Case Presentation: A 42-year-old African American woman with a history of hypertension, morbid obesity, and obstructive sleep apnea presented to the emergency department with a 12-hour history of left-sided abdominal pain, nausea and vomiting. At presentation her medications included hydrochlorothiazide, acetaminophen, ibuprofen, and lisinopril. Her first dose of lisinopril 5mg was 12 hours before the [...]

Case Presentation: A 79-year-old male patient with a history significant for metastatic melanoma to the right axillary lymph node and recurrent diarrhea secondary to ipilimumab-induced colitis is admitted for uncontrolled diarrhea with rectal bleeding.  He has had several prior admissions for diarrhea, which have been successfully treated with IV steroids, but has recurrent diarrhea when [...]

Case Presentation: A 65-year-old male underwent vascular repair for a psuedoaneurysm of left brachiocephalic arteriovenous fistula. During surgery he was noted to have excessive bleeding and also postoperatively, he continued to ooze from the surgical site. His labs revealed PT of 33.5 seconds, INR of 3.3, and PTT of 53.7 seconds. His mixing studies showed [...]

Case Presentation:   A 47-year-old woman with history of immunoglobulin G (IgG) deficiency presented with severe headache, fever, vomiting, neck pain and photophobia. On the day prior to admission, she received first dose of Intravenous immunoglobulin (IVIG) infusion for recurrent bacterial infections refractory to antibiotic prophylaxis. On examination, her temperature was 100 °F and vital [...]

Case Presentation: A 32-year-old man with no significant past medical history presented with one day of respiratory distress and fever, sore throat, left neck pain and cough for 3 days. He appeared acutely ill, febrile, tachycardic and tachypneic. Lung exam revealed bronchial breath sounds and crepitation on bilateral lower lobes. Laboratory studies revealed neutrophilic leukocytosis and a normal [...]

Case Presentation: A 19-year old Caucasian female with a history of atopic dermatitis and mild asthma developed an erythematous maculopapular rash on her bilateral palms and wrists, right-sided tender cervical lymphadenopathy, and nightly fevers and headaches five days after returning from a one-month trip to Cambodia. She presented two weeks after returning from her trip [...]

Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides are systemic autoimmune diseases affecting small blood vessels.  The clinical signs and symptoms of ANCA vasculitis are nonspecific and may include multisystem manifestations.  As a result, many conditions mimic ANCA-associated vasculitis, making the diagnosis challenging.  We report a case of ANCA-positive vasculitis presenting as rapidly progressive glomerulonephritis that was initially [...]

Ehlers-Danlos syndrome (EDS) is a group of relatively rare genetic disorders of connective tissue with EDS hypermobility type 3 being by far the most common. This disease has many complications, some of which may be easily overlooked. I report a case of nausea, vomiting, and diarrhea with gastroparesis in a patient with EDS that was [...]

Case Presentation: 54 yo White Male with PMH of hereditary hemorrhagic telangiectasia (HHT) presented with right-sided focal neurological deficits, word finding difficulties, confusion and headache.  He was treated for a brain abscess with surgical resection and antibiotics X 1 month at an OSH attributed to recently sustained head trauma.  Follow up MRI 1 month later, [...]

Case Presentation: 60 y/o African American male with h/o chronic esophageal strictures s/p multiple esophageal dilations presented to the ER with complaints of weakness and dizziness. He met criteria for sepsis with possible source as aspiration pneumonia and was started on broad spectrum antibiotics. Two sets of blood cultures done from admission grew Streptococcus mitis/oralis. [...]