Case Presentation: A18‐year‐old healthy female presented to her primary care physician in early April with isolated right calf pain. Her initial workup included an ANA, D‐dimer, Epsteinn‐Barr virus, erythrocyte sedimentation rate (ESR), creatine kinase, and creatinine, all of which were within normal limits. An MRI of the brain and spines and ultrasound of lower extremities […]

Case Presentation: A 63‐year‐old African American woman presented with 2 weeks of progressively worsening right lower quadrant abdominal pain. She noted early satiety, constipation, and an unintentional 10‐pound weight loss. On exam, her abdomen was distended and tender to palpation in the right lower quadrant with voluntary guarding. A large mass was palpated in the […]

Case Presentation: A 23‐year‐old man with untreated acquired immune deficiency syndrome (AIDS) presented with headache and new‐onset generalized seizure. He had recently been hospitalized at a local community hospital for confusion and behavior changes where he was thought to have viral meningitis. Shortly after discharge from that facility, he had a generalized tonic‐clonic seizure and […]

Case Presentation: A 14‐year‐old African American girl with no medical history presented to the emergency room (ER) with acute diffuse abdominal pain associated with nausea and vomiting. The workup included basic laboratory evaluation and abdominal radiography, which were all negative. She improved with ondansetron and was discharged from the ER. Approximately 1 week after the […]

Case Presentation: A 48‐year‐old man was referred from the clinic with worsening acute renal failure. He reported nausea without emesis but no other symptoms. His creatinine was 8.3 mg/dL (increased from his baseline of 1.4 mg/dL 12 days earlier). He denied a history of kidney disease but reported being hospitalized 2 weeks prior for an acute febrile […]

Case Presentation: A 41‐year‐old man presented with 3 weeks of nausea, vomiting, and a 10‐pound weight loss. His medical history included hemophilia A and HIV, for which he was taking highly active antiretroviral therapy (HAART). Three months after initiating emtricitabine and tenofovir therapy, he began experiencing polyuria and polydipsia. He described no additional symptoms. He […]

Case Presentation: A 45‐year‐old woman presented with 5 months of progressive right lumbar back pain radiating to the right abdomen. She denied any history of trauma or neurological symptoms. Associated symptoms included hot flashes, diaphoresis, and constipation. Her medical history was significant for uncontrolled hypertension. Her back had decreased range of motion in the lumbar […]

Case Presentation: A 47‐year‐old woman was referred to us from the gynecology department at our institution after she complained of chest pain. She was admitted to the hospital for abnormal uterine bleeding and pelvic pain and was scheduled for a vaginal hysterectomy. Preoperative electrocardiogram (EKG) showed normal sinus rhythm. Preoperative echocardiogram revealed normal left ventricular […]

Case Presentation: A 60‐year‐old man with type 2 diabetes and hypertension was admitted for low‐grade fever and worsening rash. The patient was on intravenous vancomycin (1 g daily) for 4 weeks for right knee joint methicillin‐resistant Staphylococcus aureus (MRSA) infection. Rash appeared 2 days after starting vancomycin, initially on the face and then gradually spreading to […]

Case Presentation: A 69‐year‐old woman presented with 3 months of fever and dyspnea that remained undiagnosed after an extensive workup in a local hospital. History was pertinent for remote partially treated latent tuberculosis (TB), diabetes, and remote pancreatic cancer treated with Whip‐ple surgery and chemotherapy. Chest roentgenograms (CXR) and computed tomography (CT) consistently revealed diffuse […]