Case Presentation: A 58-year-old male presented to the emergency department with a twelve-hour history of sudden, painless and progressive left sided loss of vision following the consumption of tadalafil 20mg tablet for erectile dysfunction. He denied loss of consciousness, seizures, dizziness, headache, slurred speech, palpitations, tinnitus, urinary or stool incontinence, recent trauma, recent changes in [...]

Case Presentation: A 48-year-old Columbian woman presented with 5 weeks of malaise, epistaxis, and hemoptysis. Physical exam was relevant for fever, conjunctival injection, hoarseness, coarse breath sounds, tachycardia, mononeuritis, trace lower extremity edema, and no stigmata of thrombotic microangiopathy (TMA). Labs were significant for a creatinine of 2.8, leukocytosis, thrombocytosis of 992×103, and microscopic hematuria. [...]

Case Presentation: A 56-year-old female with history of tobacco use, chronic obstructive pulmonary disease, and chronic alcoholic pancreatitis presented to the hospital with 5 days of fever, left flank pain, and dysuria. Vitals were notable for tachycardia. On physical exam, there was moderate tenderness on palpation of her left flank. Blood tests were significant for [...]

Case Presentation: A 19 year old female with history of marijuana use presented with subacute, progressive shortness of breath. Productive cough began two weeks prior to presentation. She was diagnosed with atypical pneumonia and received azithromycin from her outpatient provider. After two days without improvement in symptoms, she presented to a nearby hospital with acutely [...]

Case Presentation: A 32-year-old female presented to the hospital with a complaint of progressively worsening rash. About 3 days prior to the rash, she had experienced fevers, chills, and malaise. Physical exam was notable for erythematous papules on the forehead, arms, and chest. Blood tests were pertinent for mild leukopenia and anemia, elevated inflammatory markers [...]

Case Presentation: A 55-year-old male with a history of hypertension and bipolar disorder presented with abdominal and groin pain, and unintentional 40lb weight loss over the past 4 months. Furthermore he reported fevers, chills, hematuria, and dysuria. On physical exam he had right upper quadrant abdominal tenderness, bilateral hard and immobile inguinal lymph nodes, and [...]

Case Presentation: A 23-year-old male with intermittent controlled asthma, presented to the emergency department for recurrent hemoptysis and night sweats of two months duration. The patient also complained of loss of sensation in his left thumb, index and middle fingers and bilateral lower extremity rash of two days duration. On examination, lung fields were clear [...]

Case Presentation: A 26-year-old male with a history of schizophrenia presented with generalized abdominal pain and altered mental status. He has a history of multiple psychiatric admissions, specifically seven times in the past two years, and long-term antipsychotic usage. Most recently, he was discharged on clozapine, divaloproex, and trazodone. Initial physical exam was notable for [...]

Case Presentation: 63y old female with history of CHF, HTN, and hypothyroidism presented from primary care physician’s office for lab abnormalities. Review of systems was positive for decreased urine output, fatigue, and sinus congestion. Vitals were within normal limits and physical exam was non-contributary. Lab workup was significant for hypokalemia (2.9) and elevated Cr (4.0). [...]

Case Presentation: A 65-year old man with a history of coronary artery disease, heart failure, and Crohn’s disease, who is a resident of northern Wisconsin presented with fevers, headache, and neck stiffness. Due to concern for meningitis, he was started empirically on Ceftriaxone, Vancomycin, Ampicillin, and Acyclovir. One day after initiation of therapy, he developed [...]