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 […]

Case Presentation: An 81-year-old woman with a pertinent history of primary hypothyroidism and lung adenocarcinoma, treated with durvalumab, was admitted to the hospital in shock after being found lethargic, hypotensive, and hypoxic at home.Prior to admission, she developed weakness, fatigue, anorexia, vomiting, and diarrhea. She had recently been hospitalized with presumed septic shock attributed to […]

Case Presentation: A 68-year-old male presented to the hospital with declining mental status. His chronic medical conditions included stage IV renal cell carcinoma on nivolumab maintenance therapy, type II diabetes mellitus, chronic kidney disease, hypothyroidism on levothyroxine 150 mcg, and long-term opioid therapy for malignancy pain. He had a one-week duration of upper abdominal pain […]

Case Presentation: Central Adrenal Insufficiency (CAI) is a rare and often late diagnosis due to nonspecific signs, such as fatigue, hyponatremia, electrolyte abnormalities and fever of unknown origin (FUO). CAI suspicion arises in patients with pituitary tumors, cranial irradiation, surgery, injury, infection, exogenous glucocorticoid withdrawal, and less commonly known, opioid use disorder. A 31-year-old male […]

Case Presentation: A 71 year old male with a history of COPD, Hypothyroidism and Stage IIIA Lung Cancer status post wedge resection and prior treatment with chemotherapy and radiation currently on Pembrolizumab who presented with a two week history of fatigue. He denied any recent steroid use. Physical exam revealed hypotension and blood pressures dropping […]

Case Presentation: A 19-year-old female with a history of opioid use disorder (OUD) presented to the Emergency Department with abdominal pain, fever, and severe hypotension several days after relapsing with intravenous heroin following two years of successful maintenance on buprenorphine. She was admitted to the intensive care unit for treatment of severe sepsis including broad-spectrum […]