Case Presentation: A 9-year-old female was admitted to a community hospital for intravenous antibiotic treatment of a purulent draining wound on her left shin (Image 1), which had worsened despite completing a 5-day course of oral clindamycin. An ultrasound of the wound showed a 0.8 cm complex hypoechoic collection, prompting urgent incision & drainage for [...]

Case Presentation: Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder that can involve multiple organs, including the central nervous system (CNS). Neuropsychiatric systemic lupus erythematosus (NPSLE) refers to a spectrum of neurological and psychiatric symptoms such as cognitive dysfunction, psychosis, mood disorders, and seizures. Status epilepticus is a rare and severe presentation often associated [...]

Case Presentation: Clinical presentation: A 69-year-old female presented to the emergency for shortness of breath and bilateral low extremity edema. She had a history of chronic dyspnea and hypoxia on baseline 2 liters of oxygen and reported worsening dyspnea on minimal exertion for the week prior to admission. Review of symptoms was significant for wheezing [...]

Case Presentation: A 37-year-old female with no medical history presented for lab abnormalities. Initial blood work revealed a hemoglobin of 5.1 g/dL with a MCV and MCH unable to be calculated. Her white blood cell and platelet counts were normal. She denied melena, hematochezia, or other episodes of bleeding other than menorrhagia requiring up to [...]

Case Presentation: A 48-year-old woman with a history of fibromyalgia presented with a three-month history of progressive dyspnea, muscle weakness, weight loss (20 kg), and worsening respiratory symptoms. She initially sought care for productive cough, fever, and dyspnea, receiving treatment for pneumonia with ceftriaxone on two occasions with transient symptom relief. However, her symptoms recurred [...]

Case Presentation: A 23-year-old man without prior medical history was brought to the ED from his home for profound somnolence which had progressed over two days. EMTs at the scene noted that the patient was sluggishly responsive to painful stimuli. Initial vital signs were within normal limits, and a point-of-care glucose check was 28 mg/dL. [...]

Case Presentation: A 72-year-old male with hypertension, chronic kidney disease, and nephrolithiasis presented with six months of progressive weakness, unintentional weight loss, and fatigue. He had recurrent hypercalcemia, pancytopenia and recently diagnosed cirrhosis of undetermined etiology. The patient had three hospitalizations in the preceding six months for failure to thrive and hypercalcemia responsive to intravenous [...]

Case Presentation: A 77 year-old female without significant history presented with six months of urinary incontinence, six weeks of progressive confusion and falls, and one day of decreased speech and poor appetite. During two recent hospitalizations for acute encephalopathy, imaging revealed a frontal lobe meningioma, acoustic neuroma, and diffuse ventricular enlargement.On admission, the patient was [...]

Case Presentation: A 34-year-old male presented with 3 months of sores on his oral mucous membranes, rash, and a 50 lb weight loss felt to be due to pain with eating. He was seen by various providers in the outpatient setting and took courses of Valacyclovir, Azithromycin, and steroids without improvement. On initial presentation, there [...]

Case Presentation: A 54-year-old female presented to the Emergency Department (ED) with acute onset right leg weakness. Her medical history included recurrent cryptogenic strokes, fibromuscular dysplasia (FMD) involving the bilateral internal carotid arteries (ICAs), thrombocytopenia presumed to be immune thrombocytopenic purpura, and heterozygous Factor V Leiden and prothrombin G20210A gene mutations. Initial physical exam revealed [...]