Case Presentation: A previously healthy 4-year-old female born in Mexico was sent to the emergency department for elevated blood pressures noted at her routine outpatient clinic visit. On arrival, her blood pressure was 161/126. The patient reported polydipsia, polyuria, and weight loss. Her initial physical exam was unremarkable and her vitals were otherwise within normal [...]

Case Presentation: A 17 y.o. female with systemic lupus erythematosus (SLE) presented with several weeks of worsening migratory polyarthralgia, as well as sporadic fevers, night sweats, and chills. Prednisone was begun 3 weeks prior for a presumed SLE flare, given elevated anti double-stranded DNA (anti-dsDNA) and erythrocyte sedimentation rate (ESR) and hematuria, but provided no [...]

Case Presentation: A 12-year-old Caucasian male with no significant medical history presented with a 6-day history of bilateral leg pain following a soccer game. As an avid soccer player, he had experienced similar episodes over the past three years, managed previously as “growing pains” with NSAIDs and acetaminophen. However, this presentation raised concern for an [...]

Case Presentation: A 68-year-old male with osteoarthritis, status post bilateral knee replacement in 2014, presented with two weeks of flu-like symptoms, generalized weakness, and shortness of breath. Upon admission, the patient was noted to have a tender, swollen right knee with laboratories revealing neutrophilia with bandemia. Computed tomography (CT) of the joint revealed punctate gas [...]

Case Presentation: Mr. A is a 48-year-old male with a past medical history of end-stage heart failure. He was transported from prison due to worsening dyspnea and was admitted to the hospital with acute kidney injury. He rapidly deteriorated, requiring transfer to the Intensive Care Unit (ICU) due to worsening shock requiring vasopressors. Mr. A’s [...]

Case Presentation: A 28-year-old Middle Eastern male, previously diagnosed with Systemic Lupus Erythematosus (SLE) and biopsy-proven Lupus Nephritis at the age of 18 in Egypt, had been managing his condition with a daily dose of mycophenolate mofetil at 250 mg. During a routine clinic follow-up, laboratory tests were conducted, revealing concerning results. His 24-hour urine [...]

Case Presentation: A 67-year-old male with a past medical history of peripheral arterial disease, a chronic left lower extremity wound, and type 2 diabetes mellitus was admitted from vascular surgery clinic for osteomyelitis of the left lower extremity. He underwent multiple procedures by the podiatry service including a trans-metatarsal amputation. Intraoperative bone cultures returned positive [...]

Case Presentation: Chronic mesenteric ischemia (CMI) is defined as a gradual reduction of perfusion to the bowels. While bowel infarction is the primary concern with CMI, there may be a relationship between CMI and acute acalculous cholecystitis (AAC). We present the case of a 60-year old female with acute onset right upper quadrant (RUQ) abdominal [...]

Case Presentation: A 91-year-old male with a known history of benign prostatic hyperplasia (BPH), diastolic heart failure, pulmonary embolism, hypertension, and previous extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (E. coli) urinary tract infection (UTI) presented with encephalopathy. He was not tachypneic nor tachycardic, but his bicarbonate was low at less than 8, and his lactic acid [...]

Case Presentation: A 24-year-old Caucasian female with a family history of multiple autoimmune disorders presented with 3 weeks of bruising, petechiae, fatigue, and outside labs that revealed significant anemia and thrombocytopenia. Admission workup showed Hgb 7.6, platelets (PLT) < 3,000, and elevated MCV. Further labs showed elevated LDH, indirect bilirubinemia, haptoglobin< 10, and positive DAT [...]