Background: Understanding a patient’s goals of care (GOC) during hospitalization is vital to provide patient centered care. Despite the known importance, little is known about the quality of GOC conversation documentation. The aim of this study is to examine discussion documentation in hospitalized general medicine (GM) patients prior to intensive care unit (ICU) transfer and [...]

Case Presentation: Neisseria meningitidis, a gram-negative diplococcus, is widely known for causing meningitis and septicemia. However, its potential to trigger rare cardiac manifestations, such as pericarditis, often goes unrecognized. These atypical presentations can mimic common cardiovascular emergencies like myocardial infarction or pulmonary embolism, creating significant diagnostic challenges.A 44-year-old male with a history of type 2 [...]

Case Presentation: A 65-year-old female with a history of iron deficiency and acute blood loss anemia, schizophrenia, asthma, and hypothyroidism presented with shortness of breath and weight loss for three months. On arrival, her temperature was 101.1 F, blood pressure 84/40, heart rate 129, and spO2 97% on room air. Laboratory studies showed a white [...]

Case Presentation: We present a case of a 65-year-old Caucasian male with T2 N3 nasopharyngeal carcinoma (EBV-positive), status post concurrent gentamicin/cisplatin and radiation therapy, Parkinson’s disease, chronic kidney disease stage 3a, and pancytopenia, who initially presented with fever, altered mental status, abdominal pain, and generalized weakness.Patient was recently admitted for fever and abdominal pain. Evaluation [...]

Case Presentation: Establishing the diagnosis of tuberculosis (TB) can be challenging due to its heterogeneous presentation and limited sensitivity of testing. Pulmonary TB can share overlapping radiological, clinical, and histopathological features with other lung diseases. Physicians often wait for confirmatory testing prior to starting treatment. A 36-year-old male from Haiti presented with a 4-months of [...]

Case Presentation: A 59-year-old female with medical history significant for depression/anxiety, CAD, hypothyroidism, and tobacco use, recently admitted for leukopenia and normocytic anemia thought to be secondary to Epstein Barr Virus (EBV), Parvovirus, and adverse drug event from cefdinir use, presents with persistent fatigue and weight loss to an outside hospital. She was noted to [...]

Case Presentation: A 39-year-old obese man with type 2 diabetes, dyslipidemia, and hypertension presented to the ED with intermittent abdominal pain, diarrhea, nausea, and emesis 2 weeks after an illness with sore throat. He denied fever, chills, shortness of breath, epistaxis, gum bleeding, or easy bruising. Medications included losartan-hydrochlorothiazide, metformin, and tirzepatide. Vital signs showed [...]

Case Presentation: An 87-year-old man with a history of chronic inflammatory demyelinating polyneuropathy (CIDP) on prednisone (7.5 mg daily), coronary artery disease post-CABG with pacemaker, Parkinson’s disease, COPD, and partial vocal cord paralysis presented with progressive weakness and pancytopenia. Over three weeks, he developed worsening asymmetric weakness, slurred speech, dysphagia, and high-grade fevers unresponsive to [...]

Case Presentation: A 20 year old female with no past medical history presented for fever. She developed fevers, intermittent rash, polyarthralgias and odynophagia prompting her to present to the ED. She was febrile to 38.1 C and heart rate was 126 beats per minute. A faint erythematous facial rash was noted on physical exam along [...]

Case Presentation: We present a case of secondary Hemophagocytic Lymphohistiocytosis (HLH) triggered by Epstein-Barr Virus (EBV) in a 49 old male with no significant past medical history who worked as a cruise ship crewmember, presenting with high grade fevers and night sweats. Given his occupation, a broad differential diagnosis was initially considered, complicating timely diagnosis. [...]