Case Presentation: A 51-year-old African-American female was admitted to the hospital with 3 days of bilateral calf pain, described as a severe cramping pain that started in the left medial calf. The patient first noticed the pain after walking two blocks. The pain did not subside with rest. The next day, the patient noticed similar [...]

Case Presentation: A 54-year-old woman with no past medical history who received her influenza vaccine 2 weeks prior presented with a sudden onset of profuse gum bleeding upon brushing her teeth. In the ED, the patient was found to have a platelet count of 3 K/μL which was 285 K/μL 3 months ago. She denied [...]

Case Presentation: A 67-year-old man with history of Hashimoto thyroiditis was attending a routine clinic appointment and was found to have a resting heart rate of 40 beats per min and was referred to the emergency department. The patient had not been evaluated by a physician for two years and previous heart rates were unknown. [...]

Case Presentation: A 49 year old man with HIV (on HAART therapy), end-stage renal disease, and anal cancer presented with altered mental status, having just begun chemotherapy with mitomycin and a continuous infusion of 5-fluorouracil. Exam was significant for lethargy, difficulty concentrating, and confusion as well as occasional lip-smacking. Routine laboratory analysis was normal, other [...]

Case Presentation: A 46 year-old woman presented with one week of palpitations and dyspnea on exertion. Her medical history was remarkable for a pericardial effusion of unknown etiology two months prior, treated with pericardiocentesis in Guyana. On presentation she was hemodynamically stable. Exam was significant for distant heart sounds and decreased breath sounds at the [...]

Case Presentation: A 58-year-old man with history of heavy tobacco use, presented to the emergency department with intermittent watery nonbloody diarrhea for 4 days, associated with worsening confusion and decreased urine output. He denied recent traveling or sick contacts. On examination he was found to be febrile (102.6F), hypertensive, tachycardic (102bpm) and tachypneic (22rpm) and [...]

Case Presentation: A 65-year-old black woman with history of longstanding controlled HIV on highly active antiretroviral therapy (HAART) and chronic Hepatitis C co-infection, presented with a 2-day history of worsening lower back pain. She was compliant with her HAART regimen (darunavir, lamivudine, raltegravir and ritonavir) since her diagnosis in 1994, with persistently undetectable viral loads [...]

Case Presentation: A 54-year-old male with history of cocaine and marijuana abuse presented to the emergency room (ER) with a few-hour history of dizziness and abdominal pain. He also reported a two-month history of intermittent right upper jaw pain that he was treated for presumed gingivitis with analgesics and antibiotics. In the emergency department, vital signs [...]

Case Presentation: A 69-year-old Peruvian female with a remote history of endometrial cancer initially presented to her primary care physician with one week of subjective fevers, night sweats, bilateral ear pain and sore throat. She was prescribed amoxicillin-clavulanic acid and chest x-ray was ordered. She returned three days later with persistent symptoms. Chest x-ray from [...]

Case Presentation: A 45 year-old Hispanic-female was admitted from ophthalmology clinic to the internal medicine ward for 3 week history of left-sided blurry vision, diplopia, opthalmoplegia, ptosis, peri-orbital pain, occipital headaches, impaired V1 and V2 facial sensation, and intermittent ear pain. Her medical history was pertinent for rheumatoid arthritis on immunosuppression and poorly controlled type [...]