Case Presentation: A 73-year-old male with a history of alcoholic cirrhosis on ciprofloxacin for spontaneous bacterial peritonitis (SBP) prophylaxis presented to the emergency department with one week of abdominal pain and nausea. On admission he had a leukocytosis, stable liver function tests, and acute kidney injury. Paracentesis revealed 2,434 neutrophils in the peritoneal fluid. He [...]

Case Presentation: A 29 year-old male with no past medical or surgical history presented with one year of fevers, a 30 pound weight loss, and fatigue.  He had been evaluated by his primary care doctor and a hematologist multiple times throughout the past year without the etiology of his fevers elucidated. His exam was notable [...]

Case Presentation: A 56-year old woman with history of ESRD on hemodialysis presented with loss of consciousness. She had an AV fistula placed in her left forearm 5 days prior to presentation. She started feeling discomfort and swelling of the left side of her neck during a transcontinental flight, associated with severe lightheadedness. She continued [...]

Case Presentation:   A 76-year-old female was admitted from an outside hospital for concern for osteomyelitis of her cervical spine.  She had previously had a week of neck pain with limited range of motion due to pain.  She was treated for E. coli sepsis following positive blood and urine cultures, but her neck pain persisted.  Upon transfer, [...]

Case Presentation: 31-year-old homeless male, Jehovah’s Witness, with a history of sickle cell disease (admitted 1 month prior for pain crisis), presented with 2 days of lower back and lower extremity pain. His presenting BUN was 62 mg/dL, Creatinine 2.93 mg/dL, Total Bilirubin 5.9 mg/dL, and Hemoglobin 3.7 g/dL with a Hemoglobin S fraction of [...]

Case Presentation: A 85 year old female was presented with worsening lower back pain following a fall two weeks prior to admission. Past medical history included hypertension, diastolic heart failure, obesity and anemia. Physical exam was unremarkable except for lumbar L1-L3 bony tenderness but no neurological deficit. Pertinent laboratory findings were: corrected calcium of 14 [...]

Case Presentation: A 23 year old Caucasian female with no significant past medical history presented to clinic for evaluation of a recently diagnosed liver mass. The patient had previously been seen in the Neurosurgery clinic for complaints of numbness and tingling sensations in her bilateral lower extremities from her hips down. An MRI of the [...]

Case Presentation: A 53-year-old man presented with diarrhea and an unintentional 30 lb weight loss over four months. He had also been experiencing intermittent abdominal pain for which he adopted a diet limited to soft foods and liquids. His past medical history was significant for a recently diagnosed deep vein thrombosis, Crohn’s disease, depression, hypothyroidism, [...]

Case Presentation: A 67 year old Caucasian male with history of squamous cell carcinoma of the lower lobe of the left lung was admitted to the hospital after his pre-chemotherapy laboratory work at his oncologist showed elevated liver enzymes (AST 162, ALT 141), elevated CK (2856), CK-MB (104) and elevated troponin (0.83). The patient had [...]

Case Presentation: A 28-year old healthy female was admitted seven days post-operatively following Cesarean section for abdominal wound complications. On admission, she was septic; her scar was tender and erythematous with surrounding purple discoloration. Within a few hours, the edges of her scar turned dusky, extending well outside the originally marked boundaries. Aggressive debridement of [...]