Case Presentation: A 28 year old man presented to the ED with hypotension and tachycardia. Laboratory evaluation showed hyponatremia, hyperkalemia, hematocrit of 47.4, cortisol level<0.5, ACTH elevated at 886, TSH 11.91, Free T4 1.0 and negative anti TPO antibody. On admission, the patient had orthostatic hypotension and ashen grey skin tone. Cosyntropin stimulation test resulted [...]

Case Presentation: A 41 year old African American man history presented with 8 months of diarrhea with tenesmus. He had no past medical history and took no home medications. He also complained of cough and 15 pound unintentional weight loss in the past month, but had no nausea or vomiting. He was febrile to 103.7, [...]

Case Presentation: A 48 year-old male with a past medical history of morbid obesity, hypertension, and poorly nutritious diet consisting strictly of “pizza and chips” who presented after he was found unresponsive and incontinent of urine at home. He reportedly did not consume alcohol. Four weeks prior to presentation, he developed an acute onset of [...]

Case Presentation: 39 YO WM presented to PCP with lower back pain that he initially attributed to pulling muscles after playing golf. Pain persisted and got worse. His PCP ordered lumbar spine CT when he started to have cauda equina compression symptoms which showed intradural sacral mass. Initial labs revealed 45% eosinophilia and mild leukocytosis. [...]

Case Presentation: A 56 year-old man with a history of immunosuppressive therapy with prednisone and tacrolimus for a cadaveric kidney transplant presented with 1 month of personality change and lethargy. He was also noted to have generalized weakness and fatigue. He was initially seen 3 weeks prior to admission for these symptoms, which were attributed [...]

Case Presentation: We present a case of a 52 year old female with acutely altered mental status who was misdiagnosed of severe hypoglycemia due to a failure to recognize an incorrect common lab result.  This is a Caucasian female with a past medical history of end stage renal disease on hemodialysis, scleroderma, and Raynaud’s, who was found [...]

Case Presentation: We present a rare case of MoyamoyaDisease (MMD) in a 44-year-old Caucasian female with a medical history of severe recurrent headaches. She presented with an excruciating headache and was found to have right-sided facial droop, and dysarthria. Initial imaging demonstrated an intraparenchymal and intraventricular hemorrhage, along with chronic occlusions of the middle cerebral [...]

Case Presentation: Inflammatory polyarthritis and panniculitis are rare sequela of pancreatic disorders. This condition has been termed Polyarthritis, Panniculitis and Pancreatitis (PPP) and occurs in less than 5% of patients with underlying pancreatic disease.  A 64 year old man presented with chronic erythematous, edematous, and tender subcutaneous nodules on all four extremities. He also had bilaterally [...]

Case Presentation: We describe a typical presentation of meningococcus meningitis, diagnosed by blood culture. A Congolese man who had recently arrived in New Mexico after living in a Tanzanian refugee camp presented with a 2-day history of worsening diffuse headache, productive cough, non-bloody diarrhea, and persistent fevers. He had not had any sick contacts. He [...]

Case Presentation: Our patient is a 37-year-old gentleman with history of colonic Burkitt’s Lymphoma, in remission since 2010, eosinophilic colitis (on a prolonged steroid taper), CMV colitis, and common variable immunodeficiency, who presented with acute on chronic diarrhea. He incidentally noted worsening bilateral lower extremity weakness over the past 2 years, requiring the use of [...]