Case Presentation: We report the case of a 69-year-old Honduran male with a long history of non-valvular atrial fibrillation with a CHA2DS2-VASc Score= 2 (Age > 65 and Hypertension) anticoagulated with Rivaroxaban 20 mg po daily since 2013.  He presented with sudden onset of excruciating upper and lower back pain while seated at his cardiologist’s [...]

Case Presentation: A 44-year-old female with end-stage renal disease on hemodialysis presented to the hospital with progressive nausea, vomiting and abdominal pain. The etiology of her renal disease was unknown. She had received a renal transplant 17 years ago, which then failed. She was maintained on peritoneal dialysis (PD) for 12 years until she was [...]

Case Presentation: A 37 year old Caucasian man with known peptic ulcer disease and generalized anxiety disorder presented with a three week history of worsening right upper quadrant pain, nausea and generalized malaise.  He denied taking any prescribed medications or acetaminophen.  He denied any alcohol use during the week of admission. The patient was afebrile [...]

Case Presentation: A 31-year-old African American woman with past medical history of hypertension (HTN), gastro esophageal reflux disease (GERD), bronchial asthma and a diagnosis of Irritable Bowel Syndrome (IBS) for 10 years presented with complaints of exacerbation of chronic abdominal pain and non-bloody diarrhea for 2 weeks prior to presentation. Physical examination was unremarkable except [...]

Case Presentation: A 27 year-old male called 911 after intentional ingestion of 3g of lamotrigine and 3g of hydroxyzine.   Upon arrival to the ER, approximately one hour after ingestion, the patient had slurred speech and was lethargic, but was able to provide his own history.  The patient subsequently began to speak incoherently and became increasingly [...]

Case Presentation: Calciphylaxis is a rare cause of skin necrosis due to calcium deposition within the vasculature, most commonly seen in patients with end stage renal disease.  A 54-year-old male was transferred from a long-term acute care facility for evaluation of a 3 week history of bilateral proximal lower-extremity wounds.  His past medical history was [...]

Case Presentation: A 55 year-old male with no known medical history presented to the emergency department after a fall on both knees. He was found to have bilateral patellar tendon ruptures and multiple femoral lytic bone lesions on radiographic imaging. Subsequent laboratory testing yielded an elevated creatinine (3.42 mg/dL) and hypercalcemia (15.2 mg/dL), concerning for [...]

Case Presentation: A 75-year-old man with atrial fibrillation and no neurologic history presented to the emergency department with a one day history of somnolence, aphasia, and generalized weakness. He was nonverbal and minimally responsive to sternal rub. The patient had been diagnosed with herpes zoster in a thoracic dermatomal distribution two days prior to presentation [...]

Introduction: Pneumonia in an immunocompromised host is unique with respect to the organisms involved. The emergence of new pathogens has significant impact on therapy. Achromobacter xylosoxidans (A.xylosoxidans) is an uncommon pathogen known to cause serious infections in immunocompromised hosts. Despite its ubiquitous existence, community acquired infections are rare. We report a case of A.xylosoxidans causing invasive cavitary pneumonia. [...]

Case Presentation: A 31-year-old woman with a history of rheumatic heart disease and a murmur presented with two months of intermittent subjective fevers, diffuse malaise and inability to walk. Physical exam revealed a systolic 2/6 murmur heard best at the apex, 3 out of 5 strength with right knee extension and flexion and 3 out [...]