Case Presentation: A 79-year-old woman with a past medical history of uncontrolled hypertension, migraine, and chronic kidney disease stage 3 presented with one week of poor oral intake, nausea, vomiting, vague abdominal pain, and chronic nonproductive cough. Physical exam revealed poor skin turgor, and lungs with crackles bilaterally. Laboratory studies showed Creatinine of 5.31 mg/dl […]

Case Presentation: A 65-year-old male with a past medical history of hypersensitivity pneumonitis/bronchiolitis, coronary artery disease, hypertension and hyperlipidemia was admitted for uncontrolled pain. Myalgias and fatigue were present for a month following a tick bite and shingles. He was treated with doxycycline 100mg twice a day for 14 days and valacyclovir 1g three times […]

Case Presentation: 72-year-old male with a history of prostate cancer status post prostatectomy, recent diagnosis of pansinusitis and multiple bilateral pulmonary lesions and a mass-like consolidation of the left upper lobe presented complaining of dyspnea. He was receiving treatment for sinusitis and pneumonia with plans for outpatient bronchoscopy to rule out malignancy. On presentation, the […]

Case Presentation: A 75-year-old woman with a past medical history of latent tuberculosis, hypertension, and type 2 diabetes mellitus presented with three days of non-bloody, non-bilious emesis, diarrhea, abdominal pain, and a new onset of weakness, pitting edema, and rash with burning sensation in the bilateral lower extremities. Admission labs were notable for elevated creatinine […]

Case Presentation: A 56-year-old male presented to the emergency department for longstanding and persistently worsening headaches, subjective fevers, chills, malaise, and significant weight loss. One month prior to this visit, he had a dental abscess that was successfully treated with a course of Augmentin; since that time his headaches, chills, malaise, and significant weight loss […]

Case Presentation: A 56-year-old male with a past medical history of hemophagocytic lymphohistiocytosis (HLH), in remission following chemotherapy in 2018, left MCA CVA in 2016 without significant residual deficits, restless leg syndrome, neurodegenerative motor neuron disease with lower extremity spasticity, and peripheral neuropathy was brought to the hospital for weeks of increasing confusion and generalized […]

Case Presentation: A 34-year-old male without significant past medical history presented with fevers, progressive purpuric rash that started in the ankles and spread in a centrifugal distribution, joint stiffness, as well as a rapidly progressive right-sided neck mass. Two weeks prior to presentation he had experienced sore throat and subjective fevers which self-resolved. One week […]

Case Presentation: Levamisole is an anti-parasitic drug used in the veterinary setting. It is a frequent cocaine contaminant found in about 60-70% of samples in the United States (US) [1]. Cocaine contaminated with this substance is linked to antineutrophil cytoplasmic antibodies (ANCA) associated vasculitis [2]. As in the last decade, cocaine use worldwide has been […]

Case Presentation: An 82-year-old female with diastolic heart failure presented with one-month worsening dyspnea on exertion and a week of scant hemoptysis and fatigue. She denied tuberculosis risk factors, night sweats, fevers, or skin, joint, or urinary changes. She was fully vaccinated against COVID-19. Her medications included aspirin and hydralazine. Her past medical, surgical, and […]

Case Presentation: 68 y.o. male presented with a purpuric rash, petechia, and suspected vasculitis. Past medical history included Hypertension, Non-Alcoholic Fatty Liver disease, Obstructive Sleep Apnea, Depression/Anxiety, DM type II and obesity. Significant presentations included pruritic rash and petechiae that started about a month before the presentation, worsening dyspnea, intermittent hemoptysis, and worsening bilateral pedal […]