Case Presentation: A 71-year-old male presented to the emergency department (ED) complaining of a 3-week history of dysphagia and ~30lb weight loss. He had been transferred to the ED after a failed formal swallow evaluation, nearly three weeks after the onset of symptoms, during which he demonstrated significant aspiration even with thick liquids. In addition […]

Case Presentation: A 39 year old female presented on day 10, status post (s/p) laparoscopic gastric sleeve, with nausea, vomiting, abdominal pain and loose mucoid stools intermittently since surgery. She had history of rheumatoid arthritis, morbid obesity, with provoked lower extremity deep venous thrombosis (DVT) and pulmonary embolism (PE) who had previous IVC filter and […]

Case Presentation: A 71 year old Caucasian man with uncontrolled diabetes mellitus, stage III chronic kidney disease, hypertension, hyperlipidemia, sick sinus syndrome, and osteomyelitis of the right 2nd metatarsal s/p amputation, was transferred from an outside hospital for evaluation of rash and acute on chronic kidney injury. He first presented to the outside hospital for […]

Case Presentation: A 19-year-old woman with a history of anxiety was admitted to the hospital with one week of fever to 103 degrees F, sore throat, fatigue, and severe arthralgias. History was notable for pleuritic chest pain, an intermittent rash over her arms and thighs, and a 23-pound weight loss over 12 months, which she […]

Case Presentation: One-year prior, the patient had left total knee replacement complicated by acute limb ischemia requiring revascularization followed by graft infection for which she was initially on caspofungin and later switched to maintenance voriconazole treatment for candida glabrata infection. Few months later she started complaining of morning stiffness and swelling in multiple joints including […]

Case Presentation: A 68-year-old African-American woman with known history of refractory IgG kappa multiple myeloma presented with fever, congestion, and purulent drainage from both ears that had been progressively worsening over the past week. She initially attributed her symptoms to sinus infection and self-treated with a Neti Pot using non-sterile water. The Neti Pot was […]

Case Presentation: A 57-year-old man with past medical history of hypertension and left partial nephrectomy for renal cell carcinoma presented to the emergency department with several days of fevers, diarrhea, and fatigue. On examination, the patient was lethargic and febrile to 103°F with a blood pressure of 80/50mmHg. His labs were notable for an elevated […]

Case Presentation: A 33-year-old woman with past medical history of hypertension presented to an outside hospital with a one week history of dyspnea on exertion and acute hypoxic respiratory failure. She had also previously lived in Arizona. Upon presentation to outside emergency department, she had significant sinus tachycardia and tachypnea with an oxygen saturation of […]

Case Presentation: 63 year old female with RA on methotrexate presented with a 2 week history of fevers (Tmax of 102), nausea, and multiple episodes of diarrhea. The patient denied any recent travel, sick contacts, or antibiotic use. On admission, CT abdomen/pelvis showed extensive enterocolitis as well as thrombocytopenia with platelets of 128K. Stool GI […]

Case Presentation: Severe peripheral disease with arterial thrombosis can present as bilateral leg paralysis and extreme pain. Caution must be exercised to exclude vascular pathology ( in addition to neurologic differentials), to avoid premature closure of diagnosis and to avoid catastrophic outcomes. One such rare disorder is Leriche syndrome, whereby, patients develop aortoiliac thrombotic occlusion, […]