Case Presentation: A 46-year-old woman with a past medical history of breast cancer, on tamoxifen, presented to the hospital for two-day history of progressive and generalized rash with a fever. Two weeks prior, she took cephalexin for one week for cellulitis of her right lower leg. The patient did not report a recent travel history. [...]

Case Presentation: A 44-year-old female with a history of SLE and chronic diarrhea presented with a one-day history of fever and lethargy. On admission, she was septic with a pancytopenia and a neutropenia with an ANC of 1.6. CT of chest, abdomen and pelvis showed non-specific enteritis, concordant with the chronic diarrhea history, but no [...]

Case Presentation: A healthy 61-year-old woman residing in New York City presented with fever, fatigue, and decreased urinary output for four days. She was ill-appearing, jaundiced and hypotensive. Laboratory results were notable for WBC of 5.2/µl, hemoglobin 9 g/dl, platelet count 46,000/mm3, BUN 43 mg/dl, creatinine 4.36 g/dl, total bilirubin 4.6 mg/dl, direct bilirubin 1.5 [...]

Case Presentation: A man in his late 70s presented to the emergency department after multiple falls and new onset altered mental status. Past medical history included hypertension, hyperlipidemia, chronic kidney disease (CKD) stage III, and previous infection with anaplasmosis over a decade prior.On clinical exam, the patient was afebrile, hypoxic, and meeting SIRS criteria with [...]

Case Presentation: A 46 year old man living in southwestern Maine with a history of hypertension, hyperlipidemia, and obesity presented in late September with 2 days of numbness in the right foot that progressed to bilateral lower extremity weakness, numbness, and difficulty ambulating. Patient denied any recent illnesses, vaccinations, travel or known bites the month [...]