Case Presentation: A 65-year-old man presented with anasarca and dyspnea on exertion that progressively worsened over three weeks. He had no known cardiac, renal, or liver disease prior to presentation. Physical exam revealed elevated jugular venous distention, bibasilar crackles, tense ascites, scrotal edema, and pitting edema in bilateral lower extremities extending to the abdomen. Investigation [...]

Case Presentation: A 81 year Albanian male presented to the emergency with pain in right upper abdomen. Abnormal vitals during presentation were temperature of 101.8F, respiratory rate of 24/min and blood pressure of 85/66mmg Hg. Right upper quadrant was tender to touch with positive murphy’s sign. Lab work demonstrated WBC of 18.8 with band neutrophil [...]

Case Presentation: A 60 -year old Caucasian female presented to the emergency department with right-sided hemiparesis and dysarthria. The patient had been admitted to an outside facility one week prior to presentation for left foot osteomyelitis. That admission was complicated by right upper extremity DVT and she had been started on apixaban. When she presented [...]

Case Presentation: A 46-year-old female with a past medical history of hypertension, diabetes mellitus, and asthma who initially presented 2 weeks prior to the emergency department for right-sided facial paralysis and was diagnosed with idiopathic facial paralysis (Bell’s palsy). Despite being started on prednisone and valaciclovir, 2 weeks later she had suddenly developed left-sided facial [...]

Case Presentation: A 48-year-old female with tyrosine kinase inhibitor-resistant CML on hydroxyurea therapy admitted with 3 weeks of fever, skin redness, and swelling. Her physical examination was remarkable for the temperature of 100.1 F, localized skin erythema, and tenderness around left antecubital fossa. Her labs revealed WBC of 80,000/ mm3 with 7% blast cells which [...]

Case Presentation: A 69-year-old man with a history of tobacco use and chronic cough presented with worsening productive cough and shortness of breath. He was found to have a right lower lobe consolidation on chest x-ray and leukocytosis of 27,000 white blood cells per microliter concerning for community-acquired pneumonia. Vital signs were initially normal, and [...]

Case Presentation: A 67 year old woman presented with right upper quadrant abdominal pain and was diagnosed with acute cholecystitis. She underwent elective cholecystectomy, complicated by Clostridium difficile colitis. Despite treatment with oral Vancomycin, she had persistent diarrhea and failure to thrive for a month. Repeat Clostridium difficile toxin was negative. Esophagogastroduodenoscopy showed erosive gastritis [...]

Case Presentation: A 70 year old man presented with four days of epigastric pain, nausea, vomiting and abdominal distension. He reported 50lbs of weight loss due to decrease in appetite over two months. He denied any hematemesis or melena. Physical exam was unremarkable except for diminished bowel sounds and positive stool guaiac test. CT scan [...]

Case Presentation: The diagnosis of a sexually active young male who presents with fevers, night sweats, weight loss with opportunistic infections and then found to have an acquired immunodeficiency is going to be HIV except when it isn’t. We present a patient with a presumptive diagnosis of HIV but a negative comprehensive HIV laboratory testing [...]

Case Presentation: 54 years old man with a history of hypertension was hospitalized due to elevated BUN/creatinine of 33/4.6 mg/dL and Hb of 9.9 mg/dL (baseline 15). He endorsed dyspnea on exertion, anorexia and weight loss of 15 pounds in 6 months. One month ago, he was treated for acute bronchitis with levofloxacin and was [...]