Case Presentation: Acute adrenal insufficiency (adrenal crisis) is life-threatening and requires prompt diagnosis and treatment. We present a case of adrenal crisis with delayed diagnosis and treatment due to a normal serum cortisol level, and we discuss the role of cortisol levels in diagnosing acute adrenal insufficiency. A 28-year-old male diagnosed with HIV, on treatment, [...]

Case Presentation: A 35 year old African American woman with a past medical history of alcohol and tobacco abuse and acute pancreatitis presented to the hospital with a progressive dyspnea and nonproductive cough for one month not responding to outpatient antibiotics. Six months prior to presentation, she was hospitalized for acute pancreatitis that was attributed [...]

Case Presentation: We present a case of a 65 year old female with a recent diagnosis of small cell lung cancer (SCLC) who had completed four cycles of carboplatin and etoposide. She was subsequently initiated on maintenance program cell death ligands (PD-L1) inhibitor, atezolizumab every three weeks since January 2019. Seven months after initiation, she [...]

Case Presentation: 71-year-old African American female with history of chronic right ear infection/mastoiditis, hypertension, hyperlipidemia, stroke with residual expressive aphasia, diabetes mellitus type II and atrial fibrillation, presented to the ED for diplopia and pain to the right face. Initially the diagnosis of giant-cell arteritis was entertained and temporal artery biopsy showed no evidence of [...]

Case Presentation: A 61-year-old female with history of alcoholism presented with confusion and hallucinations. Three days prior to admission, the patient fell while intoxicated. She typically drank 1-2 bottles of wine daily. She endorsed dizziness and blurry vision since the fall as well as visual hallucinations and paranoid delusions. On examination, she was unable to [...]

Case Presentation: A 28-year-old HIV positive male presented with one week of rectal pain and bloody diarrhea. He was found to have bright red blood in vault on rectal examination. Laboratory studies were concerning for a leukocytosis with left shift, an elevated CRP (>80 mg/dl), and a positive fecal calprotectin. His CT scan demonstrated circumferential [...]

Case Presentation: A 53-year-old female with no medical history presented with worsening mental status for 3 months. All history was given by family. Three months prior to presentation she began experiencing a generalized, persistent headache. A neurologist prescribed nortriptyline for presumed migraines, with improvement. In the month prior to presentation, the patient had become less [...]

Case Presentation: The patient is a 51 year old female with a history of acute cholecystitis status post cholecystectomy who presented to the hospital for acute on chronic abdominal pain. Since her cholecystectomy five months prior, she had recurrent episodes of nausea, vomiting, and abdominal pain with persistently elevated LFTs and bilirubin. Liver biopsy and [...]

Case Presentation: A 46-year-old female presented with a 2-day history of shortness of breath, pleuritic chest pain and lower extremity swelling while taking low-molecular weight heparin (LMWH). One month prior she was diagnosed with a left lower extremity DVT after a hysterectomy. She was treated with LMWH with a planned transition to rivaroxaban. Medical history [...]

Case Presentation: A 48-year-old man with a history of gastroesophageal reflux disease and obstructive sleep apnea presented with one week of pain, warmth, and rash over the right foot accompanied by episodic fever and headaches. He was a landscaper. Six weeks ago, he fell from a ladder with resultant right nondisplaced medial malleolar and comminuted [...]