Case Presentation: A 63-year-old male with a history of heart failure with reduced ejection fraction (HFrEF), type 2 diabetes, and recent left below-knee amputation presented with worsening dyspnea, orthopnea, and leg swelling. Physical examination revealed volume overload with jugular venous distention and pitting edema. NT-proBNP was markedly elevated (10,901 pg/mL). Transthoracic echocardiography (TTE) showed a [...]

Case Presentation: A 68-year-old Jamaican woman presented with generalized fatigue of one-week duration. On presentation, she also had dizziness and constipation. She was tachycardic and lethargic on examination. Laboratory values were remarkable for hypercalcemia of 17.3 mg/dl. She had lymphocytosis as high as 77000 (ALC 42.6). Serum lactate dehydrogenase (LDH) was 7000 U/L. Peripheral flow [...]

Case Presentation: A twenty-six year old female was admitted for further evaluation after a Transthoracic Echocardiogram (TTE) showed three cardiac masses in the left and right atrium. Initial symptoms included near syncopal episodes, exertional dyspnea and fatigue. Further history revealed that the patient had right tonsillar swelling with some difficulty swallowing two months prior to [...]

Case Presentation: A 60-year-old male presented with a 4-day complaint of left forearm pain after a palm tree frond fell on his mid-arm resulting in a lump to the area. He was seen in the emergency room (ER) on the day of injury and x-ray of the arm showed no fracture. He was discharged with [...]

Case Presentation: A 58-year-old man from Thailand presented to the emergency department with a one month history of night sweats, penile pain, swelling, and scrotal wound drainage. Five months prior, he had traveled to India for a semi-rigid penile implant. After a diagnosis of “urethral tuberculosis” in Thailand, he began RIPE therapy (rifampin, isoniazid/pyridoxine, pyrazinamide, [...]

Case Presentation: A 75-year-old female with a medical history of type II diabetes mellitus, asthma, and arthritis presented with approximately three months of recurrent pneumonia. On admission, she complained of progressive generalized weakness with associated shoulder pain, shortness of breath, cough with foul-smelling sputum, and new, bilateral wrist swelling. Vital signs were significant for tachypnea [...]

Case Presentation: A 68-year-old male with history of IgG4-related autoimmune pancreatitis presented to the Emergency Department with a one-month history of generalized weakness and a 25 lb unintentional weight loss over the past three months. Labs were notable for elevated lactate (3.4 mmol/L), new thrombocytopenia (platelets 29 ×10^9/L), and a stage II acute kidney injury [...]

Case Presentation: A 30 year old male presented to the emergency department one day after release from incarceration, seeking care for a testicular mass. He reported being evaluated six months prior, however had been unable to schedule a biopsy and oncology follow-up before incarceration. He reported an increasing size of the mass, with new and [...]

Case Presentation: A 63-year-old female with insulin-dependent diabetes was transferred to our hospital for surgical evaluation of a large, ulcerated nodule on her abdomen. The patient had been injecting insulin into the same area on her abdomen for years, causing a nodule to enlarge insidiously over past decades. It ulcerated about two years ago and [...]

Case Presentation: A 22-year-old (G2P2) female with no significant past medical history presented to the emergency department with four-days of fevers, myalgias, retro-orbital headache, nausea, vomiting, abdominal pain, and petechial rash involving the bilateral lower extremities. Her symptoms began after returning from a month-long trip to Northern Mexico, where she noted numerous mosquito bites and [...]