Case Presentation: A previously healthy 19–year–old female, presented with 1 day of fever, severe occipital headaches, nausea, vomiting, diarrhea, severe myalgias and polyarthralgias. She is attending her spring semester in college while living in a dormitory. Initially, patient was tachycardic, afebrile and normotensive, but in a matter of hours she became hemodynamically unstable with profound [...]

Case Presentation: A 51–year–old female with history of anxiety, depression, and tobacco abuse was admitted to the ICU due to severe respiratory distress, hypoxia, productive cough, fever and chills. Her symptoms began 8 days prior with a mild productive cough. It progressively worsened to a persistent cough with thick green sputum streaked with blood, associated [...]

Case Presentation: A previously healthy 37–year–old male patient presented with 4 days of fever, nausea, myalgias and headaches. Patient had returned from a 3–week vacation trip to Malawi 2 weeks before this episode. He did take doxycycline as prophylaxis for few days at the beginning of his trip. Two days before the admission patient noticed [...]

Case Presentation: 71 female with multidrug resistant HIV, stable on antiretroviral therapy for 4 years on a regimen containing tenofovir, with CD4 count of 140 cells/ml and non detectable HIV viral load, presented to the hospital with elevated creatinine levels. Decline in renal function was slow and progressive with baseline creatinine of 0.8 mg/dl which [...]

Case Presentation: A previously healthy 35–year–old male patient presented with 2 weeks history of fatigue and a maculopapular rash over his back, torso, extremities and face. He had flu–like symptoms and rinorrhea just before the rash. One week before the admission, patient developed a gradually worsening symmetric lower extremity swelling. He described his urine as [...]

Case Presentation: A 20–year–old African American Female was admitted with diffuse skin thickening and intractable pain in these skin lesions. Her past medical history was significant for recurrent kidney stones for which she had undergone bilateral nephrectomy a year previously and had been on renal replacement therapy. She was suffering from severe cachexia, tachycardia of [...]

Case Presentation: A 41–year–old African–American woman traveling in Ghana experienced progressive edema, diffuse joint pain and night sweats over a 9–day period. Three days before her presentation she noted dyspnea, dry cough and inability to walk due to knee pain. As a result of her declining health, she returned home prematurely. Prior to travel, she [...]

Case Presentation: A 58–year–old woman presented with a severe headache with onset 3 hours after taking prophylactic amoxicillin for a routine dental cleaning. She described a constant bifrontal headache with mild photophobia, multiple episodes of emesis, diarrhea, fevers, chills, and myalgias. She denied any phonophobia, visual changes, neck stiffness, or other neurologic symptoms. She described [...]

Case Presentation: A 49–year–old male with diabetes mellitus presented with jaw pain and an absolute neutrophil count (ANC) of 200 cells/mm3. He denied drug use. A periodontal abscess seen on computerized tomogram was treated by incision, drainage, and antibiotics. Incidental proteinuria and microscopic hematuria were noted. Neutropenia was attributed to glipizide toxicity. As an outpatient [...]

Case Presentation: A 50–year–old male presented to the emergency department with aphasia and weakness. He had been in his usual state of health until 7 hours prior, when he acutely developed right hand weakness and word–finding difficulties. His exam was notable for dysarthria and a right–sided facial droop. A head CT demonstrated multiple front and [...]