Case Presentation: An 89 year-old woman was admitted for several days of severe constipation, abdominal bloating and absence of flatus. She had abdominal distention with minimal abdominal tenderness on exam. Initial CT imaging demonstrated significant stool burden with prominent colonic distension extending from the cecum to the transverse colon. She required nasogastric tube decompression. Several [...]

Altered Mental Status in a Psychiatric Patient: A Case of Anti-NMDA Encephalitis Case Presentation: 29-year-old female with a history of Bipolar I Disorder, in remission off medication, presented to the Psychiatric Emergency Department with hyperactivity, insomnia, impulsive purchasing and audiovisual hallucinations for two weeks. The patient was admitted to psychiatry for treatment of mania with [...]

Case Presentation: The patient was a 27 year old male who presented to the ED in July 2016 with persistent left sided chest pain and a lump over his sternum of several weeks in duration. Pain was exacerbated by touch and exertion. Other symptoms included occasional episodes of scant hemoptysis. Patient denied SOB, fevers, chills, [...]

Case Presentation: A 38 year old thin, Native American female with no known past medical history presented to the hospital with combativeness, confusion and then obtundation. She was in her normal state of health according to her family and then developed confusion and erratic behavior at work. She had no history of seizures. She did [...]

Case Presentation: A 31 year old male with no significant past medical history presented with recurrent fevers, nausea, vomiting and headaches.  He denied travel outside the U.S, camping, or hiking.  Temperature was 103F associated with tachycardia. Physical examination was unremarkable except for mild scleral icterus.Initial labs showed transaminitis, hyperbilirubinemia, leukocytosis, thrombocytopenia, and elevated ferritin > [...]

Case Presentation: A 53-year-old female with significant history of depression, epilepsy, and osteoporosis is brought to the ED by her husband for suicidal ideation.  She reports that over the last 3 months she has had increasing symptoms of depression, anxiety, and mood swings and for the last 2 weeks has had intermittent thoughts of suicide [...]

Case Presentation: A 44 year old gentleman with a past medical history significant for Crohn’s disease presented for evaluation of painless jaundice and a pancreatic mass in the setting of significant unintentional weight loss and recent flu-like symptoms including night sweats, low-grade fever, and dizziness.  Prior to admission, the patient underwent computerized tomography of the [...]

Case Presentation: A 64-year-old obese male with history of atrial fibrillation, congestive heart failure (CHF) and alcohol use presented with subacute worsening of lower extremity edema, fatigue, and exercise tolerance. Five months prior to presentation, he was admitted to an outside hospital with newly diagnosed atrial fibrillation and CHF. At that time an echocardiogram showed [...]

Case Presentation: A 63-year-old female with no PMH or FH of heart disease presented to the ER with dyspnea and pressure-like central chest pain. She reported a 3-week history of cough, sore throat and rhinorrhea. On evaluation, vital signs were T 97.8°F, BP 143/85 mmHg, HR 150/min, RR 20/min and SpO297%. Physical exam was significant [...]

Case Presentation: A 65-year-old female, Spanish speaking, Jehovah’s Witness, with a past medical history of insulin-dependent diabetes, PUD 2/2 H pylori treated but not tested for cure, and osteoarthritis who presents with hematemesis of one-day duration and abdominal pain of 5 days duration.The patient woke up vomiting blood on the morning of admission. While the [...]