Case Presentation: A 71-year-old male presented to an outside emergency room after the abrupt onset of severe abdominal pain and vomiting. Physical exam revealed fever, hypotension, and a diffusely tender abdomen with guarding. His past medical history was a complicated course of multiple admissions to outside facilities for abdominal pain over the previous six months, [...]

Case Presentation: A 48-year-old female with spina bifida was admitted for sepsis secondary to sacral osteomyelitis. She improved with broad-spectrum antibiotics, and her antibiotic regimen was narrowed to Zosyn (piperacillin + tazobactam) to complete a 6-week course. On hospital day 12, discharge was delayed pending insurance approval of an air mattress for home. Three days [...]

Case Presentation: A 32-year-old South Asian woman with history of IgA nephropathy complicated by end stage renal disease status post renal transplant (CMV/EBV positive), latent tuberculosis infection, C. Diff colitis, and recurrent urinary tract infections presented with two days of fevers and diarrhea. One week prior to admission she was seen at a local ED [...]

Case Presentation: A 39-year-old man with history of treatment-resistant tumefactive multiple sclerosis (MS) on plasmapheresis presented with a sore throat and persistent fevers for 2 days. His wife recently also had a mild cough and viral conjunctivitis. He was noted to have a temperature of 103.2 F, heart rate of 135, and oxygen saturation of [...]

Case Presentation: A 25 year-old woman with severe persistent asthma, chronic self-resolving episodes of hemoptysis, history of miscarriage, and iron deficiency anemia secondary to heavy menses presented with sub-acute worsening shortness of breath and hemoptysis despite adherence to home inhalers. Patient had multiple prior hospitalizations requiring intubation for asthma exacerbations, complicated by hemoptysis. Upon presentation, [...]

Case Presentation: An 82-year-old, Samoan male with history of poorly controlled diabetes, hypertension, COPD, and pulmonary coccidioidomycosis on fluconazole therapy (400 mg/day) was referred to the hospital by his primary doctor for treatment of a left ankle ulcer and cellulitis that had not responded to ten days of outpatient amoxicillin-clavulanate therapy. He had no constitutional [...]

Case Presentation: A 47 year old man with asthma and a 30 pack-year smoking history presented with shortness of breath, chest tightness, and intermittent fevers for the past week. For the month prior to presentation he was vaping tetrahydrocannabinol (THC) daily. He had no sick contacts and no other drug use or occupational exposures. Initial [...]

Case Presentation: A 29-year-old previously healthy male presented with acute symmetrical joint pain with swelling, back pain, headache, and photophobia. He had no established past medical history and his social history was unremarkable. He was febrile with an examination significant for upper and lower extremity joint tenderness, warmth, and joint swelling in his hands, feet, [...]

Case Presentation: A 43-year-old female with a history of NASH cirrhosis and insulin dependent diabetes was sent from the Hepatology clinic for elevated Creatinine from 1.8 to 4.8 mg/dL. Her vital signs were stable and she was admitted for the management of suspected hepatorenal syndrome. Her hospital course was complicated by 5 weeks of ICU [...]

Case Presentation: A 31 year old female with a history of polysubstance abuse was brought to the Emergency Department by family after they noted confusion, weakness, hallucinations, ataxia, vision loss, and bizarre behaviors for 2 weeks along with the patient emitting a pungent odor. Physical exam was notable for a strong odor permeating from her [...]