Case Presentation: A healthy, pleasant 25 years old male, dog-owner, with Down syndrome presented with generalized malaise, intermittent fevers, chills, sweating, abdominal pain, intermittent neck pain that progressively worsened over a week. His fever was ranging from 101-105 Fahrenheit and spiked nocturnally. He had raked the yard 2 weeks ago and his parents were concerned […]

Case Presentation: A 47 year old woman with Lynch syndrome presented with only intermittent abdominal discomfort and mucus in her stools for several months. Colonoscopy showed patchy erythema in the cecum and the transverse colon. The pathology revealed high-grade dysplasia with focal intramucosal signet ring cell carcinoma. Immunohistochemical stains were positive for CD68, CDX2, pankeratin […]

Case Presentation: 46 year old woman presented with 1 week of bilateral lower extremity tingling, numbness, abnormal gait, leg spasms and impaired concentration. Exam revealed a disheveled, confused appearing Caucasian woman with a spastic, unsteady gait. Pupils, cranial nerve testing and upper extremity neurological exam was intact. Muscle tone was spastic; reflexes brisk 3+ and […]

Case Presentation: A 59-year-old man with a history of type II diabetes, hypertension, and hyperlipidemia presented with progressive dyspnea on exertion for four weeks. On exam, the patient was tachycardic with an elevated jugular venous pressure of ~16 cmH2O, bibasilar rales, and bilateral lower extremity 2+ pitting edema. Labs were notable for an elevated BNP […]

Case Presentation: A 43-year-old man presented with one month of progressively worsening malaise and polyarthralgias to the point that he could not walk or hold utensils. He reported that shortly after removing a tick from his thigh while in upstate New York he developed fevers, anorexia, dizziness, and memory problems in addition to the rheumatic […]

Case Presentation: An 89 year-old male developed coagulase negative Staphylococcus bacteremia and infective endocarditis of mitral valve after urinary procedure for which he was started on Daptomycin for 6 weeks. At week 4, he developed fever and exertional shortness of breath without other respiratory symptoms. He was a non-smoker with no history of COPD or […]

Case Presentation: A healthy 33-year-old woman presented with bilateral facial palsy for one week. Three weeks prior to presentation, she developed fevers, headache, diffuse myalgias, and distal limb paresthesias. One week prior to admission, she developed a right-sided facial droop. At that time she was diagnosed with Bell’s palsy secondary to a viral infection; Lyme […]

Case Presentation: ST-elevation in lead aVR, with ST-depression in precordial leads, has been reported to arise from left main coronary disease, often required emergent cardiac catheterization. We present a case of unstable SVT in a patient with hypertrophic cardiomyopathy (HCM) mimicking acute coronary syndrome (ACS) and cardiogenic shock. An 89-year-old female with paroxysmal atrial fibrillation […]

Case Presentation: A 60-year-old cisgender man with CAD with previous stent placement on antiplatelets, beta blocker, and statin presented to the ED with chest pain for 1 day. The chest pain developed suddenly at rest and was described as a left-sided pleuritic pain with dyspnea on exertion. There were no other associated symptoms aside from […]

Case Presentation: A 30-year-old male presented to the ED with sudden onset flaccid paralysis involving the entire body except the head and neck. He reported heavy marijuana use 2 days prior during which he consumed excessive amounts of carbohydrates, including large bags of gummy bears and candy bars. One day after binge eating episode he […]