Case Presentation: An 86-year-old woman with a history of hypertension on oral medications and chronic systolic heart failure presented to the hospital with chest pain and dyspnea. She was noted to be acutely hypertensive, tachypneic and hypoxemic. Physical exam revealed diffuse crackles, jugular venous distention and lower extremity pitting edema. EKG was consistent with an […]

Case Presentation: A 61-year-old man with type 2 diabetes mellitus was admitted for surgical resection of left fifth metatarsal due to osteomyelitis refractory to prolonged antibiotic use. Vital signs on admission were all within normal limits; significant lab values included ESR 79 mm/hr, CRP 7.07 mg/dL, and WBC 9.2 k/uL. Following surgical debridement and amputation, […]

Case Presentation: A 15-week G2P3 pregnant 33-year-old woman with past medical history of chronic hepatitis C, current intravenous drug use (IVDU) presented from a correctional facility complaining of abdominal pain and hematuria. Exam revealed a gravid uterus and bilateral pedal edema. Patient responding only to pain and not following commands. Temp 102.8 F, HR 120’s […]

Case Presentation: A 71-year-old woman who initially presented with sepsis from MSSA bacteremia was found to have an acute splenic infarct as well as a splenic artery pseudoaneurysm that was managed by coil embolization. She was discharged on a 4-week course of cefazolin for the treatment of her MSSA bacteremia. Two weeks later, she was […]

Case Presentation: 71-year-old man with a history of atrial fibrillation, presented with four-months of fatigue, 50lb weight loss, night sweats and petechiae spreading from legs to abdomen and arms. On admission, vital signs were unremarkable. On physical exam, he had non-blanching, non-palpable petechiae extending from his lower extremities (LEs) to torso and upper extremities and […]

Case Presentation: A 62-year-old female presented with one month of progressive bilateral lower extremity pain, weakness, and functional decline. Her medical history was significant for cirrhosis secondary to hepatitis C (treated), chronic pancytopenia, and hypothyroidism. Her medications included atorvastatin, levothyroxine, omeprazole, spironolactone, tiotropium, venlafaxine, and quetiapine. She was a current smoker with a 20-pack year […]

Case Presentation: 49-year-old male patient with history of hypertension was sent by his nephrologist to the ER for unexplained worsening renal function and likely renal biopsy. Vital signs were stable, exam was unremarkable, however BUN was 85 mg/dL with creatinine of 10.1 mg/dL (baseline of 1.5 mg/dL). 24-hour urine protein excretion was 5.2 grams. The […]