Case Presentation: A 43-year-old male with a past medical history of Atrial Fibrillation on Warfarin, Stage III Chronic Kidney Disease, and Chronic Systolic Heart failure (EF 15%) presented to the ED with diarrhea and dyspnea. He was found to be in Atrial fibrillation with Rapid Ventricular Response with CHF exacerbation and shock, and he was [...]

Case Presentation: A 37-year-old woman with a history of HTN and ESRD due to preeclampsia now on hemodialysis presented to the hospital for two days of weakness, confusion, and fever. Notably, she had a recent history of blood cultures growing Acinetobacter for which she had received a course of antibiotics. Blood cultures taken at dialysis [...]

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: Raoultella ornithinolytica, a close relative of the genus Klebsiella, is a rare, Gram-negative bacterium known to cause biliary, pulmonary, and urinary tract infections in elderly or immunocompromised hosts. This case illustrates an unexpected discovery of Raoutella ornithinolytica bacteremia in a 20-year-old immunocompetent male with an underlying congenital condition called Caroli disease.A 20-year-old male [...]

Case Presentation: A 70-year-old male presented to ED with a 10-day history of fever with chills, sweating, abdominal pain and generalized weakness. The abdominal pain was predominant in right lower quadrant (RLQ), accompanied by nausea, vomiting, loss of appetite and significant weight loss more than 10 lbs. in 10 days. He denies jaundice, pruritus, constipation, [...]

Case Presentation: The case represents a 74-year-old female who presented to the emergency room with constitution of symptoms including headache, fatigue, Upper extremity/Neck pain and worsening of “skin rash”. For the past 10 years, the patient had suffered from Compulsive Skin picking disorder, necessitating multiple visits to PCP and Dermatologist with recurrent courses of antibiotics [...]

Case Presentation: A 33-year-old male with a past medical history of gout presented with a 5-day history of intermittent fevers, arthralgias, testicular pain and swelling. He denied dysuria, penile discharge, lymphadenopathy, and rashes. He reported having 3 female sexual partners over the past 6 months with consistent condom use and no history of sexually transmitted [...]

Case Presentation: A 70-year-old man with a history of adenoid cystic carcinoma initially presented with a 1-2 week history of olfactory and auditory hallucinations in the setting of intermittent fever. He reported that in addition to those symptoms he had diarrhea, which he attributed to having eaten undercooked meat. His auditory hallucinations involved hearing African [...]

Case Presentation: The patient is a complex patient with multiple hospitalizations. Prior to her hospital course her past medical history was notable for Roux-en-Y gastric bypass, alcohol abuse, and dilated cardiomyopathy with preserved EF. Patient original presentation was related to a perforated marginal ulcer requiring laparoscopic Graham patch. The ICU course was complicated by an [...]

Case Presentation: A 63-year-old man with a history of atopy recently started on dupilumab presented to a hospital in Central Appalachia with 1-week of flu-like symptoms, rigors, and right upper abdomen pain. He was hypoxic with SpO2 75% on room air, febrile to 103.3°F, tachycardic to 105 bpm. He was placed on 2 L nasal [...]