Case Presentation: A 6-month-old term female with history of mild reflux presented to the pediatric emergency department for seizure-like activity. Her mother described three episodes of eyes jerking and head bobbing, each occurring on waking from a nap and lasting about 30 seconds. She reported the patient’s eyes jerking rapidly to the right and slower [...]

Case Presentation: A 10-year-old Hispanic female with 7 years of episodic cervical lymphadenopathy and fever, presented with typical episode, new abdominal pain and emesis. Review of systems was positive for weight loss, night sweats, and diarrhea; she denied rash, cough, sore throat, and arthralgia. History was notable for many prior antibiotics, recently azithromycin and fluconazole [...]

Case Presentation: H.C. was admitted to the hospital at 7 weeks of age for failure to thrive. Patient is an ex 37 6/7 weeker, BW was 1.84 kg (0.02%, Z=-3.57), and was induced due to IUGR and oligohydramnios. H.C had an uneventful newborn nursery stay and normal newborn screen. On admission, weight was 2870 g, [...]

Case Presentation: A 23 month old female with minimal primary care visits presented to the ED after a syncopal episode. She was found to be tachycardic, tachypneic, and hypoxic. Physical exam revealed an irritable, pale child with a 3/6 systolic murmur and hepatomegaly. CBC was significant for a Hgb of 1.5. CXR revealed cardiomegaly. Due [...]

Case Presentation: An 8-year-old female with a 10-day history of intermittent myalgia and fatigue presented to the emergency department after waking with severe, diffuse myalgias. Initial laboratory work-up included CBC, CMP and CPK. Most significant was a CPK of 35,000 units/L. Aggressive fluid repletion was started for presumed viral induced rhabdomyolysis. After 5 days of [...]

Case Presentation: A 15 year-old female with developmental delay presents with intermittent abdominal pain, decreased appetite, and vaginal discharge. Parents disclose a 30 lbs weight loss over 2 years, along with vaginal discharge that was evaluated by self-swab testing and deemed a “normal variant” from menses. When she presented to her PCP’s office, she was [...]

Case Presentation: A 66 year-old Caucasian male presented to the emergency department with intermittent fevers, chills, fatigue and dyspnea of 1 week duration. He denied any nausea, vomiting, abdominal pain, changes in bowel habit or significant trauma. He lived in a wooded area and had 3 previous Lyme infections but denied any recent tick bite, [...]

Case Presentation: A 29-year-old Caucasian woman presented to the emergency department with fever, sore throat, epigastric and right upper quadrant abdominal pain of 5 days duration. Physical examination was positive for fever (40oC), tachycardia (heart rate 114 beats per minute), and a palpable liver and spleen on abdominal examination. Notable laboratory investigations included pancytopenia – [...]

Case Presentation: A 75-year-old African-American female with a past medical history of hypothyroidism, hypertension, and Alzheimer’s dementia presented to the emergency room with altered mental status and concern for possible stroke; family also reported new seizure-like activity. Vitals on admission were significant for severe hypertension however, she was afebrile. Physical exam was limited due to [...]

Case Presentation: A 19 year-old Caucasian woman presented with progressive fatigue, dyspnea on exertion and dizziness for 3 weeks. Her symptoms were preceded by an unknown bug bite approximately 3 weeks ago. She was seen in urgent care two weeks prior to admission and given a course of unknown antibiotics and started on steroids. She [...]