Case Presentation: A 66-year-old male with a history of neuromyelitis optica (NMO) on rituximab, paraplegia, knee arthroplasty with prior prosthetic joint infections, and chronic urinary catheter complicated by frequent UTI’s with prior growth of Pseudomonas, methicillin-resistant S. aureus (MRSA), E. coli, and Proteus, presented with fever and purulent urine. He was insensate below the umbilicus [...]

Case Presentation: An 81-year-old woman was referred with a 1-month history of subacute progressive bilateral leg edema and a 1-week history of pain and inflammation in both lower legs. She had no history of fever or weight loss. Physical examination revealed pitting bilateral edema with tenderness. No heart murmurs or jugular venous distention were noted. [...]

Case Presentation: We present a rare case of hydralazine-induced diffuse alveolar hemorrhage (DAH) in a 74-year-old male with a history of hypertension. The patient was admitted with symptoms including hemoptysis, dyspnea, and dark urine. Initial findings included a biopsy-confirmed leukocytoclastic vasculitis, elevated MPO antibodies, and evidence of DAH on bronchoscopy. Despite the absence of glomerulonephritis, [...]

Case Presentation: A 65-year-old female with a history of iron deficiency and acute blood loss anemia, schizophrenia, asthma, and hypothyroidism presented with shortness of breath and weight loss for three months. On arrival, her temperature was 101.1 F, blood pressure 84/40, heart rate 129, and spO2 97% on room air. Laboratory studies showed a white [...]

Case Presentation: A 69-year-old male with a history of type 2 diabetes mellitus and hypertension presented with acute-onset encephalopathy in the setting of subacute progressive cough and worsening diffuse pain. Labs revealed corrected calcium 15.1 mg/dl, Hgb 6.8 g/dl, Cr 1.2 mg/dl, total protein 11.9 g/dl, and albumin 2.5 g/dl. Radiological studies showed a large [...]

Case Presentation: The patient, a 29-year-old G1P1 female, presented to the emergency department with a 3-day history of double vision, frontal headache, and gait instability. Eye examination was significant for asymmetric bilateral internuclear ophthalmoplegia. Admission labs demonstrated mild leukocytosis without left shift and elevated inflammatory markers including complement levels and IL-6. An MRI of the [...]

Case Presentation: 29-year-old Hispanic male with history of intravenous drug use (IVDU) with fentanyl and methamphetamine, was brought to the hospital after being found confused on the streets. Patient was very cachectic, tachypneic and had track marks in the cubital fossa suggestive of IVDU. Patient was febrile with 100.6 F, had leukocytosis with WBC 18 [...]

Case Presentation: A 55-year-old female with alcohol use disorder and untreated hyperthyroidism was admitted to an outside hospital for abdominal pain, atrial fibrillation with heart rate in the 190’s, and hypotension requiring vasopressors and ICU care. Work up revealed low TSH (< 0.010 [range: 0.450 - 5.330]) and elevated free T4 (FT4) (4.74 [range: 0.60 [...]

Case Presentation: A 72-year-old man with hypertension and tobacco use presented to the emergency room with three days of nausea, vomiting, substernal chest pain, and thoracic back pain, following weeks of worsening vertigo. He also described a year of progressive tinnitus, diplopia, unsteady gait, and restless legs. Vital signs were stable. Physical exam revealed bilateral [...]

Case Presentation: A 23-year-old man without prior medical history was brought to the ED from his home for profound somnolence which had progressed over two days. EMTs at the scene noted that the patient was sluggishly responsive to painful stimuli. Initial vital signs were within normal limits, and a point-of-care glucose check was 28 mg/dL. [...]