Case Presentation: A 78 year old man with a past medical history of diabetes on insulin and chronic back pain initially presented with several days of diarrhea. On admission he was found to have Clostridium difficile colitis that improved slowly on oral vancomycin. On hospital day 7 he developed acute debilitating back pain and was [...]

Case Presentation: A 70-year old-man with a history of HLA-B27-associated anterior uveitis, spondyloarthropathy, and drug- induced leukocytoclastic vasculitis on chronic prednisone and mycophenolate, presented with 3-weeks of worsening fatigue and weakness. At admission, he was afebrile, tachycardic, and had a diffuse rash. On day 2, he began spiking fevers. Labs were notable for WBC count [...]

Case Presentation: A 59-year-old incarcerated male presented to the hospital with abdominal pain, fever, and vomiting. Initial diagnostic workup showed a total leukocyte count of 14.2 x 103 /uL. The alkaline phosphate and total bilirubin were normal at 73 IU/L and 1.2 mg/dL, respectively. The Computerized tomography (CT) with contrast of the abdomen and pelvis [...]

Case Presentation: A 54-year-old man with a history of alcoholic cirrhosis presented to the emergency department for evaluation of a new facial rash and was found to be hypercalcemic to 15.6 mg/dL. A subsequent ionized calcium and cystatin C were also found to be elevated at 1.90 mMol/L and 2.55 mg/L (eGFR 23), respectively. His [...]

Case Presentation: Iatrogenic pneumothorax is a usually benign complication most commonly caused by transthoracic needle aspiration, central venous catheterization, and thoracentesis, amongst other standard hospital procedures, with an incidence of 1.36% by some estimates. Here we describe a rare case of iatrogenic pneumothorax involving a dry-needling (DN) procedure.Description:A 66-year-old female with a medical history of [...]

Case Presentation: A 55-year-old male with a history of coronary artery disease, left ventricular (LV) mural thrombus, tobacco use, and recent thalamic, splenic, and renal artery infarcts, presented with two weeks of worsening pain and cyanosis of his left third and fourth toes, associated with claudication. He denied numbness or loss of strength. He denied [...]

Case Presentation: A 28-year-old Caucasian male of European descent presented to the emergency department with a four day history of left upper quadrant abdominal pain that occurred following a day of skiing at 11,000 feet. On initial examination, he was afebrile, hemodynamically stable, and in distress from abdominal pain that localized to his left upper [...]

Case Presentation: A 46-year-old male with alcohol use disorder and cirrhosis presented to the emergency department for 1 day of persistent ascitic fluid leakage from his umbilicus. Exam was significant for ascites and a reducible, ulcerated umbilical hernia. The ulcer was cleaned, sealed with skin glue, and the patient was discharged. He presented again 7 [...]

Case Presentation: A 53-year-old male with a history of Goodpasture syndrome, systemic lupus, and Wegener’s granulomatosis underwent a deceased donor kidney transplant for end-stage renal disease. Two days post-surgery, the patient developed anemia and thrombocytopenia, elevated lactate dehydrogenase, and increased creatinine, prompting a preemptive diagnosis of TTP. Plasmapheresis was initiated every other day, alternating with [...]

Case Presentation: 21-year-old Caucasian male with no known medical history, has brought himself to the ED for evaluation of short-term memory issues. The patient denies any fever or chills, weakness, head trauma or similar complaints in the past. He exercises regularly, denies smoking alcohol or drug use. He has been using was finasteride since an [...]