Case Presentation: A 75–year–old female with a history of schizophrenia and diabetes mellitus was transferred to our hospital for sepsis and worsening rash. The rash first appeared on the flexor surfaces of her upper extremities, progressing to her entire body over 3 months. At the referring hospital, she was empirically started on vancomycin, cefepime, and [...]

Case Presentation: This is an 81–year–old woman with rate controlled atrial fibrillation, hypothyroidism and invasive ductal carcinoma, which was diagnosed in 2008, and treated with breast sparing surgery and radiation. At her first ER visit, she presented with severe neck pain that radiated to her left shoulder associated with diaphoresis, weakness and lightheadedness. She was [...]

Case Presentation: A 61–year–old man was admitted with a three–week history of productive cough, fever, chills, night sweats and fatigability. He experienced progressive pleuritic chest pain and dyspnea. His past medical history was significant for CAD S/P bypass surgery and a pacemaker placed for bradycardia 10 years ago. Patient denied any IV drug abuse. Vital [...]

Case Presentation: A 51–year–old man with liver cirrhosis secondary to alcoholism and hepatitis C complicated with refractory, paracentesis–dependent ascites was found unresponsive in his apartment. His medications were furosemide, spironolactone, thiamine and folic acid. On presentation, he appeared critically ill and unresponsive with GCS 3. Temperature was 26°C, BP 70/36, HR 50/min, RR 35/min, and [...]

Case Presentation: A 67–year–old male presented to our emergency department complaining of typical chest pain few minutes after smoking cocaine. Pain was retrosternal and radiating to left shoulder associated with diaphoresis and nausea but no vomiting. On arrival, he continues to be in pain with stable vital signs. He was diaphoretic and distressed with normal [...]

Case Presentation: A 62–year–old man presented with a 3–day history of fever, chills, night sweats, fatigue, and arthralgias, associated with generalized non–pruritic painless skin rash. He has past medical history significant for hypertension, ulcerative colitis in remission and CAD status post bypass surgery. He was taking azathioprine, mesalamine, simvastatin and lisinopril. On presentation, temperature was [...]

Case Presentation: A 58–year–old male patient, who had worked as a welder for 30 years, complained of 3 months history of progressively worsening hemoptysis. He underwent thoracotomy and right upper lobectomy 5 years ago for suspected malignant nodules but histopathology revealed welding related nodules. He had been an active smoker until 5 years ago. On [...]

Case Presentation: A 56–year–old male presented with generalized body aches, chills and fever for 8 days. Symptoms were associated with palpitation, sweating, headache, and dry cough. He denied any IV drug abuse. Physical exam showed tachycardia with irregularly irregular pulse, high grade fever of 40°C, precordium auscultation revealed normal heart sounds with no murmur. Site [...]

Case Presentation: A 60–year–old woman with no past medical history presented with sudden onset of confusion, mutism, agitation, and behavioral changes that were precipitated by a stressful family event. On initial presentation, she had no focal neurologic deficits but was completely non–verbal. She was noted to be restless, pacing around the room, and engaging in [...]

Case Presentation: A 44–year–old man with no significant past medical history was admitted to the hospital for further evaluation of intermittent chest pain. He had no similar episodes in the past. He denied symptoms of dizziness, syncope or shortness of breath. His father had premature coronary artery disease. Otherwise, no history of arrhythmia or sudden [...]