Case Presentation: A 54 year-old-woman presented with one week of progressive fatigue, shortness of breath, and productive cough.  Physical exam revealed fever of 101.6⁰ F, poor oral dentition, bilateral pulmonary crackles and left lower quadrant abdominal tenderness. Initial laboratory workup was remarkable for elevated procalcitonin which prompted initiation of broad spectrum antibiotics. Chest X-ray was [...]

Case Presentation: A 30 yo female without significant medical history presented to hospital complaining of facial swelling and dyspnea on exertion of 3 days duration. She described increasing fatigue, nausea and throat discomfort but denied diarrhea, cough, sputum production, fever, chills, rigors, sweats or abdominal pain. The patient had attributed her symptoms to contact with [...]

Case Presentation: A 70 year old male with metastatic malignant melanoma on immunotherapy with nivolumab and ipilimumab was sent to the hospital by his oncologist for abdominal pain and elevated liver enzymes.  His labs were notable for AST 275, ALT 1138, alkaline phosphatase of 394 and total bilirubin of 3.94. This patient had no known [...]

Case Presentation: A 51–year–old female, with no significant past medical history, presented to the emergency room with dyspnea and swelling of the throat. The patient first began to experience shortness of breath two months prior to this encounter. At that time, the patient was evaluated in the emergency department of an outside hospital. Pulmonary embolus [...]

Case Presentation: An otherwise healthy, 48-year-old man from Maine presented with URI symptoms and five days of “inability to warm his feet” after a recent kayaking trip. He was afebrile and nontoxic. On exam he had mottling of the fingers and toes, and labs were notable for elevated AST, ALT, LDH, CPK, troponin, acute renal [...]

Case Presentation: A 67-year-old male was hospitalized for right lower extremity skin abscess with cellulitis complicated by methicillin sensitive Staphylococcus Aureusbacteremia. The patient received piperacillin/tazobactam (pip/taz) and vancomycin over the first 5 days of hospitalization which was de-escalated to cefazolin at discharge.   Thirty-six hours after discharge, the patient was readmitted with expanding area of erythema, [...]

Case Presentation: An 82 year-old presented with acute onset hypoxia after a laparoscopic subtotal gastrectomy for stage I gastric adenocarcinoma. Upon extubation, she had positional episodes of desaturation to 79% when sitting up, with other vitals signs normal and no dyspnea. Her oxygen saturation was 91% when supine. Her lungs were clear to auscultation bilaterally. [...]

Case Presentation: A 49 year old man with AIDS on anti-retroviral therapy (CD4 count 113) presented to the hospital with dizziness, abdominal pain, and generalized fatigue and malaise. He developed fever as high as 39.9 degree Celsius shortly after admission along with anemia and thrombocytopenia. The patient underwent complete infectious workup including viral and atypical [...]

Case Presentation: A 65-year-old woman with hepatitis C-induced liver cirrhosis status-post liver transplantation, coronary artery disease and gout, presents with one week of progressive fatigue, weakness, and severe pain in her right leg and left shoulder. She was on atorvastatin for cardiac disease and had recently started Ledipasvir/Sofosbuvir for hepatitis C two months prior. She [...]

Case Presentation: 84 year old previously healthy female with history of hypertension, Diabetes and chronic kidney disease stage 2 presented to the ER with dizziness. She reported light headedness with frequent room spinning while ambulating. She denied any other associated symptoms. In the ER she was noted to have a Blood pressure of 208/103 and [...]