Case Presentation: A 69 year old male was brought to the emergency department from a rehabilitation facility with altered mental status. Two months ago, he had been admitted for lumbar osteomyelitis for which he was started on Vancomycin and Cefepime and was discharged to a rehabilitation facility. After six weeks of therapy, he was more […]

Case Presentation: 71-year-old male with multiple myeloma being treated with dexamethasone, elotuzumab and bortezomib, prior mediastinal plasmacytoma s/p chest radiation therapy and Crohn’s disease was admitted with high-grade fever, chills, productive cough. Labs revealed pancytopenia with neutrophil count of 1.2. Patient was started on broad-spectrum antibiotics for febrile neutropenia. IV Azithromycin was added to the […]

Case Presentation: 71-year-old male with extensive smoking history was referred to the hospital by his PCP for new-onset severe hyponatremia of 117mMol/L. He denied any active complaints and initial physical examination showed an euvolemic male. Low serum osmolality of 245mOsm/kg but high urine osmolality of 309mOsm/kg and high urine sodium of 68mEq/L were suggestive of […]

Case Presentation: A 43-year-old Caucasian woman with stage IV rectal adenocarcinoma metastatic to liver and lung presented with new onset generalized tonic clonic seizures. She was receiving her second line treatment with 5-FU continuous infusion Day number 7 of 7 of the 5th cycle. This was preceded by confusion and altered mentation since the previous […]

Case Presentation: A 41-year-old African American male with a past medical history of overactive bladder and benign prostatic hyperplasia presented to the emergency department (ED) with increasing proximal bilateral lower extremity muscle pain for five days. His pain was accompanied with increasing difficulty with ambulation. The patient also noted persisting hematuria, urgency, and hesitancy for […]

Case Presentation: A 28-year-old man with Stage IV colon adenocarcinoma presented to the emergency department with nausea, vomiting, dyspnea on exertion, and generalized weakness. Two weeks ago, he experienced similar symptoms during his first cycle of fluorouracil (FU) bolus and infusion, oxaliplatin and leucovorin chemotherapy (FOLFOX). Two days ago, he was symptomatically premedicated and received […]

Case Presentation: An 80-year-old female with a history of type 2 diabetes mellitus presented with progressively worsening ataxia and left-sided weakness for 6 months. She had no symptoms attributable to bradycardia and was not taking AV nodal blocking medications. Examination revealed mild left hemiparesis and ataxic gait, with a heart rate of 40 beats/min but was otherwise unremarkable. […]

Case Presentation: A 52-year-old male presented for an evaluation of hematuria. The complete blood count, basic metabolic panel and liver function tests were within normal limits. A CT abdomen and pelvis showed an incidental, 1.5 cm lesion in the right hepatic lobe. Following fine needle aspiration biopsy of the lesion, the tissue demonstrated a slightly […]

Case Presentation: Thiamine deficiency is a known complication of bariatric surgery presenting commonly as Wernicke encephalopathy or dry beriberi. Pure sensory ascending neuropathy as a presenting complaint, however, is rare, which we describe here in the acute setting after intragastric balloon (IGB) placement. A 48 year old obese but otherwise healthy female underwent an uncomplicated […]

Case Presentation: A 40-year-old Bosnian male presented with five days of subjective fevers and dry cough associated with dyspnea. Patient stated he started smoking cigarettes again 10 days prior to admission after quitting for 7 years. Chest imaging demonstrated diffuse bilateral ground glass opacities and consolidations concerning for acute infection. Serologic workup was significant for […]