Case Presentation: A 69 year old man with stage IV melanoma (with brain, lung, adrenal, and gastric metastases) s/p treatment with three cycles of ipilimumab/nivolumab last 1 week ago presented with 6 days of lightheadedness, nausea, and generalized fatigue. While waiting to see oncologist bystanders witnessed the patient become unconscious with jerking motions of his [...]

Case Presentation: A 24 year-old woman with history of breast cancer status post mastectomy and adjuvant chemoradiation therapy presented with one week of fevers and cervical lymph node enlargement. On presentation, she was febrile with a temperature of 38.7⁰C. Physical exam was notable for tender, firm, bilateral posterior cervical chain lymphadenopathy up to 1cm. WBC [...]

Case Presentation: A 62 year old woman with a history of hypertension suddenly developed a headache starting 3 days after receiving the influenza vaccine. The headache worsened and was associated with nausea, photosensitivity and vomiting. The next day she was lethargic, and that night, her husband states she sat up in bed and started “speaking [...]

Case Presentation: A 32 year old female presented with 2 month history of acute onset pressure-like chest pain occurring after yelling at her children and radiating to the back. The symptoms recurred and become progressive while doing house chores. The pain was relieved by rest. Family history was positive for premature coronary artery disease, dyslipidemia [...]

Case Presentation: A 43 year old male with a past medical history of stage 4 chronic kidney disease, hypertension treated with Minoxidil, former smoker, was initially diagnosed 9 years prior with presumed viral small pericardial effusion that remained stable on follow-up with serial echocardiograms. He presented with dyspnea and chest tightness with exertion, orthopnea, paroxysmal [...]

Case Presentation: The patient is a 70 y.o. female with a history of hypertension, bilateral lower extremity deep vein thrombosis (DVT), and peripheral neuropathy, who was brought to the emergency room (ER) by EMS due to the recent onset of altered mental status. Starting a few days ago, her son noted that she was not [...]

Case Presentation: A 32 year-old female with history of systemic lupus erythematosus, depression and anxiety was admitted to the medical ward with cytomegalovirus pneumonitis and viremia. On hospitalization day 21, patient had an acute change in mental status becoming nonverbal and non-interactive with examiner. Medications at the time of incident were ceftriaxone, valgancyclovir, thiamine, prednisone [...]

Case Presentation: A 32-year-old woman with history of lupus not on steroid or immunosuppressive therapy for more than 10 years presented with headache, generalized weakness, abdominal pain, nausea, vomiting, and malaise. On exam, the patient was afebrile with tachycardia and hypotension. She was ill-appearing with a diffusely tender abdomen, mild hepatomegaly, and enlarged axillary and [...]

Case Presentation: A 49-year-old actively competing male powerlifter presented to our institution for a second opinion of swelling, painful purpura, and necrotic skin ulcerations of the arms and legs. One month prior to presentation, he noticed swelling and discoloration of his right leg, and 10 days prior, he developed a painful ulceration with a central [...]

Case Presentation: A 56 year-old woman with a history of untreated Hepatitis C, anal cancer status post chemotherapy and radiation, current IV heroin use, and MRSA tricuspid valve endocarditis presented with lethargy, jaundice, abdominal pain, oliguria, fevers and lower extremity swelling and rash. On arrival, she initially had fluid-responsive hypotension and fever up to 102. [...]