Case Presentation: A 54 year-old Caucasian male presented with 1 week of progressively worsening bilateral lower extremity weakness. This was preceded by 1 month of nausea, vomiting, and right upper quadrant pain. On evaluation, his vitals were within normal limits and his physical examination was significant for bilateral proximal lower extremity weakness with normal distal [...]

Case Presentation: A 67-year-old woman with a history of osteoporosis, GERD, diverticulitis, and osteoarthritis presented to the emergency department with altered mental status and a witnessed tonic-clonic seizure one day after receiving zoledronic acid (ZA) for treatment of osteoporosis. The seizure was refractory to medical management and she required intubation for airway protection. Labs were [...]

Case Presentation: A 61-year-old African American male with past medical history of type I diabetes mellitus, hypertension, benign prostatic hyperplasia, stage IV chronic kidney disease, and peripheral vascular disease presented to the hospital for altered mental status, lethargy, and hypoglycemia. Home medications included amlodipine, atorvastatin, ergocalciferol, insulin detemir, insulin lispro, lisinopril, sertraline and tamsulosin. After [...]

Case Presentation: A-28-year-old male with history of asthma and bipolar disorder presented to our hospital with a 10-day old, painful rash on bilateral lower extremities. History was significant for flea bites that occurred a day before the rash started. The rash started off as 3/10 petichae on both legs, but over 2 days it rapidly [...]

Case Presentation: A 78-year-old Japanese man with chronic heart failure and type 2 diabetes presented with a 2-day history of recurrent fever six days after the termination of a 12-day antimicrobial treatment for pyelonephritis caused by Escherichia coli. The physical examination revealed a body temperature of 38.9 °C, respiratory rate of 24 breaths per minute, [...]

Case Presentation: A 56 year-old man with a history of psoriasis on adalimumab, coronary artery disease with prior stents, presented with chest pressure, dizziness, and dyspnea on exertion after noticing three days of melena and crampy abdominal pain. He denied nausea, vomiting, hematemesis, or bright red blood per rectum. Other than taking aspirin 81mg once [...]

Case Presentation: A 65 year-old man with a past medical history of CAD s/p CABG, ischemic cardiomyopathy with EF 35%, bicuspid aortic valve stenosis s/p aortic valve replacement, and asbestosis presented to the ER for evaluation of anterior neck swelling, dyspnea on exertion, dysphagia, and a 30 lb unintentional weight loss over 5 months. On [...]

Case Presentation: A 46 year-old male from India presented with acute epigastric abdominal pain, dysphagia, decreased appetite, nausea, and generalized weakness. This case starts 6 months prior to admission when he was found to have an elevated creatinine at a routine primary care visit. Subsequently, due to worsening kidney function, a kidney biopsy was performed [...]

Case Presentation: A 21-year-old healthy Hispanic male presented to the hospital for evaluation of fever and sore throat for 4 weeks. He had no significant past medical history and he was not on any medications. His vital signs were within normal limits. Physical exam revealed icterus and no hepatosplenomegaly. The remainder of the physical exam [...]

Case Presentation: A 45-year-old woman with a history of ER-/PR-/Her2+ breast cancer previously in remission, recently diagnosed with recurrent metastatic breast cancer pathologically and on imaging, presented to the hospital with multiple days of dyspnea and dry cough. Vitals were remarkable for hypoxia and tachycardia. Electrocardiogram showed sinus tachycardia without ischemic changes. Troponin and B-type [...]