Case Presentation: A 50 year old obese female with a past medical history of rheumatoid arthritis, bilateral DVT and PE 4 years ago on apixaban, hypothyroidism, fibromyalgia, and chronic migraines presented to the emergency department with daily fevers, shortness of breath, and anxiety for one week. She reported persistent chest heaviness and productive cough of [...]

Case Presentation: 49 year old woman with past medical history of alcoholic cirrhosis and autoimmune hemolytic anemia treated with a course of steroids and rituximab 3 months prior who presented with 3-days of nausea, nonbloody/nonbilious vomiting and diarrhea associated with dysuria, and suprapubic discomfort. Vitals notable for heart rate 129/min, BP 115/61mmHg. Labs significant for [...]

Case Presentation: A 75-year-old male with a history of left upper lobe neuroendocrine lung cancer in remission presented to the hospital with progressive diplopia and headaches for 4 weeks. Prior to admission, he had recently been diagnosed with squamous cell carcinoma (SCC) on the vertex scalp which appeared at the onset of diplopia. Histology showed [...]

Case Presentation: A 66-year-old female with pan-hypogammaglobulinemia from therapies for stage IV diffuse large B-cell lymphoma (DLBCL) and psoriatic arthritis on aprimelast presented with 6 months of severe diarrhea and hypokalemia. She achieved complete remission of DLBCL with R-CHOP and CAR-T therapy 15 and 8 months before symptom onset, respectively. Severe pan-hypogammaglobulinemia was detected 3 [...]

Case Presentation: A 65-year-old male was admitted with COPD exacerbation. Imaging studies showed advanced emphysematous changes and cardiomegaly. He was found to be in newly detected atrial fibrillation for which a transthoracic echocardiogram (TTE) was obtained. TTE revealed a moderately dilated left atrium (LA) with a large, highly mobile mass (6.8 x 3.5 cm) prolapsing [...]

Case Presentation: An 87-year-old female with stage 4 chronic kidney disease, hypertension, and heart failure presented with concern for acute kidney injury based on outpatient laboratory studies. She had sought prior care for worsening fatigue, lightheadedness, productive cough, and decreased urine output. Lab results revealed a creatinine of 4.4 mg/dL (baseline 1.7 mg/dL) and potassium [...]

Case Presentation: A 24-year-old male with a history of pancytopenia presented to the emergency department with generalized abdominal pain. One year prior, he started having intermittent mild abdominal pain which was attributed to irritable bowel disease. Three months prior, he developed a pruritic red rash on his arms and legs and intermittent bleeding from his [...]

Case Presentation: A 76-year-old female with a past medical history of hypertension, hyperlipidemia, and hypothyroidism presented to the hospital with fatigue and headaches that had been ongoing for a few days. The patient had chronic watery diarrhea but denied having any dark stool, hemoptysis, or recent antibiotic use. On physical exam, vitals were stable, she [...]

Case Presentation: A 48 y/o man with history of chronic methamphetamine use, schizophrenia, and bipolar disorder presented after being found unconscious associated with urinary incontinence. He was treated for toxic metabolic encephalopathy in setting of sepsis from urinary tract infection and multifocal pneumonia. However, his mental status declined despite initiation of antibiotics. He was alert [...]

Case Presentation: A 27 year old woman with systemic lupus erythematosus (SLE) and history of a single seizure episode presented with acute altered mental status. The patient was initially disoriented and nonverbal, able to open eyes but unable to track, intermittently responding to commands, and later deteriorating, becoming obtunded and eventually comatose. Her NIH Stroke [...]