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, […]

Case Presentation: An 18 year old female with a history of cirrhosis due to autoimmune hepatitis on immunosuppressants presented with acute low back strain. On presentation, her vital sign was remarkable for heart rate of 129 bpm. Physical exam revealed splenomegaly with mild pedal edema and low back tenderness. Laboratory evaluation showed a hemoglobin of […]

Case Presentation: 18-year-old female college student with a past medical history of polycystic kidney disease, febrile seizures and treated Kawasaki’s disease presented with bilateral lower extremity muscle weakness, which was acute and uniform without any patterns such as ascending or descending quality. The severity of the symptoms lead to patient’s inability to ambulate without support […]

Case Presentation: We report a 32 yr old HIV positive lady who presented with acute onset right thoracic multi-dermatomal herpes zoster and ipsilateral upper and lower limb weakness. She had been on HAART since 2002 but stopped her medications for few months prior to presentation. Her examination was significant for right side localized vesicular rash […]

Case Presentation: A 64 yr old gentleman presented to the emergency department of our hospital with abdominal pain and hematuria. Initial laboratory evaluation revealed unremarkable metabolic profile and mild anemia (Hgb -9.3 g/dl). Urinalysis was full of RBC’s with negative culture. CT abdomen revealed bilateral hydroureteronephrosis (HDUN) with a bladder mass (Fig I). Cystoscopy revealed […]

Case Presentation: A 24-year-old gentleman gentleman presented to the emergency room complaining of left precordial discomfort and syncopal event at work. His system review was negative. He acknowledged using marijuana with the last usage being the morning of presentation. His initial EKG revealed sinus bradycardia (Figure A). His preliminary blood work revealed normal chemistry, TSH. […]

Case Presentation: An 89 year-old female with hyperlipidemia presented with diplopia, vertigo, and dysarthria. Seven weeks prior to presentation, she developed horizontal diplopia. Four weeks prior, she noted vertigo with no hearing loss, tinnitus, or aural fullness. Two weeks prior, her speech became slurred. She presented to an outside hospital where MRI with contrast was […]

Case Presentation: Case 1: A 56 year old female with history of metastatic adenocarcinoma of lung on cycle 1 day 8 of carboplatin/permetrexed/pembrolizumab therapy presented with fever, headache and altered mental status. She was diagnosed with Methicillin resistant Staphylococcus aureus (MRSA) bacteremia and was treated with antibiotics. She presented with potassium levels of 3.4 mmol/l […]