Case Presentation: A 24-year-old Caucasian female with a family history of multiple autoimmune disorders presented with 3 weeks of bruising, petechiae, fatigue, and outside labs that revealed significant anemia and thrombocytopenia. Admission workup showed Hgb 7.6, platelets (PLT) < 3,000, and elevated MCV. Further labs showed elevated LDH, indirect bilirubinemia, haptoglobin< 10, and positive DAT [...]

Case Presentation: A 41 years-old Scottish male patient with a past medical history significant for erectile dysfunction, prior EBV infection, hyperlipidemia, umbilical hernia, and urethral meatal stenosis was referred by his PCP to rheumatology for oral thrush and recurrent oral ulcers for 3 years. The patient was initially seen by an Infectious disease doctor who [...]

Case Presentation: A 65-year-old female with a history of focal epilepsy and carotid stenosis with recent endarterectomy presented with four weeks of abrupt aphasia, right sided weakness and several days of altered mental status and unusual left-hand movements. Since the endarterectomy one month prior to presentation, her family reported cognitive decline, memory loss and increased [...]

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: 47 year old male with left temporal meningioma s/p resection, and recent immigration from India presented with fevers and worsening encephalopathy. CTH was unremarkable however MRI showed leptomeningeal hemispheric, brain stem, and cord signal with perivascular enhancement concerning for CNS TB however included a broad differential. He was started on empiric antibiotics for [...]

Case Presentation: The patient is a 43-year-old female with asthma, hypertension, and obesity who presented to her PCP for cough, pharyngitis, and dyspnea. Exam revealed jaundice, livedo reticularis, and pallor. Complete blood counts (CBC) showed white blood cells 22.8 x109/ L, hemoglobin 8.9 g/dL, and platelets 674 ×109/L. Her family history had no hematologic malignancies [...]

Case Presentation: A 79 y/o obese male with a history of hemochromatosis on scheduled phlebotomies, hypertension, afib, and hyperlipidemia presented to the ED for the third time in a week with chief complaints of nausea, syncope, and diaphoresis. Vitals signs were normal on presentation. Preliminary investigations were unremarkable except for glucose of 48. The patient [...]

Case Presentation: A 13-year-old previously healthy boy presented to the emergency department with 1 day of jaundice and scleral icterus as well as acute on chronic progressive abdominal pain. Review of systems was notable for unintentional 5 kg weight loss over the past year, fatigue, oral ulcers, Raynaud’s phenomenon, and gross hematuria. He had no [...]

Case Presentation: A previously healthy two-year-old male presented with six days of painless right ptosis, fever, cough, and nasal congestion. He had no ocular or head trauma. He had tried antihistamines without benefit. Non-contrast CT head showed only paranasal sinus disease. See Image 1.He was evaluated by Neurology and Ophthalmology and found to have complete [...]

Case Presentation: A 72-year-old male with a history of ischemic cardiomyopathy, infectious endocarditis, subarachnoid hemorrhage, and esophageal cancer presented with symptoms of fever, altered mental status, bilateral lower extremity weakness, spasms and pain. Of note, the patient was on nivolumab, undergoing targeted radiation therapy for esophageal cancer; and vancomycin and cefepime for infectious endocarditis. The [...]