Case Presentation: A 47–year–old Caucasian male with a history of diabetes, hypertension and depression sustained a fall in the woods and had a fracture of the right ankle a week prior to admission. He had internal fixation of the ankle at another facility and was discharged on pentazocine, doxycycline, ondansetron and paroxetine. He started experiencing [...]

Case Presentation: A 29–year–old African American male with no prior medical history was admitted to the hospital with substernal chest pain and cough with minimal expectoration for the past 3 months. He reported a 25 lb unintentional weight loss and subjective fever without chills or night sweats for a week. He denied any prior blood [...]

Case Presentation: A 94–year–old African American female patient admitted to the hospital with altered mental status and slurring of speech. Patient daughter had home blood sugar measured as 22 mg/dl. She had been suffering from recurrent hypoglycemic episodes for the past 2 years with one hospital admission for hypoglycemia 2 years ago. She used to [...]

Case Presentation: 61–year–old female with a medical history of asthma, fibromyalgia, hypertension, osteoarthritis, insomnia and anxiety was admitted to the hospital for persistent low–grade fever, cough and myalgias for 12 weeks. Extensive outpatient workup including chest X–ray, CT scan chest and bronchoscopy was negative. Outpatient treatment with prednisone, bronchodilators, cough suppressants, esophageal reflux medications and [...]

Case Presentation: A 50–year–old woman with left breast cancer and a 10–pack–year smoking history presented to the emergency department with pleuritic right–sided chest pain and dyspnea. Six days earlier, she had undergone bilateral total mastectomy. She was neither febrile nor hypoxic. Blood pressure and pulse were normal. Her mastectomy surgical sites were without evidence of [...]

Case Presentation: A 71–year–old man with chronic lymphocytic leukemia (CLL) and chronic obstructive pulmonary disease presented with fatigue, fever, and right knee pain and swelling. He denied right knee trauma. He also reported dyspnea and cough productive of clear sputum. Imaging studies of the right lower extremity revealed a large, aggressive–appearing lesion of the proximal [...]

Case Presentation: An 8–year–old boy presented with 1 day of agitation, hypertension, and encephalopathy. Prior to presentation, he was babbling incoherently with some extremity shaking, incontinent of urine and became somnolent. He had a history of attention deficit hyperactivity disorder and post–traumatic stress disorder for which he took citalopram, clonidine, and methylphenidate. On examination, he [...]

Case Presentation: A 65–year–old female with metastatic breast cancer, glioblastoma multiforme, bilateral pulmonary emboli diagnosed 4 days prior to admission started on enoxaparin, presented with syncope. On the day of admission the patient collapsed on the street suddenly without any prodrome. She reported abdominal pain for the prior 2–3 days, no other new symptoms, and [...]

Case Presentation: A 37–year–old Caucasian female with a history of hypothyroidism presented with acute, diffuse, cramping abdominal pain, bloody diarrhea and green mucous discharge. The patient was admitted to our institution for acute gastroenteritis. Physical exam was significant for diffuse tenderness to palpation in the abdomen. The hospital course consisted of nausea, non–bilious vomiting and [...]

Case Presentation: A 51–year–old man with a past medical history significant for obesity, cirrhosis and COPD presented to an outside emergency department for evaluation of progressive edema. The patient was diagnosed with alcoholic cirrhosis 15 years prior but reported that he had not consumed alcohol since that diagnosis. He had recently returned from a trip [...]