Case Presentation: A 38-year-old male presented to the hospital with fatigue and progressive exertional dyspnea. He had a childhood history of Kawasaki disease (KD) with no treatment or subsequent follow up. Physical exam revealed marked volume overload, JVD, bibasilar crackles, and an S3 at the left ventricular apex.  EKG was unremarkable. Chest x-ray showed pulmonary [...]

Case Presentation: This is a 53-year-old Caucasian female with a history of hypertension, recent stroke, and obesity, who presented with chest pain. She had intermittent chest discomfort as a child and was told she had asthma; however, over the past few months, her chest pressure became more frequent and occurred both with activity and rest. [...]

Case Presentation:       A 33 year-old Hispanic male without significant history presented with an unremitting fever for 5 days, associated with myalgais, fatigue, night sweats, and a rash. Upon admission, he was tachycardic, hypotensive and febrile at 103F. Physical exam revealed a diffuse non-blanching, maculo-papular rash, sparing the face, palms and soles. Labs [...]

Case Presentation: A 77 year old male with history of HTN, HLD, MR presented with two weeks of cervical neck pain, chills, neck stiffness, and malaise. Blood cultures drawn on admission grew a coagulase-negative Staphylococcus, which was later identified as Staphylococcus lugdunensis; an MRI of the spine was consistent with discitis. A TEE revealed a [...]

Case Presentation: A 64 year old male presented with a three day history of fever, hand soreness and rash.  On the day of presentation, he had just returned from the Caribbean, however denied any history of ill contacts, recent hiking or contact with large bodies of water.  There were no known allergies, recent changes in [...]

Case Presentation: A 22 year-old woman presented with sudden-onset shortness of breath and five days of progressively worsening rhinorrhea and cough.  She was tachycardic and tachypneic, with diffuse inspiratory and expiratory wheezes bilaterally. Oxygen saturation was 78% on room air. Accessory muscle use was observed. Lactate was 2.4 mEq/L. Chest radiograph was unremarkable. After treatment [...]

Case Presentation: A 55-year-old female with Child-Pugh1 Grade C cirrhosis and an umbilical hernia presented with 5 days of fluid leakage from her hernia site. Four months prior to presentation, she had developed tense ascites requiring serial paracentesis. Her hernia became blue and ulcerated, and intermittently drained small amounts of fluid; however, the opening had [...]

Case Presentation: Introduction: Tracheal tumors commonly arise as metastasis from neighboring thyroid, esophageal, laryngeal or lung tumors. Primary tracheal tumors are extremely rare with an incidence of 1 in 1,000,000 persons per year. Often presenting with non-specific symptoms, diagnosis is difficult. Case Report: A 59-year-old Caucasian male with a history of marijuana abuse, arterial thrombosis, [...]

Case Presentation: Hypercoagulable disorders pose an increased lifetime risk of developing venous thromboembolic events (VTE). It is established that patients with these disorders usually need lifelong anticoagulation once they have more than one thromboembolic event. With the emergence of novel oral anticoagulants (NOAC), management of these patients has been streamlined. However, in times of medical [...]

Case Presentation: An ADL-independent 75-year-old woman with a history of diabetes who was receiving insulin therapy visited our emergency department owing to fever and chills, which had started 3 days before the visit. At that time, her consciousness level was GCS E4V4M6, temperature was 36.8°C, pulse rate was 83 beats/minute, blood pressure was 82/46 mmHg, [...]