Case Presentation: Asenapine is widely acknowledged as a well-tolerated medication, exhibiting only infrequent severe adverse events1. The necessity of liver enzyme testing remains a topic without a unanimous consensus2. This case study discusses a patient who experienced significant liver damage upon initiating asenapine. As far as our understanding goes, this represents the initial documented instance [...]

Case Presentation: A 57-year-old man with depression and prior suicide attempts presented after being found unresponsive at home with empty bottles of doxepin, amitriptyline, and another unidentified pill bottle. In the ED, he had a GCS of 6, was intubated for airway protection and admitted to MICU. Sodium bicarbonate, fentanyl and propofol infusions were started [...]

Case Presentation: A 80 year-old man with past medical history of frontotemporal dementia and seronegative rheumatoid arthritis (RA) presented with a maculopapular rash that started two weeks ago on his back that progressed to his chest, abdomen, neck, face, scalp, and arms. Physical exam also showed oral mucositis. For his RA, he had been on [...]

Case Presentation: Posterior reversible encephalopathy syndrome (PRES) is a neurological disorder characterized by symptoms of encephalopathy and radiographic findings suggestive of vasogenic edema. Although PRES is most often triggered by hypertensive emergencies, sepsis and immunosuppressive medications have also been implicated in its pathogenesis. We present a case of PRES due to lithium toxicity.A 47-year-old female [...]

Case Presentation: Two brothers aged 12 and 16 were referred to the ED from clinic for acute worsening of symptoms in the setting of known mercury exposure. In the preceding six months, both had experienced waxing and waning of non-specific symptoms, including musculoskeletal pain and paresthesias, urinary urgency, non-bloody diarrhea, body aches, night sweats, generalized [...]

Case Presentation: A 54-year-old man with congestive heart failure, chronic kidney disease and atrial fibrillation (on digoxin 0.125 mg daily for 3 years) presented to the emergency department with fatigue, weakness, vomiting, poor oral intake and whole body “involuntary sudden movements.” Neurological exam revealed generalized symmetrical choreiform movements more pronounced in the head, upper torso [...]