-old woman with a history of hypertension and type 2 diabetes mellitus presented to an outside hospital with persistent nausea and vomiting, a 45 pound weight loss, and dysphagia over a 4-week period. In addition to the new diagnosis of atrial fibrillation, esophagogastroduodenoscopy identified a lesion in the gastric cardia concerning for […]

Case Presentation: A 36-year-old woman with medical history only significant for obesity presents with confusion and difficulty ambulating one week prior to our evaluation. Two months ago, she underwent an uneventful laparoscopic sleeve gastrectomy for morbid obesity (BMI ~40.4). After further discussion with her family it was revealed she had worsening nausea and vomiting after […]

Case Presentation: This is a 77/F with Diabetes Mellitus, Hypertension and severe osteoarthritis who was admitted with 1 day history of mental status change, headache and neck pain with progressive pain in her hands, wrist and knee. Vitals signs revealed fever to 103F, BP 142/72, HR 72 and RR 16. Patient was lethargic but arousable, […]

Case Presentation: A 67 year- old man presented with three weeks of progressively worsening painful ulcers in bilateral lower extremities and fingers. The lesions started as numerous erythematous lesions on his legs and fingers five months ago that subsequently turned into inflamed blisters and ultimately evolved into painful crusted ulcers. He was treated with antibiotics and […]