Case Presentation: A 55-year-old male with history of bilateral degenerative hip joint disease presented for worsening serosanguinous drainage from his wounds one week after bilateral hip replacement. He further developed diaphoresis and chills and received cephalexin at an outside hospital from where he was later discharged. He did not have improvement from antibiotics and his [...]

Case Presentation: We present a 79-year-old woman with a longstanding history of seropositive, erosive, and nodular rheumatoid arthritis. Her rheumatoid arthritis was diagnosed over 40 years prior and had been complicated by Large Granular Lymphocytic (LGL) Leukemia and Felty syndrome with confirmed splenomegaly and neutropenia. She was originally treated with filgrastim for severe neutropenia. About [...]

Case Presentation: A 61-year-old male with past medical history of type 2 diabetes, hypertension, hyperlipidemia, tobacco use disorder, Raynaud phenomenon, and provoked DVT presented from an outside hospital with abrupt onset of a purpuric lower extremity rash with discoloration and ulceration of the distal fingers and toes. At the time of the patient’s DVT several [...]

Case Presentation: Two patients developed tongue necrosis as an unusual presentation of giant cell arteritis (GCA).Case 1:A 61-year-old female presented with a one month history of painful swelling and ulceration of her tongue with weight loss. She received a punch biopsy of her tongue that showed ischemic, necrotic, and autolytic changes. After large areas of [...]

Case Presentation: A 65 year-old female with past medical history of type 1 diabetes mellitus, renal transplant, breast cancer, sarcoidosis, and hypothyroidism presented with acute onset of severe pain, numbness, and weakness of bilateral upper and lower extremities. The patient developed rapidly progressive fatigue and weakness over three days following acute bronchitis six weeks prior. [...]

Case Presentation: A 38-year-old female presented to the emergency department with profuse vomiting, fever, chills, lightheadedness, dizziness, and the inability to tolerate oral intake. She had been in her usual state of health until two hours after returning from a doctor’s appointment where she received methylene blue intravenously. Past history included hypothyroidism, postural orthostatic tachycardia [...]

Case Presentation: A 79-year-old female nonsmoker with chronic bronchiectasis on 3 liters of home oxygen presented with worsening shortness of breath. The patient’s baseline creatinine (cr) was 0.85 mg/dL, eGFR 60, and she was admitted with cr of 2.2 mg/dL. Urinalysis showed proteinuria, pyuria, hematuria with few bacteria, with new onset anemia (Hgb 7.8) on [...]

Case Presentation: A 29-year-old man with a history of morbid obesity, asthma, and chronic tracheostomy presented with 3 weeks of abdominal pain. The pain was intermittent and epigastric, without relationship to eating. He had poor appetite and nausea, though no emesis. He denied use of ibuprofen or alcohol. He denied fevers or chills. The pain [...]

Case Presentation: A 34 year old female presented to the emergency department with several days of rapidly progressive skin and tongue lesions. Over the preceding months, she was evaluated by outpatient otolaryngology for recurrent otalgia and sinusitis, receiving antibiotics and prednisone without improvement. She underwent electromyography with neurology and was diagnosed with peripheral neuropathy of [...]

Case Presentation: An 80-year-old man with recently-diagnosed pulmonary fibrosis presented to the hospital with ascending bilateral lower extremity pain and weakness. His symptoms began in both feet and calves, and progressed proximally toward his thighs over the past 6 weeks. During this timeframe, his symptoms evolved from being able to ambulate for miles and climb [...]