Case Presentation: A 46-year-old male with no known past medical history presents with worsening chronic cough of one-year duration. He also reports shortness of breath and increasing fatigue during the same timeframe. On presentation, he is noted to have numerous umbilicated facial lesions that are actively bleeding. He was febrile to 103F, tachycardic to 130s, […]

Case Presentation: An 85-year-old female with a history of non-Hodgkin’s B-cell lymphoma on Ibrutinib is brought into the emergency department (ED) by ambulance for generalized, progressive weakness and recurrent falls. She was recently diagnosed with herpes zoster 2 weeks prior, on her right upper extremity and denies being started on any medication. She complained of […]

Case Presentation: A 41-year-old female with a history of orthotopic liver transplant for cirrhosis from non-alcoholic fatty liver disease presented with 1 week of fevers. Her liver transplant was 3 years prior to presentation. She reported a 3-month history of diarrhea and odynophagia preceding the onset of fevers (maximum 38.8 C).On presentation, initial vital signs […]

Case Presentation: A 31-year-old man with rheumatoid arthritis (on adalimumab, methotrexate, and prednisone) presented with a 3-day history of fatigue, severe asymmetrical weakness of the lower extremities (left > right), and painful vesicular rash spanning multiple dermatomes in the left > right lower extremities (Image 1). There was no evidence of myelopathy or meningismus on […]

Case Presentation: A 90 year old Caucasian female with history of complicated diverticulitis s/p partial colectomy and Waldenstrom’s Macroglobulinemia (last treatment with Cyclophosphamide and Dexamethasone 1 week prior to presentation) was admitted with 2 day history of crampy lower abdominal pain, bloody streaked diarrhea, vomiting, and subjective chills. Physical examination elicited tachycardia and diffuse abdominal […]

Case Presentation: A 68-year-old man with a history of cryptogenic cirrhosis and hepatocellular carcinoma status post liver transplant with donor positive for cytomegalovirus (CMV), and recent treated CMV reactivation, was transferred from a nearby hospital with acute hypoxic respiratory failure requiring intubation secondary to Pneumocystis jirovecii pneumonia (PJP) identified on bronchoalveolar lavage. He was treated […]

Case Presentation: A 39-year-old female with a history of primary sclerosing cholangitis status post-liver transplant in 1986 on cyclosporine, ankylosing spondylitis, Monoclonal gammopathies with undetermined significance, and migraines presents with progressive headaches, fevers (up to 101 F), and neck stiffness over the past 2 weeks. She was found to have photophobia, meningismus, and a positive […]