Case Presentation: A 27 yo male with ulcerative colitis (UC) and childhood asthma presented with a dry cough, fever and weight loss for 6 weeks. One and a half years prior to admission, he was diagnosed with UC for which he was started on oral mesalamine 1.2 g/day. Prior to admission, he visited an outpatient [...]

Case Presentation: A 43 year-old man with history of alcohol abuse presented with progressive shortness of breath. He was found with severe pneumonia and subsequently developed cardiac arrest. Initial EKG suggested anteroseptal infarct, age undetermined; troponin was elevated with a peak of 0.188 ng/mL (normal <0.031 ng/mL). A left heart catheterization (LHC) revealed non-obstructive coronary [...]

Case Presentation: A 48-year-old female presented with dyspnea and pleuritic pain 3 weeks after a month-long hospitalization due to septic shock with methicillin susceptible staphylococcus aureus (MSSA) bacteremia. Initial workup had revealed no definitive source. Transthoracic echocardiogram had shown preserved ejection fraction without vegetation or significant valvular abnormality. Transesophageal echocardiogram (TEE) was attempted but had [...]

Case Presentation: An 89 year-old woman was admitted for several days of severe constipation, abdominal bloating and absence of flatus. She had abdominal distention with minimal abdominal tenderness on exam. Initial CT imaging demonstrated significant stool burden with prominent colonic distension extending from the cecum to the transverse colon. She required nasogastric tube decompression. Several [...]

Altered Mental Status in a Psychiatric Patient: A Case of Anti-NMDA Encephalitis Case Presentation: 29-year-old female with a history of Bipolar I Disorder, in remission off medication, presented to the Psychiatric Emergency Department with hyperactivity, insomnia, impulsive purchasing and audiovisual hallucinations for two weeks. The patient was admitted to psychiatry for treatment of mania with [...]

Case Presentation: The patient was a 27 year old male who presented to the ED in July 2016 with persistent left sided chest pain and a lump over his sternum of several weeks in duration. Pain was exacerbated by touch and exertion. Other symptoms included occasional episodes of scant hemoptysis. Patient denied SOB, fevers, chills, [...]

Case Presentation:  A 52-year old female with recently diagnosed rheumatoid arthritis (RA) and chronic kidney disease (baseline creatinine 2.6) was admitted with a 2 week history of fatigue, myalgias, mouth ulcers and a desquamating rash along her lower abdomen. She received a 10-day course of prednisone, fluconazole and amoxicillin from her primary care provider without [...]

Case Presentation: A 38 year old thin, Native American female with no known past medical history presented to the hospital with combativeness, confusion and then obtundation. She was in her normal state of health according to her family and then developed confusion and erratic behavior at work. She had no history of seizures. She did [...]

Case Presentation: A 31 year old male with no significant past medical history presented with recurrent fevers, nausea, vomiting and headaches.  He denied travel outside the U.S, camping, or hiking.  Temperature was 103F associated with tachycardia. Physical examination was unremarkable except for mild scleral icterus.Initial labs showed transaminitis, hyperbilirubinemia, leukocytosis, thrombocytopenia, and elevated ferritin > [...]

Case Presentation: A 53-year-old female with significant history of depression, epilepsy, and osteoporosis is brought to the ED by her husband for suicidal ideation.  She reports that over the last 3 months she has had increasing symptoms of depression, anxiety, and mood swings and for the last 2 weeks has had intermittent thoughts of suicide [...]