Case Presentation: An 80-year-old female with a history of atrial fibrillation on warfarin, type 2 diabetes mellitus, vitamin D deficiency, and CKD stage III presented as a transfer for further management of a worsening left lower extremity ulceration. Onset was 2 weeks prior without any concordant symptoms of infection and was initially evaluated by her [...]

Case Presentation: 73-year-old male had a witnessed fall at home with a minor head injury without loss of consciousness. Later, his wife noted him having new onset convulsive seizures and immediately notified EMS. Upon EMS arrival, he was alert but confused- his fingerstick glucose measured 11 mg/dL. He received oral glucose and was transferred to [...]

Case Presentation: Idiopathic CD4 lymphocytopenia (ICL) is a disease characterized by persistently low CD4 T-cell counts without HIV infection or any other discernible cause of T-cell suppression. Individuals with ICL are at increased risk of opportunistic infections, lymphomas, and autoimmune diseases. Diagnosis can be difficult, and prognosis can vary widely depending on the diseases that [...]

Case Presentation: A 29-year-old man with ulcerative colitis and autoimmune hepatitis (both diagnosed at age 15) was admitted to the hospital with a month-long history of hematochezia complicated by anemia and kidney injury. Historically, the patient’s AIH and UC was managed with an immunosuppressive medley; however, the patient had not used any medications within the [...]

Case Presentation: A 69-year old male with past medical history significant for granulomatosis with polyangiitis and lower extremity deep vein thrombosis (DVT) presented with worsening pain, swelling and erythema of his right lower extremity. He reported exposure to stagnant rainwater in his yard a day prior to admission. Hours after the exposure he developed fever [...]

Case Presentation: A 36-year-old female presented with a month history of cramping abdominal pain, nausea and vomiting that started after an episode of diarrheal illness associated to ingestion of mangoes. Her symptoms were worse with food intake and consequently, she reported a 25-pound weight loss. Her PCP had performed a urea breath test and an [...]

Case Presentation: A 33-year old female presented with 24 hours of subjective fever, severe neck, and chest pain. She was seen 6 months ago for arthralgia of the metacarpophalangeal, proximal interphalangeal and knee joints. Her home medication included Prednisone and Hydroxychloroquine prescribed for Lupus. Her physical examination demonstrated neck crepitus, bilateral crackles, ulcers in the [...]

Case Presentation: Patient was a 37 year-old gentleman with history of recently diagnosed heart failure, hypertension, non-Hodgkin’s lymphoma s/p chemotherapy and prior methamphetamine use who presented with chest pain. He reported a history of heart failure but had never had cardiac imaging. This diagnosis had been made clinically based on lower extremity edema. He had [...]

Case Presentation: A 25-year-old previously healthy male presented with two weeks of right arm and leg weakness, paresthesia, difficulty walking, and low-grade fever. Head CT revealed two masses in the superior left cerebral hemisphere. Head MRI showed two intensely enhancing masses measuring 2.6 x 2.7 cm and 1.6 x 1.7 cm with marked surrounding edema [...]

Case Presentation: 77 year old male with history of complete heart block with permanent pacemaker placement and recent diagnosis of nonvalvular atrial fibrillation on apixaban presented to emergency room with chief complaint of abdominal pain and dyspnea on exertion. The complete blood count, electrolyte panel, and serum creatinine were unremarkable. The initial troponin was elevated [...]