Case Presentation: A 16 year old boy with obesity presented for dehydration in the setting of three months of abdominal pain, nausea, and non-bloody, non-bilious emesis. Outpatient work-up had been unrevealing. He also endorsed cannabis use and vaping. He had lost 70 pounds during this time. New symptoms in the days prior to admission included dizziness [...]

Case Presentation: A 67 year-old woman presented with six weeks of worsening disorientation. Her husband reported severe insomnia, abnormal behaviors, decreased short-term memory, and very labile mood. She had a history of well-controlled bipolar disorder on chronic lithium therapy. She had a forty pack-year smoking history. She was diagnosed with a urinary tract infection and [...]

Case Presentation: A 66-year-old female became noncompliant with home medications presented to the emergency room with altered mental status. She had an established diagnosis of decompensated cirrhosis on a recent discharge from hospital leading to metabolic encephalopathy. Five days into her hospital stay, the patient refused medications and nutrition leading to an IV saline treatment. [...]

Case Presentation: A 59-year-old previously healthy female presented to the emergency department with progressive cognitive decline, psychomotor retardation, and both auditory and visual hallucinations of subacute onset for which she was previously admitted to inpatient care at two separate hospitals. Extensive testing during these admissions were negative for: infection, metabolic derangement, hematologic malignancy, toxins, heavy [...]

Case Presentation: A 68 year old man with PMH of cerebral palsy, cognitive impairment, and chronic pain with intrathecal baclofen pump initially presented with sepsis due to baclofen pump pocket infection, and underwent explantation of baclofen pump. Intraoperative cultures grew pseudomonas, so on POD 3 cefepime was initiated. On POD 4, he developed encephalopathy, becoming [...]

Case Presentation: The patient is a 58-year-old female who was initially treated at an outside facility for severe COVID-19 infection that presented as a nonverbal encephalopathy. During this, she developed seizures and required intubation for airway protection. Labs were notable for hemoglobin: 7.7g/dL, calcium: 8.1 mg/dL, and arterial ammonia: 107 mcg/dL. Encephalopathy at that time [...]

Case Presentation: A previously healthy 20 year old female presented to the emergency department for change in mental status. Five days prior to presentation, the patient was diagnosed at a local urgent care facility with Infectious Mononucleosis and discharged with a course of Prednisone 20 mg. Per family, since starting steroid therapy she began developing [...]

Case Presentation: Patient is a 47-year-old female with a past medical history of uncontrolled type 2 diabetes, hypertension, and stage 3 chronic kidney disease. She was admitted to the hospital on 10/14/22 with intractable nausea/vomiting (N/V) and diarrhea. She had been in and out of the hospital for the past few months with these symptoms. [...]

Case Presentation: A 62-year-old malnourished, Hispanic man presented with fever and malaise for 1 week associated with headache. Past medical history was significant for rheumatoid arthritis treated with prolonged, unmonitored prednisone, chronic obstructive pulmonary disease, and a history of 18 cats at home. On examination, the patient was alert and oriented, febrile, and cachectic, but [...]

Case Presentation: A 64-year-old male with a history of spinal cord injury complicated by quadriplegia, neurogenic bladder and bowel presented with an obstructed suprapubic foley catheter, severe localized pain over the suprapubic area, and a blood pressure of 84/56 on arrival. The patient was administered intravenous fluids and started on 4.5g of piperacillin/tazobactam every 8 [...]