Case Presentation: A 34-year-old African American male with history of HTN, HLD, obesity, T2DM complicated with ESRD on hemodialysis the past 2 years presented to our EC in Houston for progressively worsening dyspnea, volume overload and confusion. The patient had been previously receiving regular hemodialysis three times weekly. However, due to lack of transportation, he [...]

Case Presentation: 5 59-year-old male with alcoholic cirrhosis, hypertension, COPD, and diabetes mellitus presented with a 3-month history of progressive confusion and altered mental status. His family reported memory decline, prompting multiple ER visits primarily focused on cirrhosis-related complications, overlooking the neurological symptoms’ etiology. Initial improvement following hepatic encephalopathy treatment was short-lived, leading to rapid [...]

Case Presentation: 51-year-old female with a past medical history of end-stage renal disease on intermittent dialysis and a recent vitreous hemorrhage status post pars plana vitrectomy with endo-laser photocoagulation 2 days prior to admission, presented with post-operative severe bilateral eye pain, headaches, and fevers. She was diagnosed with acute angle-closure glaucoma in the left eye [...]

Case Presentation: A 32-year-old female with a past medical history of substance use, anxiety, and depression presented with one day of facial erythema. The patient reported that she woke up with facial tenderness and swelling. She also had four days of nasal congestion which improved with Nyquil. On physical exam, patient was tachycardic, tachypneic, afebrile, [...]

Case Presentation: A 40-year-old man with a history of severe tophaceous gout, not currently on treatment, was directly admitted to the hospital after routine labs showed hypercalcemia (14.1mg/dL) and an elevated creatinine (4.2mg/dL). Vital signs were stable. Exam was significant for large nodules and tophi across most joints, with innumerable subcutaneous nodules embedded in the [...]

Case Presentation: A 44-year-old woman with past medical history of anxiety, depression, and seizure disorder presented with seizure-like activity consisting of asynchronous bilateral upper and lower extremity shaking, throughout which patient was alert and responsive. Patient had a 5-year history of these episodes, with a recent increase in frequency exacerbated by stress. Prior extensive workup [...]

Case Presentation: An 18-year-old male presented with ascending paralysis, starting in the lower extremities and progressing to the upper extremities over 24 hours after a carbohydrate rich meal. Other review of systems was negative. He reported one prior ICU admission for similar symptoms, but details were not available. Father and grandfather had similar presentations of [...]

Case Presentation: A 45-year-old female with past medical history of gastric sleeve in 2018 and follicular thyroid carcinoma status-post total thyroidectomy in 2019, resulting in hypothyroidism, is currently taking Levothyroxine 200mcg daily. Patient presented to the Emergency department with increasing fatigue for the past 3 weeks. She reported progressive shortness of breath on exertion, “loss [...]

Case Presentation: The patient was a 31-year-old healthy female who presented with acute onset headache reaching maximum severity within one minute (thunderclap) associated with sexual activity at the time of orgasm. The first episode had occurred one week prior to presentation with three subsequent episodes, each with the same trigger. During each episode, she reported [...]

Case Presentation: 61-year-old man with coronary artery disease, tobacco use, and partial R toe amputation after trauma presented to an outside hospital with 3 months of fevers, night sweats, and 30 kg weight loss. He was found to have pancytopenia, splenomegaly, and retroperitoneal lymphadenopathy raising concern for malignancy. These findings prompted a bone marrow biopsy [...]