Case Presentation: A 54 year old female with no past medical history presented to the emergency room complaining of “sore throat” for the past two days.  She described it as throat tightness and fullness and was associated with mild dyspnea, dysphagia and low-grade fever. Her vital signs were stable with O2 saturation of 92% on [...]

Case Presentation: A 46-year-old male without significant past medical history presented with progressive dyspnea, syncope, and epigastric pain. An electrocardiogram displayed sinus tachycardia without signs of ischemia. A chest radiograph demonstrated a widened mediastinum. A subsequent transthoracic echocardiogram demonstrated pericardial effusion and tamponade. Patient had hypotension that was unresponsive to repeated intravenous fluid boluses, prompting [...]

Case Presentation: Our patient was a 58 year old male with a history of metastatic melanoma on nivolumab and ipilimumab who was directly admitted from clinic to the medicine service for increased lethargy and flu-like symptoms. The patient described a one week history of fevers/chills, headache, muscle ache, and malaise; as well as nausea, vomiting, [...]

Case Presentation: A 44 year-old woman presented with 10 days of acute onset decreased vision.  She reported “floaters” and bright flashes in her eyes, left worse than right. Her eyes felt “tired,” but not painful and she had no headache. A retinal specialist found bilateral optic nerve and macular edema, worse in her left eye. [...]

Case Presentation: A 56 year-old woman with well-controlled peri-rectal Crohn’s disease on infliximab presented to the hospital for management of a 2.5 year history of painful, draining vulvar dermatitis that had been biopsied twice and showed lichen simplex chronicus. Prior therapies included topical steroids and multiple antibiotic courses without significant or sustained improvement. MRI to [...]

Case Presentation: A 74-year-old female with a past medical history of chronic pulmonary emboli, left ventricular heart failure, and hypertension presented with shortness of breath on exertion and bilateral lower extremity edema for one week. On examination, she was found to have jugular venous distention, crackles in bilateral lung bases, and 3+ pitting peripheral edema. [...]

Case Presentation: An 80 year old lady presented with fever and confusion since 4 days. She denied any recent trauma, infection, dehydration, medication change, or nutrient deficiency. Her medical history was only significant for anxiety, for which she took alprazolam at home. On physical exam she appeared agitated and disoriented, with a heart rate of [...]

Case Presentation: A 40 year old female presents with intermittent mid-sternal squeezing chest pain, radiating to the left arm since 2 days. She denied any positional change in symptoms or family history of coronary artery disease. Her medical history was significant for hypertension and smoking, and her only home medication was lisinopril. Physical examination was [...]

Case Presentation: A 19-year-old Caucasian man, with no past medical history presented to ER with acute onset generalized muscle weakness, more pronounced in both legs, which started upon awakening in the morning. He reported 40 lbs weight loss over 2 months in spite of increased appetite. Patient denied palpitations, heat intolerance, dysphagia or change in [...]

Case Presentation: A 29-year-old male patient with no past medical history was admitted initially with bilateral lower extremities (LE) weakness and right side facial paralysis. Before the onset of the symptoms, he reported that he developed round red spots with fever after being in the woods. His neurologic exam was positive for absent reflexes in [...]