Case Presentation: A 71–year–old man with a past history of long standing asthma presented with productive cough for 1 week and nausea, vomiting, diarrhea, fevers, headache, and generalized weakness for 1 day. In the last 6 months, he had been extensively evaluated for recurrent asthma exacerbations refractory to treatment. Examination was remarkable for generalized flushing, […]

Case Presentation: A 61–year–old male with worsening back pain and right leg weakness secondary to lumbar spinal stenosis underwent an elective L2–S1 laminectomy with L4–L5 fusion. His past medical history included essential hypertension with medication noncompliance and laparoscopic cholecystectomy. Preoperatively, his blood pressure ranged between 106–142 systolic and 69–76 diastolic. On postoperative day 1, he […]

Case Presentation: A 60 year old male presented with acute dyspnea and pleuritic retrosternal chest pain. His past medical history was significant for Wegener’s granulomatosis (WG) in remission for four years. His history was negative for venous thromboembolism (VTE) risk factors or prior VTE. He was up to date on age appropriate malignancy screening. His […]

Case Presentation: This is a 21–year–old male presenting with a 3–month history of worsening colicky periumbilical abdominal pain. The patient has had fevers, night sweats, diarrhea and hematochezia associated with this pain. He has a known history of autosomal recessive chronic granulomatous disease (CGD) and had severe pulmonary aspergillosis as a child but otherwise has […]

Case Presentation: A 75–year–old African American woman was admitted following two weeks history of fatigue, jaundice, anorexia, intermittent nausea and vomiting. Her physical exam was unremarkable except for profound icterus. She was previously maintained on rituximab since August 2009 for the treatment of longstanding rheumatoid arthritis unresponsive to methotrexate. The last dose was administered five […]

Case Presentation: A 71–year–old woman with a history of inverse psoriasis (occurs on skin folds versus extensor surfances), breast cancer status post right lumpectomy and radiation, last treated 3 months ago, presents to the hospital with right breast erythema, blistering, and pain. Erythema was first noted one month prior to presentation. She was seen by […]

Case Presentation: A previously healthy 28–year–old female medical student presented with four days of high fevers (up to 39.9 C) and epigastric pain. In the past month, she completed an infectious disease rotation, then went camping with freshwater lake and cave exposure, without any noted bug bites or animal contact. On presentation, the patient was […]

Case Presentation: A 44–year–old woman with 30–pack year smoking history, diabetes and non–alcoholic fatty liver disease presented with shortness of breath since two months and recurrent right sided pleural effusion on chest radiographs. Prior to admission, computed tomography scanning (CT scan) of the chest showed pleural effusion without pulmonary masses or pulmonary embolism. Thoracentesis revealed […]

Case Presentation: An 81–year–old man with a history of chronic obstructive pulmonary disease, congestive heart failure and chronic kidney disease presented to our hospital with 6–day history of increasing shortness of breath, fever (self recorded 102 f), chills, rigors and cough with grey sputum. Physical examination revealed bilateral rales and no skin lesions. Total white […]

Case Presentation: A 68–year–old man with stable lupus nephritis diagnosed in 1999, presented with progressive difficulty with swallowing and speaking since May 2009 requiring percutaneous endoscopic gastrostomy tube placement in August 2010. Muscle atrophy, twitching and cramping developed along with emotional lability. Exam revealed pseudobulbar affect, tongue fasciculations, a marked mixed dysarthria, and marked muscle […]