Case Presentation: A 28-year-old woman with sickle cell disease and chronic pain who required inpatient care several times yearly presented with worsening nausea, emesis and uncontrolled pain to the emergency department (ED). Symptoms were typical of prior pain crises. The patient followed regularly with a hematologist undergoing monthly red blood cell exchange transfusions. In the [...]

Case Presentation: A 47 year old female with a history of depression and remote Roux-en-Y gastric bypass surgery, presented for an elective laparoscopic gastrectomy due to hypertrophic pyloric stenosis causing complete gastric remnant outlet obstruction. Her home medications included duloxetine, pantoprazole and alprazolam. Vital signs on admission revealed blood pressure 147/83 mm Hg, pulse 80 [...]

Case Presentation: A twenty-two-year-old male with no significant past medical history who presented with chest pain and found to have ST-segment elevation in leads II, III, aVF and V4-V6 leads. On subsequent EKG’s, patient had new ST-segment elevations in antero-lateral leads with dynamic changes. Cardiac catheterization showed acute dissection with thrombosis of the distal left [...]

Case Presentation: 41 year old male with a history of substance use (Phencyclidine/PCP) was brought to the hospital after being found nude and unconscious outside for an unknown period. At presentation he was awake but mute, not following commands nor tracking with his eyes. He was intermittently agitated. Exam notable for fever 103F, heart rate [...]

Case Presentation: A 32 year old female with Systemic Lupus Erythematosus (malar rash, discoid lupus erythematosus, alopecia) presented with sepsis following a trans-jugular liver biopsy, which was obtained due to chronic transaminitis, thrombocytopenia, hypoalbuminemia, and imaging findings suggestive of early cirrhosis. Liver biopsy showed sinusoidal dilatation without evidence of cirrhosis. Initial work up was notable [...]

Case Presentation: A 52 year-old man with metastatic esophageal adenocarcinoma undergoing chemoradiation presented with two weeks of asymmetric numbness. On initial presentation, he noted progressive, ascending bilateral lower extremity numbness to the waist. Examination was normal, except for decreased pinprick below T10, loss of vibratory sense below mid-thigh, decreased proprioception of the left toe, positive [...]

Case Presentation: A 69-year-old immune-competent male presented with one-month history of fatigue and weakness. Patient endorsed decreased oral intake. He also noted dyspnea on exertion, non-productive cough and peripheral edema. Past medical history was significant for coronary artery disease, hypertension and chronic obstructive pulmonary disease (COPD). He was tachycardic but otherwise normal sinus with clear [...]

Case Presentation: A 61-year-old man presented for a pre-transplant evaluation and complaint of dyspnea on exertion. He also complained of bilateral lower extremity edema and worsening abdominal distension. Past medical history was significant for alcoholic cirrhosis, hypothyroidism, and hypertension. His vital signs were within normal limits and findings on physical exam included diffuse anasarca with [...]

Case Presentation: A 60 year old male with stage IV lung adenocarcinoma metastatic to the brain being treated with carboplatin/pemetrexed and 3 doses of pembrolizumab presented to the emergency department with frequent watery and bloody diarrhea. He had been having >10 stools a day for 6 weeks, lost 35-40 pounds and was unable to eat [...]

Case Presentation: A 51 year old Haitian male with a history of hypertension and what he described as “low sodium” presented to the emergency room with 4 days of dizziness, frontal headache, and nausea preceded by a 2 week onset of dry mouth and malaise. He had been prescribed hydrocortisone on a previous hospitalization, which [...]