Case Presentation: Pneumonia in an immunocompromised individual has a broad differential; the initial work-up and selection of antimicrobials can be challenging. We present a case of concomitant pulmonary nocardiosis and Pneumocystis jirovecii pneumonia (PJP). A 60-year-old male with hepatitis C infection status-post treatment with a negative viral load and chronic kidney disease (CKD) due to [...]

Case Presentation: 84 yo M with a history of CAD with HFrEF presented for a routine BiV AICD upgrade whose course was complicated by VT storm requiring amiodarone and lidocaine before conversion back to his outpatient medication mexiletine. Postoperatively, the patient developed a morbilliform rash, which was attributed to an antibiotic allergy as the patient [...]

Case Presentation: A 94-year-old Female with chronic kidney disease (stage 4), recurrent urinary tract infections (UTIs), and hypertension presented with a 3 day history of worsening general weakness, left thigh soreness, and a left thigh hematoma which was noted by the home health aide. The patient had a hospitalization 1 month prior in which she [...]

Case Presentation: An 88 year old man with a history of severe aortic stenosis with transcatheter aortic valve replacement and unprovoked pulmonary embolism (on lifetime warfarin) presented with four days of lethargy and weakness. He denied any fevers, chills, abdominal pain, diarrhea, or urinary symptoms. He was compliant with scheduled dental cleanings and took prophylactic [...]

Case Presentation: A 37-year-old woman with history of ulcerative colitis and focal nodular hyperplasia (FNH) of the liver presented with right upper quadrant (RUQ) abdominal pain. An extensive workup including endoscopic retrograde cholangiopancreatography (ERCP) eventually diagnosed primary sclerosing cholangitis (PSC).  However, review of systems was also significant for epistaxis.  Family history was significant for father [...]

Case Presentation: A 54 year old female with history of SLE, ESRD on hemodialysis, CAD and aortic valve replacement, was admitted for confusion that started the morning of admission. CT head, basic labs and urine toxicology were non-revealing. EEG recordings were consistent with subclinical non-convulsive status epilepticus and the patient was admitted to the ICU. [...]

Case Presentation: A 35 year-old female with a past medical history significant for type 2 diabetes mellitus, polycystic ovarian syndrome and migraine headache presented with alteration of mental status for 2 weeks. Patient endorsed progressive, generalized fatigue with intermittent episodes of confusion, behavioral disturbance, hypersomnia and short-term memory loss. Vital signs on admission were significant [...]

Case Presentation: A 64 year-old male with a past medical history significant for COPD presented with fever, abdominal pain and rash. Patient endorsed fever and chills for 2 weeks prior to inpatient hospitalization.  Patient subsequently noted intermittent generalized abdominal pain associated with hematochezia.  Patient noted onset of bilateral lower extremity rash the day of hospital [...]

Case Presentation: A 38-year-old man with untreated hyperthyroidism presented with two-week history of progressively worsening weakness and dyspnea along with a six-month history of unintentional 38 pound weight loss, diarrhea, and palpitations.  Exam was notable for confusion, cachexia, diffuse thyromegaly, jugular venous distension, exophthalmos, thyroid bruit, bilateral rales, and tachycardia (HR to 150s).  A transthoracic [...]

Case Presentation: A 26 year-old Singaporean man with no past medical history presented with two weeks of fevers and abdominal pain. Five months prior to admission, the patient traveled to Singapore.  Two weeks prior to presentation, he had an episode of sharp, right-sided abdominal pain accompanied by emesis.  He continued to have intermittent fevers, chills, [...]