Case Presentation: We describe a case of new-onset unknown ascites due to atraumatic bladder rupture. A 56 year-old female with past medical history of functional urinary retention (prolonged urine holding due to phobia of public restrooms) and remote surgical history of TAH/BSO and C-section presented with recurrent ascites of unknown etiology. She initially presented to […]

Case Presentation: Our patient is 78-year-old female with a history of mitral regurgitation, left ventricular outflow tract obstruction (LVOT) with systolic anterior motion (SAM) of mitral valve, migraines, and hypertension presented with lightheadedness. She had increased blood pressure at her recent office visit few weeks back necessitating an increase in dosage of verapamil. At presentation, […]

Case Presentation: A 17-year-old female was transferred from an outside hospital for persistent cough, infiltrate on chest x-ray (CXR), and draining nodules on her legs and back. 1 month prior to transfer, she developed cough, shortness of breath, and malaise without fever. A CXR was consistent with pneumonia and doxycycline was initiated. 5 days later […]

Case Presentation: A 17-year-old male presented with complaints of worsening muscle spasms and tremors for the past 3 weeks. History was notable for a diagnosis of mercury poisoning about 3 months ago when he presented with back pain, for which he completed a course of succimer. However, he continued to feel unwell despite chelation therapy, […]

Case Presentation: Case 1: A 14-year-old male presented to the ED with history of a convulsive syncopal episode (third lifetime event). All syncopal episodes occurred with exertion and required cardiopulmonary resuscitation. Episodes were initially considered to be due to a seizure disorder and were treated with antiepileptic therapy (Keppra). Given event recurrence despite escalating doses […]

Case Presentation: A 16-year-old Caucasian male presented to the pediatric emergency department with 10 days of worsening lumbar back pain, myalgias, difficulty ambulating and fevers. His medical history was significant for severe nodulocystic acne vulgaris, and he was started on isotretinoin at 80mg/day (1.4mg/kg/day) three weeks prior to presentation. Approximately 10 days after starting the […]

Case Presentation: Our patient is a 15-year-old female, previously healthy, who presented with right facial swelling. She developed swelling of her right upper lip after rupturing a pimple located on her lip. Over the next two days, erythema developed, and the swelling progressed to include her right eye, cheek, both lips, and around her jaw […]

Case Presentation: The clinical signs of acute drug reaction are almost always none specific and rarely pathognomonic. We present a case of 15 years old male who after starting amitriptyline developed serotonin syndrome with marked neuroexcitatory, autonomic hyperactivity and acute encephalopathy. A 15-year-old male with recent below knee amputation (BKA) from a trauma requiring blood […]

Case Presentation: A 7-week-old male was admitted to a children’s hospital by his pediatrician due to “failure to thrive” (FTT). He was born full-term, passed his critical congenital heart disease (CHD) screening, and had normal newborn screens. He was exclusively breastfed and regained birthweight by 9 days of age. Over the subsequent weeks, his parents […]

Case Presentation: A previously healthy, immunized 4-year-old female presented with one week of ongoing fevers (Tmax 40oC), left ankle swelling with refusal to bear weight, and right hand swelling and erythema. On presentation, she was febrile (38.9oC), tachycardic (HR 143), hypotensive (BP 60/48), and tachypneic (RR 34). In addition to left ankle and right hand […]