Case Presentation: Our patient is a 62-year-old Eastern European female with no significant past medical history who was brought to the emergency department after a sustaining a syncopal episode. At the time of exam, she was largely asymptomatic, and her review of systems was positive for a brief isolated episode of mild chest pain that [...]

Case Presentation: We present a rare manifestation of adrenal insufficiency with initial symptoms limited to psychosis. A 51 y.o male, with hypothyroidism, but no prior psychiatric history presented with acute behavioral changes. Approximately 14 days prior to presentation he was diagnosed with sinus infection, treated with antibiotics and oral hydration. He consumed excessive fluids and [...]

Case Presentation: A 95-year-old man presented with progressive right lower extremity swelling. He reports a chronic history of overflow incontinence. Laboratory evaluation revealed a normal coagulation profile, creatinine of 1.5 milligrams per deciliter. A venous duplex ultrasound demonstrated acute occlusive deep venous thrombosis (DVT) in the right lower extremity. A computed tomography (CT) venogram confirmed [...]

Case Presentation: Our patient was a 71 year-old male admitted for acute respiratory failure secondary to aspiration pneumonia in the setting of advanced Parkinson’s disease (PD) requiring endotracheal intubation. After multiple failed attempts to extubate in light of supraglottic edema, the patient underwent a tracheostomy in the operating room (OR) with propofol, lidocaine, fentanyl and [...]

Case Presentation: Our patient was a 56 year-old immunocompromised male with a history of active CML (Chronic Myelocytic Leukemia) on active chemotherapy who was undergoing treatment with doxycycline and fluconazole for actinomycosis and coccidioidomycosis diagnosed via BAL (bronchoalveolar lavage) and sputum culture respectively during a recent hospitalization two weeks prior. He presented with persistent non-productive [...]

Case Presentation: We present the case of a 46-year-old male from Guyana with a history of type-2 diabetes mellitus who presented with cellulitis of his left foot.  He is a rice farmer working in brakish water environments and had sustained a laceration on the left medial surface of his foot. Five days prior to admission, [...]

Case Presentation: This is a 79-year-old female with a history of stage 3 chronic kidney disease and Sjogren’s syndrome who presented with a two month history of worsening malaise and arthralgia, and a two day history of abdominal distention. On admission, laboratory testing revealed an alkaline phosphatase of 132U/L, aspartate aminotransferase (AST) of 195U/L, alanine [...]

Case Presentation: A 20 year-old G1P1 female with no significant history presents with acute left lower abdominal and thigh pain.  She has had no recent surgeries or immobility and has never been on oral contraceptives.  Her pregnancy was complicated by pre-eclampsia and she delivered at 37 weeks.  Physical exam demonstrated tenderness and induration of her [...]

Case Presentation: A 75-year-old man with bladder transitional cell carcinoma complicated by lung and renal metastases presented with one week of progressive shortness of breath at rest. His dyspnea worsened when reclining and improved with increased home oxygen. He denied chest pain, cough, or lower-extremity edema but noted diplopia, dysphagia, fatigue, and bowel and bladder incontinence. [...]

Case Presentation: An 80-year-old man with psoriasis on ustekinumab and type 2 diabetes mellitus (A1c 5.9) presented with seven days of fever. Two weeks prior to presentation, he underwent epidural steroid injection to the cervical spine for treatment of chronic neck pain. One week later, he developed fever to 103 °F. The patient had recently [...]