Case Presentation: 42 year old male with history of alcoholism and chronic tophaceous gout on allopurinol, presented with acute left elbow pain and swelling. Exam showed synovitis of left wrist and elbow, distal interphalangeal joint (DIJ) and right knee and tophi  on left DIJ.  Arthrocentesis of left elbow revealed purulent fluid with leukocytosis (5000,000/mm3) and [...]

Case Presentation: A 49 year-old Asian female with a history of multinodular thyroid, cervical stenosis, and latent tuberculosis infection (LTBI) presented to the emergency department with five-day history of nonproductive cough, pleuritic chest pain, and intermittent fevers and chills. During the previous year, she had completed three months of LTBI treatment with isoniazid and rifapentine [...]

Case Presentation: A 56-year-old man presented with one day of high fevers to 104°F, myalgias, and non-productive cough. His past medical history is significant for polycystic liver disease leading to liver transplant, and metastatic neuroendocrine tumor managed with intravenous somatostatin. Two weeks prior to admission, he began a taper of his immunosuppressive medication. On the [...]

Case Presentation:  A 55-year-old African-American male presented to the emergency department with brown urine, decreased urinary frequency, and acute on chronic back pain with bilateral leg soreness. He was intermittently bed-bound over the last 2 weeks due to pain. He stated that his chronic back pain is normally controlled with Acetaminophen/Hydrocodone, Pregabalin, and Tramadol. Recently, [...]

Case Presentation: An 80 year-old man presented with one day of confusion, worsened cough, and subjective fevers. He had a productive cough since emigrating from Mexico six months ago, but no complaints of dyspnea. He had a history of diabetes and stable angina for the past year. On presentation, he was tachycardic with a temperature [...]

Case Presentation: A 29 year old male with HIV/AIDS only intermittently taking antiretroviral therapy (ART), Pneumocystis jirovecii (PJP) pneumonia actively being treated with trimethoprim-sulfamethoxazole (TMP-SMX) and prednisone, and cutaneous Kaposi sarcoma all diagnosed one month ago at an outside clinic presented to the hospital with worsening cough and shortness of breath. Initial vitals were notable [...]

Case Presentation: A 69-year-old Caucasian male with a history of hypertension, COPD, psoriasis and basal cell carcinoma underwent robotic assisted laparoscopic prostatectomy for treatment of prostate cancer. One week after surgery, he presented to his surgeon with pain and erythema around the supra-umbilical port. He was treated with amoxicillin-clavulanate for presumed surgical site infection; however [...]

Case Presentation: A 73 year-old female with a history of recurrent DVT’s on Warfarin, microscopic polyangiitis and ulcerative colitis status post total colectomy initially presented with altered mental status. Lab workup revealed acute renal failure for which she underwent intermittent hemodialysis. Due to a suspicion for microscopic polyangiitis relapse, the patient was started on steroids. [...]

Case Presentation: 70-year-old male with remote past medical history of prostate cancer and COPD presented to the emergency department with new onset left side weakness along with left side facial droop. Patient underwent CT scan of the head which was negative and an MRI of the brain which showed multiple bilateral small strokes that raised [...]

Case Presentation: A 61 years old male patient not known to have any medical problem presented to the emergency department after he noticed swelling in his mouth which increased in size to involve both lips, he reported loose bowel movements in the last couple weeks and mild arthralgia. His physical examination was completely normal apart [...]