Case Presentation: A 64-year-old male with a history of idiopathic portal vein hypertension requiring splenectomy at age four, COPD, and treated lung cancer presented with dyspnea and anorexia. Clinical examination revealed tachypnea, tachycardia, dry cough, cachexia, and dry skin. CT scans showed bilateral pulmonary opacities and confirmed asplenia. He was admitted to the intensive care [...]

Case Presentation: Acquired thrombotic thrombocytopenic purpura (TTP) is a rare antibody-mediated thrombotic microangiopathy that requires prompt identification and treatment. We present the case of a 32-year-old female with a history of systemic lupus erythematosus, asthma, augmentation mastopexy (11 years prior), and an antecedent episode of TTP following silicone breast implant placement who presented with back [...]

Case Presentation: A 70-year-old man treated with Nivolumab for metastatic melanoma, presented with mild nausea and vomiting for a few days. He denied a change in urine output or appearance of urine, flank pain, or difficulty urinating. Creatinine on admission was 8.9 mg/dl (baseline 0.8mg/dl). Urinalysis revealed mild proteinuria, 21-50 WBCs/hpf. Spot protein/creatinine ratio was [...]

Case Presentation: A 78-year-old female with dextrocardia presented to the hospital from her outpatient dermatologist for hypotension, hypoxia, and altered mental status. She became diaphoretic, dyspneic (SpO2 78%), and hypotensive with systolic blood pressure in the 80s after applying topical lidocaine for a microneedling procedure. Initial exam noted diaphoresis, diffuse facial erythema and flushing, orolabial [...]

Case Presentation: A 77 year-old female without significant history presented with six months of urinary incontinence, six weeks of progressive confusion and falls, and one day of decreased speech and poor appetite. During two recent hospitalizations for acute encephalopathy, imaging revealed a frontal lobe meningioma, acoustic neuroma, and diffuse ventricular enlargement.On admission, the patient was [...]

Case Presentation: A 56-year-old female with a history of recurrent MRSA sinusitis and c-ANCA and PR3 positive granulomatosis with polyangiitis (GPA) presented with right-sided facial droop sparing the eye and upper face, unilateral facial numbness, and right-sided tongue deviation that began four hours before presentation. She also endorsed sinus fullness for the past three days [...]

Case Presentation: We present a case of a 65-year-old Caucasian male with T2 N3 nasopharyngeal carcinoma (EBV-positive), status post concurrent gentamicin/cisplatin and radiation therapy, Parkinson’s disease, chronic kidney disease stage 3a, and pancytopenia, who initially presented with fever, altered mental status, abdominal pain, and generalized weakness.Patient was recently admitted for fever and abdominal pain. Evaluation [...]

Case Presentation: A 25-year-old female with a history of Systemic Lupus Erythematosus (SLE), lupus nephritis, cardiomyopathy, transient ischemic attack, and epilepsy presented as an ICU transfer for Altered Mental Status (AMS). The patient initially presented to an outside hospital for this complaint, which was attributed to seizures. Her course was complicated by severe hypotension, again [...]

Case Presentation: The patient is a 24-year-old female with Situs Inversus Totalis (SIT), obesity, Stage D non-ischemic dilated cardiomyopathy (NIDCM), history of out of hospital cardiac arrest (ventricular fibrillation arrest) with subsequent dual chamber implantable cardioverter-defibrillator (ICD) placement who was managed as an outpatient on home inotrope therapy as a bridge pending left ventricular assist [...]

Case Presentation: A 77-year-old male with history of hypertension, hyperlipidemia, type 2 diabetes mellitus, and chronic kidney disease (stage 3a) presented with generalized weakness and fatigue. He denied other symptoms, including myalgias, cold intolerance, or oliguria. Laboratory evaluation revealed blood urea nitrogen (BUN) of 56.9 mg/dL, serum creatinine (SCr) of 5.93 mg/dL, and glomerular filtration [...]