Case Presentation: A 35–year–old man presented with new onset seizures. He reported progressively worsening bilateral occipital headache that suddenly resulted in a “white–out” of his vision. He lost consciousness, and was taken to an outside hospital where he had a seizure. His blood pressure was 240/125 mmHg, was started on a nicardipine drip and transferred [...]

Case Presentation: A 73–year–old woman presented with one week of bilateral hand weakness and increasing confusion. She had a baseline Alzheimer’s dementia, but her family reported that her confusion markedly increased in the prior week, with a noticeable progression of dementia in the previous four months. With the exception of decreased strength in both upper [...]

Case Presentation: A 67–year–old woman presented with 3 h of sharp, intermittent chest pain and palpations. The episodes lasted for several minutes at a time and were associated with shortness of breath, nausea, diaphoresis, and lightheadedness. The pain was substernal with radiation to her right neck, shoulder, and upper back. She had a history of [...]

Case Presentation: A 35–year–old man presented with 6 h of epistaxis. He had a lifelong history of von Willebrand disease (vWD) type IIB, but denied previous hospitalizations or transfusions. He reported prior epistaxis episodes that all resolved with pressure, but this bleed did not respond to his usual maneuvers. He denied nasal trauma or nonsteroidal [...]

Case Presentation: A 48–year–old man with AIDS and a CD4 count of 68 presented with two weeks of fevers, night sweats, nausea and decreased appetite. He had been well until two months earlier when he was diagnosed with strongyloids and treated. One month later he presented with fever, leukopenia, anorexia, and fifteen–pound weight loss. He [...]

Case Presentation: A 29–year–old woman with a history of HIV nephropathy and end–stage renal disease presented one day of headaches, nausea, and vomiting. She noted no trauma, and no new neurologic abnormalities. She did note that she had not taken her anti–hypertensive medications, and that she had missed her last two dialysis appointments. Upon arrival [...]

Case Presentation: An 81–year–old man presented with sharp pain in his left foot of 4 h. His left foot was cold with cyanosis of the great toe and distal tips of the second and third digits. His left–sided, posterior tibial pulse was barley palpable while popliteal and dosalis pedal pulses were not palpable. He had [...]

Case Presentation: A 49–year–old T4 paraplegic man presented after being found down in his yard for one day. He was oriented only to self and had several large stage–three decubitus ulcers. His left foot was erythematous, edematous and tender to palpation with red streaking reaching to the thigh. He was febrile with an associated leukocytosis. [...]

Case Presentation: A 64–year–old man presented with fatigue, fever, and bilateral lower extremity pain. He had a history of Laennec’s cirrhosis and was awaiting liver transplant. He noted no recent travel, ill contacts or occupational exposures. He had no headache, chest pain or abdominal pain. His blood pressure was 62/35 mmHg, heart rate was 114 [...]

Case Presentation: A 76–year–old women presented with two days of hemoptysis, dyspnea on exertion, and fatigue stating she coughed up two cups of blood per day. She had no previous history or exposure to tuberculosis, and had never been homeless or incarcerated. She denied tobacco or drug use, any fever, chills, or sick contacts. She [...]