Case Presentation: A 49-year-old male with primary sclerosing cholangitis and newly diagnosed locally advanced cholangiocarcinoma was initiated on 5-Fluorouracil (FU) based chemotherapy (FOLFOX) as an outpatient (Figure 1). Within one day of receiving FOLFOX, the patient presented to the ED with acute, intermittent chest pain radiating to his left arm and shortness of breath. Vital [...]

Case Presentation: A 70-year-old male with medical history significant for rheumatoid arthritis presented to the emergency department with several days of odynophagia, oral ulcers, skin lesions and epistaxis. He was treated for foot cellulitis with TMP-SMX for one week prior to admission. The patient had been receiving 10 mg SQ weekly injectable MTX for Rheumatoid [...]

Case Presentation: A 78-year-old gentleman with a past medical history of scalp melanoma, renal papillary cell carcinoma, Ewing sarcoma, and end-stage renal disease presented to an outpatient Oncology appointment with bilateral ptosis, diplopia, myalgias, and bilateral proximal leg weakness less than one week following pembrolizumab infusion and influenza vaccination. He was sent to outpatient Neurology [...]

Case Presentation: A 67-year-old woman with a history of metastatic squamous cell carcinoma of the lungs and plaque psoriasis presented with subacute pruritic and painful descaling lesions of the skin after pembrolizumab maintenance therapy (Figure 1.A). The lesions on the skin were erythematous and desquamating, worse in the upper extremities, lower extremities, abdomen, and trunk. [...]

Case Presentation: LF is a 63 year-old female with a history of schizoaffective disorder, gastroparesis, and stage III chronic kidney disease (CKD) who was initially admitted to the inpatient psychiatric unit for psychosis with suicidal and homicidal ideation in the context of medication nonadherence. Mental status exam was remarkable for persecutory delusions and auditory hallucinations. [...]

Case Presentation: A healthy 44-year-old woman with latent TB on isoniazid (INH) for 6 months was sent to the hospital by her primary care physician for elevated liver tests and right sided abdominal pain, anorexia, and jaundice for two weeks. She had normal liver tests prior to starting INH. She denied illicit drugs, alcohol or [...]

Case Presentation: 47 year-old male with PMH of hypertension, DM, CAD and ESRD on peritoneal dialysis, presented with altered mental status for 1 day. He had developed a vesicular rash in the right upper extremity and was diagnosed with herpes zoster at another facility 2 days prior, for which he was prescribed valacyclovir that was [...]

Case Presentation: A 42 year-old Caucasian male with a past medical history significant for schizoaffective disorder with command auditory hallucinations, often commanding him to harm himself or others, with multiple suicide attempts by ingestion, and history of poly-substance abuse, was found by his friend on the floor of his apartment, seemingly unconscious, with copious amounts [...]

Case Presentation: A 54-year-old woman with stage IV endometrial stromal sarcoma s/p TAH, BSO, and ileocolic resection for bowel involvement, presented with acute onset of altered mental status on the evening of receiving her day 3 of cycle 3 ifosfamide infusion. On presentation, patient was tachycardic to HR 110s, afebrile, and otherwise with stable vital [...]

Case Presentation: A 63-year-old female with history of end-stage renal disease, atrial fibrillation (AFib), cirrhosis, and Parkinson’s disease was admitted to the hospital after an unwitnessed fall with persistent encephalopathy and altered mental status. Upon admission the patient was found to have wide QRS complexes with an Atrial fibrillation, clinical findings of heart failure, and [...]