Case Presentation: A 51-year-old African American Female with PMHx of sickle cell trait, vitiligo (developed 5 years ago), T2DM, HTN, unspecified seizure disorder who presented with altered mental status and found to have severe pancytopenia. She presented hemodynamically stable with a physical exam notable for: pale conjunctiva and diffuse skin hypopigmentation consistent with vitiligo. Medications: [...]

Case Presentation: A 24-year-old man with a past medical history of mitochondrial encephalopathy with lactic acidosis and stroke-like episodes (MELAS), malnutrition status-post percutaneous endoscopic gastrostomy (PEG) tube placement, and superior mesenteric artery (SMA) syndrome presented to the hospital with generalized tonic-clonic seizures and severe lactic acidosis. His seizures were treated with levetiracetam, and his lactic [...]

Case Presentation: Inappropriate sinus tachycardia (IST) was initially described as a non-paroxysmal increase in the resting sinus heart rate in otherwise healthy individuals (1). It is most often seen in young females and rarely in the elderly (2). Herein we report a case of an elderly female diagnosed with IST. 67-year-old female with past medical [...]

Case Presentation: A 64-year-old woman with a history of ankylosing spondylitis, Crohn’s disease, asthma, and prior diagnosis of drug-induced lupus presents for a diffuse pruritic rash. Six days prior, she developed a single flat violaceous lesion limited to her left jaw and urticaria on her chest. She was started on prednisone 60 mg by her [...]

Case Presentation: Our patient is a 74-year-old male with a history of thrombocytopenia thought secondary to ITP, hypothyroidism, and prior spontaneous coronary artery dissection requiring cardiac bypass who was transferred from an outside hospital for acute kidney injury and abdominal distention. A few weeks prior to admission, the patient experienced congestion, cough and low-grade fever [...]

Case Presentation: A 63-year-old male with past medical history significant for uncontrolled diabetes mellitus type 2 presented with 4 days of chest pain and dyspnea. Patient was afebrile and vital signs were within normal limits. Lung and cardiac exam were unremarkable without cardiac murmur or rub. ECG showed ST elevations and troponins were negative. Left [...]

Case Presentation: A 49-year-old male presented with shortness of breath, fatigue and four weeks of dark stools. He had previously been diagnosed with IgG lambda multiple myeloma (MM) with renal insufficiency and hypertension. He had MM disease progression despite completing chemotherapy and had declined further treatment. Physical exam revealed an ill-appearing, pale mane with a [...]

Case Presentation: A 48-year-old man presents with chief complaints of fever, nausea, vomiting, rash and discoloration of hands and feet for 1 day. He was admitted to intensive care unit for septic shock and altered mental status. Patient was intubated and started on intravenous fluids, pressor medications and broad-spectrum antibiotics (vancomycin and piperacillin/tazobactam). On day [...]

Case Presentation: 55 year old man with history of diabetes, hypertension and remote history of testicular cancer treated with chemotherapy and orchiectomy in 1993 and currently with no active malignancy presents with fever and malaise which began about a week ago. On admission, his laboratory results were notable for leukocytosis with a white blood cell [...]

Case Presentation: This patient was a 32 year old male with one week of fevers, coughing, and shortness of breath. On examination, the patient was tachycardic with an oxygen saturation of 85%. He had increased work of breathing with accessory muscle use, but no crackles or wheezing. Complete blood count showed leukocytosis. CT angiogram showed [...]