Case Presentation: A 51 year old female recently diagnosed with metastatic goblet cell carcinoid mixed adenocarcinoma of the appendix with metastasis to the peritoneum, mesentery, small and large bowel status post ileo-cecectomy and ileostomy presented with acute onset anxiety and mania. Patient presented with a two-day history of decreased sleep, flight of ideas and increased [...]

Case Presentation: A healthy 65-year-old male was admitted to the hospital for presumed COPD exacerbation and despite treatment developed hypoxic respiratory failure and shock, transferring to the intensive care unit (ICU) for further management.On arrival, he was tachycardic (120 BPM), BP 74/47 mmHg, febrile (39.0℃) and mechanically ventilated (RR 14) concerning for septic shock. Examination [...]

Case Presentation: A 33-year-old woman presented to the hospital following seven days of persistent fever and non-productive cough despite a course of azithromycin prescribed by her primary care physician. She denied shortness of breath, chest pain, palpitations or lower extremity swelling. She reported no sick contacts or travel in the last six months. She endorsed [...]

Case Presentation: A 76-year-old man with seropositive RA treated with MTX 15-20mg weekly for at least four years presented to the hospital with worsening fatigue, generalized weakness, poor appetite, and dyspnea. Contrast-enhanced computed tomography of chest abdomen and pelvis (CT CAP) demonstrated numerous pulmonary nodules, centrally hypodense left retroperitoneal soft tissue masses which may represent [...]

Case Presentation: A 54-year-old never-smoker female with hypothyroidism and rheumatoid arthritis on etanercept presented with intermittent hemoptysis. Three days prior, she reported coughing ~100mL of frank blood and clots (Figure 1) over the course of 24 hours, with smaller volumes over the next two days (~50 mL total). She recounted a similar episode of hemoptysis [...]

Case Presentation: A 37-year-old woman with a history of endometriosis, fibroids status post fibroidectomy, and previous spontaneous pneumothorax presented with 3 days of progressively worsening right pleuritic chest pain and dyspnea on exertion. She had a similar presentation nine months prior at an outside hospital and was found to have a spontaneous right pneumothorax requiring [...]

Case Presentation: A 78-year-old woman with severe persistent asthma on a maximum dose of inhaled corticosteroids (ICS) was admitted for lethargy and skin nodules on her thighs. She had three hospital admissions in the past two months for reported pneumonia. She was found to have fever, left basilar crackles, and multiple violaceous, firm, tender subcutaneous [...]

Case Presentation: A 22-year-old male with a history of atopic dermatitis presented with worsening of eczema lesions around his eyes and mouth with blurring of vision bilaterally despite being on oral antibiotics. 2 weeks ago he was treated with a steroid taper for eczema flare in his forearms. Patient reported that he has always had eczema patches around his [...]

Case Presentation: A 40 year-old male with a past medical history of HIV presented with two days of fever, emesis and diarrhea. Two weeks prior he had seen his PCP and had a CD4 650cells/mcL with an undetectable viral load. He was started on Abacavir/Dolutegravir/Lamivudine and had been taking it as directed. On admission he [...]

Case Presentation: A 66-year-old man with uncontrolled type 2 diabetes mellitus (hemoglobin A1c = 18.1%) presented with one month of worsening pleuritic chest pain, productive cough and 10-pound weight loss. He denied any gastrointestinal (GI) symptoms, including diarrhea or abdominal pain. He worked as a clinical nursing assistant. Patient denied any recent international travel, animal [...]