Case Presentation: A 71-year-old man presented with pus from the umbilicus. Past medical history was pertinent for persistent urinary tract infection for a month, complicated by feculent urine and pneumaturia despite two rounds of antibiotics, and 20-lb weight loss. He was found to have purulent drainage from the umbilicus. Lower abdomen was tender without rebound [...]

Case Presentation: A 54-year-old male with a medical history significant for hypertension, hyperlipidemia, and type II diabetes initially presented to a local Emergency Department for acute left arm weakness. He had been seen at an urgent care clinic four days prior for upper respiratory infection and prescribed amoxicillin. A non-contrast computerized tomography (CT) scan of [...]

Case Presentation: 57 year old male with history of hypertension, hyperlipidemia, poliomyelitis with right leg atrophy and chronic crutch use presented with right-sided hearing loss, vertigo, and arm numbness. MRI brain and MRA head and neck revealed acute infarction in the right inferior cerebellum in the Anterior and Posterior Inferior Cerebellar Artery territories; left cerebellar [...]

Case Presentation: A 51-year-old man with seropositive rheumatoid arthritis (RA) and chronic intra-abdominal arterial aneurysms attributed to RA-associated vasculitis presented with a one-day history of right upper quadrant abdominal pain and melena. His vital signs were within normal limits. Notable laboratory studies included hemoglobin 6.1 g/dL, total bilirubin 1.4 mg/dL, AST 161 U/L, ALT 217 [...]

Case Presentation: A 30-year-old man with sickle cell anemia presented to the ED with pain in his left hip similar to prior vasooclussive crisis (VOC). There was no identifiable trigger and his review of symptoms was negative. Past medical history included sickle cell anemia complicated by acute chest syndrome (ACS), avascular necrosis of the right [...]

Case Presentation: A 22-year-old woman with a history of Adult Onset Still’s Disease presented with one week of acute abdominal pain, dyspnea and intermittent fevers. She was found to have thrombocytopenia to 15,000. Infectious workup was negative except for Rhinovirus/Enterovirus on viral panel. HIV and HHV8 were negative. MRI Abdomen showed hepatosplenomegaly and computed tomography [...]

Case Presentation: A 56-year-old African American male with hyperlipidemia on a statin presented with two days of generalized abdominal pain, malaise, and weakness. Physical exam was unremarkable. Initial labs were notable for WBCs of 22.7 X103/ml, creatinine phosphokinase (CPK) of 28,992 U/L, BUN/Cr of 82/2.02, and AST of 957 U/L. Urine dipstick was positive for [...]

Case Presentation: A 58-year-old female presented to the emergency department after a lower lip laceration from slipping in her bathtub. She has a history of chronic trigeminal neuralgia and is now complaining of progressive weakness, imbalance over the past year, memory loss, and urinary incontinence for the past two days. On exam, the patient was [...]

Case Presentation: A 61 year old female presented to the emergency department with 1 day of nausea, vomiting, and fever. The day prior to her symptom onset, she had undergone a colonoscopy for colon cancer screening that was normal. Her medical history was notable for splenectomy in 2000 for a hamartoma.On presentation, her temperature was [...]

Case Presentation: A 46-year-old female with a history of amphetamine abuse, depression, and hypertension presented to the ED for acute onset of bilateral lower extremity weakness and urinary incontinence. She denied other associated symptoms. The patient’s neurologic exam was notable for symmetrically decreased lower extremities motor strength and reflexes to 2/5, decreased sensation below L1, [...]