Case Presentation: A 53-year-old woman with a history of irritable bowel syndrome-diarrhea (IBS-D), chronic pain syndrome and years of nonspecific symptoms including chronic diarrhea and neuropathy, presented with bilateral lower extremity edema. Multiple outpatient visits and studies demonstrated nonspecific autoimmune condition with questionable monoclonal gammopathy of undetermined significance (MGUS) as well as a presumed diagnosis [...]

Case Presentation: An undomiciled 48-year-old man with HIV presented with fever, chills, rigors, and bilateral leg swelling with pain for 1 week. He had developed worsening painful weeping ulceration most prominently over his right leg below the knee after exposure to water during a series of thunderstorms over the week prior. Physical examination revealed fever, [...]

Case Presentation: A 69-year-old man with prior right adrenalectomy for primary hyperaldosteronism presents with lightheadedness, resistant hypertension, and hypokalemia.He had been diagnosed with primary hyperaldosteronism several years prior following workup for resistant hypertension, chronic hypokalemia, and orthostasis. At that time, he was found to have an elevated aldosterone level associated with suppressed renin and normal [...]

Case Presentation: A 49-year-old man with metastatic pancreatic adenocarcinoma diagnosed three months ago and not yet on therapy presented to the emergency room with symptoms of nausea, vomiting, and abdominal pain for one day. Computed tomography of the abdomen and pelvis showed splenic infarcts, bilateral renal infarcts, and increased size of hepatic metastases. On the [...]

Case Presentation: 72 years old Caucasian male presented to the hospital with the complaint of generalized maculopapular rash involving the chest and bilateral upper and lower extremities with the itching for the last 12 hours. He also had been having diarrhea for the last 2 days which was loose watery in consistency and yellowish in [...]

Case Presentation: A 60 year old male with history of diverticulitis, uric acid nephrolithiasis, gout presented with 1 day history of sudden onset left lower quadrant pain and decreased urine output. Pain was a constant aching pain that radiated to his left flank and was gradually worsening. Since symptom onset, patient also reported scant urine output with no [...]

Case Presentation: A 19 year-old obese man presented to the emergency room with 5-day history of periumbilical rash, pain and bloody purulent umbilical discharge.On presentation, the patient was febrile (38.4 C), hypotensive (98/54 mmHg), and tachycardic (111 beats/min). On exam, the periumbilical region was erythematous, indurated, and tender to palpation without rebound tenderness or guarding.Laboratory [...]

Case Presentation: Gastrointestinal (GI) manifestation of chronic lymphocytic leukemia (CLL) is very rare. This usually occurs after acute blastic transformation of CLL to diffuse large B-cell lymphoma called Richter transformation (RT). We report the first case in literature of anal ulceration caused by CLL without RT.A 67-year-old female with a history of partially treated CLL [...]

Case Presentation: A 63-year-old man with asthma, chronic rhinosinusitis, and fifty-pound weight loss in the past seven months, was admitted to the hospital for left parietal and right occipital stroke. Asthma was diagnosed in childhood and was well-controlled without recent exacerbation. Patient had focal right hand weakness of 4/5 strength, petechiae on the left lateral [...]

Case Presentation: A 24 year-old woman presented to the emergency room for a sore throat and diffuse body aches, with weakness in her shoulders and hips to the point that she required assistance with ambulation over the past week. She was afebrile and normotensive at admission but initial labs were significant for a WBC of [...]