Case Presentation: 66 year old man with a history of eosinophilic granulomastosis with polyangiitis presented with ascending numbness and unsteadiness that worsened over two days and finally manifested as paraesthesia and weakness in all extremities, gait imbalance, and diplopia. Three weeks prior to presentation, the patient had received the flu vaccine. Neurology was consulted upon [...]

Case Presentation: This patient was a 44-year-old female with a past medical history of localized scleroderma (morphea) of the breast diagnosed by punch biopsy. She presented to the emergency department with right upper quadrant pain and nausea. At that time, a CT scan showed a heterogeneous liver without a definitive underlying mass. Her workup revealed [...]

Case Presentation: A 32 year old male presented with worsening headaches over several weeks. He had multiple previous visits to medical and psychiatric facilities often leaving against medical advice (AMA). On his last hospital visit, a large brain mass was discovered on imaging. However, he left AMA before work-up was complete. He was later brought [...]

Case Presentation: A previously healthy 38-year-old man presented with 8 days of intermittent colicky RUQ pain and jaundice. He denied any OTC or illicit drug use but did report daily alcohol use. On admission HAV, HBV, HCV, and HIV 1 & 2 screening, urine drug screen, and autoimmune workup were negative. Ceruloplasmin, serum copper, serum [...]

Case Presentation: A 41-year-old female presented with a three-day history of nausea, vomiting, and diffuse abdominal pain radiating to her back. The day prior to admission, the patient started having hematemesis, characterized as “streaks” of blood in her emesis. The patient had recently been in a motor vehicular accident leading to a tibial plateau fracture [...]

Case Presentation: A 94-year-old female with a past medical history of cerebrovascular accident (no residual effects) presented with an intertrochanteric fracture of the right proximal femur after a mechanical fall. On arrival, the patient was afebrile, vital signs hemodynamically stable. On exam, the patient was alert and oriented x3 with no focal deficits, extremities warm [...]

Case Presentation: A 55-year-old woman with a history of Trisomy 21, dementia and seizure disorder previously on Levetiracetam presented with acute altered mental status that began 24-48 hours prior. Patient initially presented to her neurologist 4 days prior to admission for concern of behavioral changes by her caretakers and was started on valproic acid (VPA). [...]

Case Presentation: A 50 year-old African American male with type 2 diabetes requiring insulin, end stage renal disease on peritoneal dialysis, coronary artery disease, infertility, chronic pancreatitis, alcohol use disorder, and recent influenza presented with fever and cough. He was afebrile, hypotensive, tachycardic, and tachypneic with a leukocytosis and bibasilar consolidations on chest x-ray. He [...]

Case Presentation: While erythema migrans (EM) is the most common feature of Lyme disease occurring in about 60% to 90% of cases in North America, Lyme Carditis is very rare and generally accounts for less than 1% in most series.We hereby present a rare case of complete heart block in a 34-year-old healthy male in [...]

Case Presentation: A 68-year-old woman with a history of remote coronary artery bypass surgery and aortic valve replacement presented with multiple syncopal episodes. The patient was in her usual state of health until three months prior to presentation when she experienced an episode of dizziness quickly followed by loss of consciousness. Multiple similar episodes of [...]