Case Presentation: A 63-year-old male presented to our institution with progressive dyspnea and associated hemoptysis of several days duration. He was a former cigarette smoker, having smoked approximately 1 pack per day for 45 years, who had recently transitioned to using electronic cigarettes, or “vaping,” 3 months prior. With regards to his vaping, he reported [...]

Case Presentation: A 75-year-old male presented to our institution with lethargy and unremitting headache of several weeks duration. His history was significant for squamous cell carcinoma of the lung status post lobectomy with recurrence 4 years later being treated with palliative radiation, chronic obstructive pulmonary disease (COPD), and hypertension. He described his headache as daily, [...]

Case Presentation: Disseminated Coccidioidomycosis is a rare fungal infection that can have various presentations in a hospitalized patient. Given the high mortality rate associated with delayed diagnosis, it is essential to keep this rare infection on the differential. A previously healthy 37-year-old Hispanic male presented with a one-month history of cough, high-grade fevers, night sweats, 15-pound [...]

Case Presentation: A 32 year old Caucasian female with a fourteen year history of relapsing-remitting MS was admitted to the hospital for evaluation of severe headache, fatigue and dizziness. On physical exam she was tachycardic and very pale. Pertinent labs were as follows: hemoglobin (Hb) 4.1 mg/dL (baseline Hb 10.5 mg/dL), red cell distribution width [...]

Case Presentation: Mr. M is a 66 year old man with a history of a kidney transplant and extensive coronary disease with a recent myocardial infarction and code blue arrest 2 months prior to admission. He presented to an outside facility with altered mental status and seizures attributed to severe hyponatremia (Na 115). The patient [...]

Case Presentation: Anti-thyroid Drugs (ATD) such as propilthiourcil (PTU) and methimazole (MTM) can cause a number of systemic changes such as fever, rash, and respiratory symptoms (from epistaxis to diffuse alveolar hemorrhage). Guidelines almost always recommend MTM over PTU because it has fewer side effects. We present a patient diagnosed with Grave’s Disease who developed [...]

Case Presentation: A 42-year-old man presented to an outside hospital emergency department with a complaint of worsening left hip pain and swelling. He attributed the pain to a sports related injury from a baseball tournament he had participated in the prior week. He was diagnosed with muscle strain on two previous emergency department visits. Additional [...]

Case Presentation: A 68-year-old man presented with dyspnea, wheezing and productive cough. He was hypoxemic and a chest radiograph revealed a left lower lobe infiltrate and he was admitted with a Chronic Obstructive Pulmonary Disease exacerbation and pneumonia. His troponin was mildly elevated and he was started on a heparin infusion. The intravenous line infusing [...]

Case Presentation: A 68-year-old woman with a history of hypertension and possible interstitial lung disease presented with one week of worsening midsternal chest pain, diaphoresis and nausea. Initial vitals were unremarkable. Exam revealed bibasilar crackles but no murmur, gallop, elevated jugular venous pressure or abdominal tenderness. An electrocardiogram showed no acute ischemic changes. Initial troponin [...]

Case Presentation: A 31 year old woman with sickle cell disease (SCD), homozygous SS variant, reported infrequent bony vaso-occlusive crises, necessitating the use of ibuprofen at times, when she presented for a routine clinic visit. Her review of systems was significant for mild unilateral, non-radiating, sharp headaches lasting a few minutes at a time and [...]