Case Presentation: A 47-year-old woman with obesity, diabetes mellitus, hypertension, and liver cirrhosis presented with septic shock and acute renal failure along with volume overload necessitating urgent dialysis. She received broad-spectrum antibiotics, which were later narrowed to cover extended spectrum beta-lactamase-producing (ESBL) Enterobacter found in her blood cultures. Fifteen days after admission and initiation of [...]

Case Presentation: A 38 yr. old female presented with personality and behavior changes for the last 4 months which were described as episodes of impulsivity and outbursts of anger. Patient endorsed frequent episodes of headache and confusion caused by strong odors such as spices and garlic. She had progressive short-term memory deficit, often asking same [...]

Case Presentation: A 22-year-old male with history of syringomyelia and Chiari malformation status post repair presented as a transfer for a 1-week history of fever, progressive dyspnea, reduced appetite, and headache. On his initial presentation, he was found to be hypoxic after which a chest radiography showed an enlarged cardiac silhouette. Lab work showed new [...]

Case Presentation: A 55-year-old woman with a history of rheumatoid arthritis presented for generalized weakness, dysuria, nausea, and dizziness of 1 week duration. She developed progressive weakness with associated decreased exercise tolerance, nausea, and diarrhea. Her oral intake decreased. There was no inciting event and did not note any recent close contacts with similar symptoms.Her [...]

Case Presentation: A 51 year old male with history of obesity, spinal stenosis, and gout presented with 1 week of worsening low back pain with bilateral radiculopathy. He had no bladder or bowel incontinence, or other neurologic compromise. He was afebrile, with normal vital signs. Lab data was significant for WBC 25 x 10^9/L, hemoglobin [...]

Case Presentation: A 44-year-old male hospitalized for an extended period with severe diarrhea and polyarthritis developed worsening anion gap metabolic acidosis (AGMA) over the course of 10 days. The patient was being treated for septic arthritis in the background of polyarticular gout with vancomycin, ceftriaxone, colchicine, indomethacin, and acetaminophen. Acetaminophen was dosed as needed on [...]

Case Presentation: Pasteurella multocida is a Gram-negative coccobacillus that can cause infections following bites or scratches from domestic animals. We present a case of an older adult who was admitted for sepsis secondary to Pasteurella multocida bacteremia after numerous cat bites and scratches. A 76-year-old man with a past medical history notable for PVD, CKD [...]

Case Presentation: A 44-year-old man with history of uncontrolled diabetes mellitus, gastroparesis, chronic malnutrition, and cognitive impairment presented to the emergency room with two weeks of nausea, vomiting, and inability to tolerate oral intake. Given chronic malnutrition and inability to control symptoms with anti-emetics, enteral access was obtained and both tube feeds and motility agents [...]

Case Presentation: A 58 year old female with history of hypertension, hypothyroidism and noninsulin dependent diabetes mellitus presented with two days of involuntary movements of her right upper extremity. Bloodwork was remarkable for blood glucose 1273MG/DL, anion gap 15, serum creatinine 2.0 MG/DL from normal baseline, no ketosis. Infectious workup with urinalysis, respiratory viral panel [...]

Case Presentation: A 27-year-old man with a family history of Grave’s Disease presented with acute onset pleuritic chest pain and associated shortness of breath. The patient endorsed subjective fevers and myalgias for one day prior to admission. Vital signs were significant for a heart rate of 110, otherwise unremarkable. Initial work-up showed troponin elevation to [...]