Case Presentation: A 58-year-old male with limited prior health care utilization with presumed longstanding untreated HTN, otherwise unknown medical history, presented to a rural hospital with lethargy, confusion, acute renal failure of unknown duration. His personal history is significant for being exposed to pigs and chicken. On exam, he had a left lower extremity wound [...]

Case Presentation: This is the case of a 44-year-old Hispanic male with a history of polysubstance use (alcohol, marijuana and cocaine) and vitamin B12 deficiency presented to the emergency department with lower limb weakness, fasciculations, spasms, paresthesia, ataxia, left-sided blurry vision, emesis and intractable hiccups for several days. He initially symptoms started in September 2018 [...]

Case Presentation: A 21 year old man with no past medical history presented to the emergency department with shortness of breath, vague upper midline abdominal pain, nausea, vomiting and watery, non-bloody diarrhea for four days. He denied any sick contacts or recent travel. Patient admits to smoking JUUL e-cigarettes for 3 years. Vital signs were [...]

Case Presentation: A 21-year-old African American, primigravid presented at eight weeks gestation with a two-week history of progressively worsening lower abdominal and back pain, as well as intractable nausea and vomiting. Her symptoms were accompanied by tachycardia, hypertension, constipation, dark urine and blistering lesions on her lips. On exam, she was tender across her abdomen [...]

Case Presentation: A 31-year-old female with diabetes mellitus, history of IV drug use on methadone, and untreated HCV infection presented with shortness of breath for one week. She developed a cough productive of green sputum with associated shortness of breath, subjective fevers, chills, pleuritic chest pain, nausea, and vomiting. One day prior to symptoms starting, [...]

Case Presentation: A 29 year old woman presented with a generalized tonic clonic seizure and progressively worsening ataxia over the last six months. She also had memory deficits and diplopia. Her past medical history included Li Fraumeni syndrome and an immature ovarian teratoma that was treated with a right oophorectomy and chemotherapy in 2015. Her [...]

Case Presentation: A 65-year-old male presented to the emergency department with a 5-week history of epigastric pain, nausea, constipation and weight loss. Past medical history was significant for combined liver and kidney transplant 3 years prior due to hepatitis C cirrhosis and hepatorenal syndrome. Chronic immunosuppression consisted of mycophenolate mofetil, tacrolimus and prednisone. Laboratory studies [...]

Case Presentation: Sweet syndrome, or acute febrile neutrophilic dermatosis, is an inflammatory condition characterized by acute onset of tender skin lesions composed of dermal neutrophilic infiltrate. Clinical variants are based on lesion morphology. One variant, giant cellulitis-like Sweet syndrome, is characterized by giant erythematous lesions, a case of which is described here. Discussion: A 90 [...]

Case Presentation: Patient is a middle-aged African-American female with a history of hypertension and hyperlipidemia, for which she had been on atorvastatin for approximately four years. She originally presented to her primary care physician for evaluation of a one month history of progressive myalgias and proximal muscle weakness. Creatine phosphokinase (CPK) level was elevated to [...]

Case Presentation: Patient is a 29 year old male with no significant past medical history who presented for evaluation of worsening shortness of breath and headaches over one month. He had also lost 15 pounds and was experiencing night sweats and significant fatigue. He required ICU admission for hypoxic respiratory failure. CT chest showed multiple [...]