Case Presentation: A 55 year-old male with occasional cocaine use and no significant medical history presented with slurred speech for one day. Initial vital signs showed BP 122/73, HR 64, RR 18, Tm 97.2, SaO2 84% on room air. Physical examination was notable for lethargy and slurred speech. There was no facial asymmetry or focal [...]

Case Presentation: A sixty-two year old woman presented with altered mental status, acute right-sided weakness, hypoglycemia, and acute-on-chronic kidney disease. Physical exam was also significant for lower extremity edema. A head CT demonstrated left parietal meningioma. Her symptoms resolved, but her hospital course was complicated by worsening pulmonary hypertension, diastolic dysfunction and progression of her [...]

Case Presentation: A 42-year-old African American woman with a history of hypertension, morbid obesity, and obstructive sleep apnea presented to the emergency department with a 12-hour history of left-sided abdominal pain, nausea and vomiting. At presentation her medications included hydrochlorothiazide, acetaminophen, ibuprofen, and lisinopril. Her first dose of lisinopril 5mg was 12 hours before the [...]

Case Presentation: A 79-year-old male patient with a history significant for metastatic melanoma to the right axillary lymph node and recurrent diarrhea secondary to ipilimumab-induced colitis is admitted for uncontrolled diarrhea with rectal bleeding.  He has had several prior admissions for diarrhea, which have been successfully treated with IV steroids, but has recurrent diarrhea when [...]

Case Presentation: A 65-year-old male underwent vascular repair for a psuedoaneurysm of left brachiocephalic arteriovenous fistula. During surgery he was noted to have excessive bleeding and also postoperatively, he continued to ooze from the surgical site. His labs revealed PT of 33.5 seconds, INR of 3.3, and PTT of 53.7 seconds. His mixing studies showed [...]

Case Presentation:   A 47-year-old woman with history of immunoglobulin G (IgG) deficiency presented with severe headache, fever, vomiting, neck pain and photophobia. On the day prior to admission, she received first dose of Intravenous immunoglobulin (IVIG) infusion for recurrent bacterial infections refractory to antibiotic prophylaxis. On examination, her temperature was 100 °F and vital [...]

Case Presentation: A 69-year-old right-handed Asian male was referred to our hospital for evaluation of chronic headache of 4 months duration. On examination, he was afebrile with stable vitals and did not have any focal neurological deficits. Initial laboratory evaluation, including complete blood counts, a comprehensive metabolic panel, and urinalysis were within normal limits. Cerebrospinal [...]

Case Presentation: A 32-year-old man with no significant past medical history presented with one day of respiratory distress and fever, sore throat, left neck pain and cough for 3 days. He appeared acutely ill, febrile, tachycardic and tachypneic. Lung exam revealed bronchial breath sounds and crepitation on bilateral lower lobes. Laboratory studies revealed neutrophilic leukocytosis and a normal [...]

Case Presentation: A 24 year old caucasian male with no significant past medical history was admitted with right flank pain and hematuria of 5 days duration. The pain was stabbing in chararcter, non-radiating with no significant aggrevating or allevaiting factors. The patient reported episodes of intense pain that lasts for three to four hours, with [...]

Case Presentation: A 19-year old Caucasian female with a history of atopic dermatitis and mild asthma developed an erythematous maculopapular rash on her bilateral palms and wrists, right-sided tender cervical lymphadenopathy, and nightly fevers and headaches five days after returning from a one-month trip to Cambodia. She presented two weeks after returning from her trip [...]