Case Presentation: 70 year old male admitted for a complicated UTI was placed on piperacillin / tazobactam empirically and subsequently developed abdominal distension and small bowel obstruction. He was admitted to the ICU for fulminant colitis secondary to severe Clostridium Difficile with concern for toxic megacolon. Labs showed a WBC of 34 along with an [...]

Case Presentation: 42-year-old woman with a history of pulmonary embolism and Antiphospholipid syndrome on lifelong anticoagulation with warfarin presented with severe neck pain and headache for five days. Examination revealed an ill appearing woman, febrile to 101F with excruciating neck pain aggravated by movement in all directions and swallowing. Labs were remarkable for an elevated [...]

Case Presentation: A 39-year-old Hispanic male presented to his primary care physician with progressive fatigue, leg weakness, and occasional falls. His past medical history was unremarkable. A clinical diagnosis of disk herniation was made and treated conservatively.  Two weeks later, he presented to our emergency department (ED) with upper and lower extremity weakness, unable to [...]

Case Presentation: A 24 year-old male presented with chest pain and a diarrheal illness. He complained of intermittent chest pains which began two weeks prior, described as retrosternal, aggravated by lying down and improving on sitting up. One week following this, he started experiencing fevers, chills along with nausea, vomiting and diarrhea. Given persistent high [...]

Case Presentation: An 82-year-old man with a past medical history of coronary artery disease, atrial fibrillation, heart failure with reduced ejection fraction, stroke, non insulin-dependent diabetes mellitus and chronic kidney disease stage III presented to the hospital with uncontrollable movements of his right-side upper and lower extremities. His symptoms began spontaneously two weeks earlier and [...]

Case Presentation: A 36-year-old female with no clear past medical history other than possible mood disorder presented after three days of decreased level of consciousness. Associated symptoms included body aches, fever, chills, nausea, vomiting, and headaches. The patient had been suffering from flu-like symptoms two weeks prior to presentation and was treated with antibiotics. The [...]

Case Presentation: A 30 year old Hispanic female with no past medical history presented with a one week history of progressive dyspnea and lower extremity edema. Her dyspnea was present at rest, and she also reported orthopnea and nocturnal cough. She denied any associated chest pain, nausea, or diaphoresis. Upon presentation, vital signs were stable [...]

Case Presentation: A 42-year-old Ethiopian woman presented to the emergency department complaining of an enlarging neck mass, dysphagia, anorexia, vomiting and constipation for the previous two weeks. She had no relevant past medical or family history. On admission, she became acutely altered requiring intubation for airway protection. She was normotensive and tachycardic, and a significant [...]

Case Presentation: A 68-year-old Caucasian male with intact immunoglobulin multiple myeloma (IIMM), presents with a 1-day history of fevers, confusion, and weakness. This patient’s IIMM was characterized by elevated serum IgA levels (5,186 mg/dL on diagnosis. Normal 82-453 mg/dL) and an elevated monoclonal IgA lambda (m-spike) on serum electrophoresis (6.13 g/dL on initial diagnosis), but [...]

Case Presentation: Pericardial effusion is relatively common in patients with uncontrolled hypothyroidism, but rarely, it progresses to cardiac tamponade. We describe a case of myxedema coma presenting with cardiac tamponade.   Discussion: A 63-year-old African American morbidly obese lady with history of hypothyroidism presented with worsening dyspnea and unresponsiveness. Family reported that she is non-compliant [...]