Case Presentation: A 49-year-old male with primary sclerosing cholangitis and newly diagnosed locally advanced cholangiocarcinoma was initiated on 5-Fluorouracil (FU) based chemotherapy (FOLFOX) as an outpatient (Figure 1). Within one day of receiving FOLFOX, the patient presented to the ED with acute, intermittent chest pain radiating to his left arm and shortness of breath. Vital […]

Case Presentation: A 58-year-old-woman with no significant past medical history presented to her primary care physician with bilateral lower extremity edema. She was treated with compression stockings but returned after four months without improvement. She was diagnosed with chronic venous insufficiency and referred to a vascular surgeon for a superficial venous ablation, which was ineffective. […]

Case Presentation: An 80-year-old gentleman with a past medical history of type 2 diabetes mellitus and stage III chronic kidney disease (baseline creatinine 1.2-1.4 mg/dL) presented to the emergency department with generalized weakness, falls, unintentional weight loss, and constipation. Labs were significant for hypercalcemia (13.2 mg/dL), elevated creatinine (1.96 mg/dL), suppressed intact PTH (10 pg/mL), […]

Case Presentation: A 79-year-old male with vasculopathy, hypertension, diastolic heart failure, and dialysis-dependent end stage renal disease presented after having hypotensive syncopal episodes during initiation of his last 3 outpatient dialysis sessions. Upon dialysis cessation, he quickly awakened fully oriented with a normal hemodynamics. On arrival, physical exam findings were unrevealing, as were a subsequent […]

Case Presentation: A 47-year-old woman with lupus presented with one week of urinary frequency and dysuria. Over the prior year, she had pelvic pain, night sweats, 20 pounds of unintentional weight loss, and eight episodes of pan-susceptible E. coli urinary tract infections (UTIs), each successfully treated. Her chronic medications were prednisone, hydroxychloroquine, and azathioprine.A computed […]

Case Presentation: A 44-year-old man with multiple myeloma and cardiac amyloidosis on chemotherapy, and atrial fibrillation on apixaban, presented with three days of worsening shortness of breath and edema. He was admitted to the emergency room observation unit for treatment of a mild heart failure exacerbation. He was noted on admission to have rapidly developed […]

Case Presentation: A 76-year-old male with metastatic renal cell carcinoma presented to the hospital due to multiple syncopal episodes. The patient was prescribed pembrolizumab by infusion every 3 weeks (last dose was a week and a half prior). His presenting vitals were significant for a heart rate of 30 beats per minute and systolic blood […]

Case Presentation: A 45-year-old female with no significant medical history presented to the ED with three days of sharp epigastric pain radiating to the right lower quadrant associated with fever, chills, and multiple episodes of non-bilious, non-bloody emesis. She denied chest pain, shortness of breath, or bruising. Physical examination revealed normal vital signs except a […]

Case Presentation: A previously healthy 57-year-old man with a history of chronic sinusitis who received the Ad26.COV2.S vaccination 13 days ago without incident presented to the ED with left lower extremity swelling and pain, left medial thigh ecchymosis, transient episodes of right hand paresthesia and weakness, severe headache with transient blurry vision, and progressively worsening […]

Case Presentation: A 73-year-old woman with past medical history of metastatic endometrial adenocarcinoma previously treated with Pembrolizumab (stopped 4 months prior) presented with six weeks of persistent fatigue, myalgias, nausea, and vomiting. On presentation, she was noted to be hypotensive with labs notable for hyponatremia and hypomagnesemia. She appeared lethargic with dry mucous membranes and […]