Case Presentation:   A 76-year-old female was admitted from an outside hospital for concern for osteomyelitis of her cervical spine.  She had previously had a week of neck pain with limited range of motion due to pain.  She was treated for E. coli sepsis following positive blood and urine cultures, but her neck pain persisted.  Upon transfer, [...]

Case Presentation: A 23 year old Caucasian female with no significant past medical history presented to clinic for evaluation of a recently diagnosed liver mass. The patient had previously been seen in the Neurosurgery clinic for complaints of numbness and tingling sensations in her bilateral lower extremities from her hips down. An MRI of the [...]

Case Presentation: A 67 year old Caucasian male with history of squamous cell carcinoma of the lower lobe of the left lung was admitted to the hospital after his pre-chemotherapy laboratory work at his oncologist showed elevated liver enzymes (AST 162, ALT 141), elevated CK (2856), CK-MB (104) and elevated troponin (0.83). The patient had [...]

Case Presentation: A 28-year old healthy female was admitted seven days post-operatively following Cesarean section for abdominal wound complications. On admission, she was septic; her scar was tender and erythematous with surrounding purple discoloration. Within a few hours, the edges of her scar turned dusky, extending well outside the originally marked boundaries. Aggressive debridement of [...]

Case Presentation: A 47-year-old woman with a history of alcohol abuse presented to the emergency department with one week of altered mental status. Review of systems was significant for involuntarily 100 lbs. weight loss over one year with no change in appetite.  She reported no prescribed or over-the-counter medication use. Vital signs on presentation were [...]

Case Presentation: A 68-year-old male with neurogenic bladder requiring self-catheterization, atrial fibrillation on coumadin, and osteoarthritis on chronic ibuprofen presented with lower extremity weakness after a fall. He was found to have a supratherapeutic INR of 6.6 and temperature of 39°C. Laboratory work showed leukocytosis to 15.5 th/mm3 and urinalysis with 3+ leukocyte esterase and [...]

Case Presentation: A 60-year old female with past medical history significant for diabetes, hypertension, and hypothyroidism presented with acute onset confusion progressing over the course of 5 hours. On exam, patient’s vitals were significant for an elevated blood pressure (179/104). She was only oriented to herself and showed no focal motor deficits, but did have [...]

Case Presentation: A 58- year-old female presented with vomiting, dizziness, and a blood pressure of 80/60 mmHg. Laboratory: serum creatinine 3.1 mg/dl (baseline 1 mg/dl), BUN 34 mg/dl (baseline 10 mg/dl), corrected calcium 12.3 mg/dl, low PTH , normal 25-OH vitamin D, and normal PTH-related protein. Two months prior, serum calcium was normal and 25-OH [...]

Case Presentation: A 30-year-old previously healthy man presented with one week of fatigue, malaise, and confusion, complaining of dull neck pain. In the ED he became acutely agitated and combative, eventually requiring sedation and intubation for altered mental status. Initial vitals were normal, with BP 130/85 and HR 66, but then patient developed a fever [...]

Case Presentation: A 76-year-old woman with history of non-small cell lung cancer status post chemoradiation five years ago presented with acute onset of diffuse muscle weakness and swelling in bilateral forearms and legs, with a “woody” texture on palpation but without fluctuance. BP and HR were normal, but she had recurrent fevers as high as [...]