Case Presentation: A 25-year-old female presented with a 2-day history of right-sided abdominal pain, nausea and vomiting. She had multiple emergency department visits for lower back pain for the last 3 years. CT scan of abdomen showed right advanced chronic hydronephrosis secondary to ureteropelvic junction (UPJ) stenosis. Labs revealed normal renal functions. UPJ stenosis was [...]

Case Presentation: A 42 year-old man with a history of methamphetamine use, hypertension and uncontrolled type 2 diabetes (Hgb A1C 13.5%) presented with a dental abscess and hyperglycemia (>400) without DKA. Three teeth were extracted; cultures revealed candida spp. He received antibiotics and fluconazole. On the 4th day he developed right facial paralysis and central retinal [...]

Case Presentation: A 58 year-old male with chronic obstructive pulmonary disease (COPD) and two recent admissions to an outside hospital for pneumonia presented with fever, chills, and a productive cough of three months duration. On admission, he was afebrile, tachycardic, and required his home two liters of supplemental oxygen. Physical exam was notable for coarse [...]

Case Presentation: 64 year old male with history of PTSD, COPD, GERD, prostate cancer status post prostatectomy, hyperlipidemia and right total knee replacement presented after developing severe pain in his knees. Pain was associated with myalgia, malaise, arthralgia, anorexia, headache, chills, cough and weakness. Exposure history included travel to Seattle and recently working in a [...]

Case Presentation: An 80 y/o Hispanic man with past medical history significant for COPD, ascending aortic aneurysm s/p graft repair 10/06, and recent biventricular pacemaker implantation 4/16 due to third-degree heart block presented with dyspnea, productive cough, orthopnea and fever to 103 F in 5/16. Physical examination revealed III/VI diastolic murmur, bilateral pulmonary rales, peripheral [...]

Case Presentation: A 68-year-old white male with a history of Factor V Leiden, deep vein thromboses (DVT), pulmonary embolism (PE), atrial fibrillation, and hyperthyroidism on warfarin therapy for 12 years presented to the emergency department (ED) with acutely worsening, bilateral, black, necrotic ulcerations of his lower extremities with associated edema, purpura, and progressive sloughing of [...]

Case Presentation: A 72-year-old Indian male with follicular lymphoma treated with chemotherapy and immunotherapy presented to our center with a four day history of right-sided facial droop, dysphagia and hoarseness. The patient had a one-year history of recurrent sinus and ear infections and was evaluated at an outside hospital for a nasopharyngeal (NP) mass. Biopsy [...]

Case Presentation: We describe a rare case of a nephrotic syndrome (NS) as a complication of secondary syphilis (SS), which resolved with appropriate treatment of the infection. This is a 54 year-old male with no pertinent medical history, who presented to clinic with bilateral palmar rash. He was diagnosed of secondary syphilis with positive Venereal [...]

Case Presentation: We describe a patient with relapsing polychondritis (RPC) who developed a complete heart block, mitral valve insufficiency and aortic root dilation. A 72-year-old man with a history of RPC presented with fatigue, lightheadedness and syncope, which was secondary to the new onset complete heart block (CHB). Further investigation showed an elevated C-reactive protein [...]

Case Presentation: Xanthogranulomatous Pyelonephritis (XGP) is an uncommon sequelae of chronic renal inflammation whose process may invade local structures.  We present a rare case of an invasive Xanthogranulomatous Pyelonephritis (XGP) extending into the thoracic cavity in a 48 year-old female presenting with chronic productive cough. This previously healthy patient presented with dyspnea, productive cough, and [...]