Case Presentation: A 78 y/o M with PMH of papillary thyroid CA, BPH, and primary myelofibrosis of the bone marrow (has JAK2 mutation, leukocytosis and thrombocytosis, has not received therapy to date) presented with 8 day history of early satiety, fatigue, and new increasing ascites. An inItial diagnostic paracentesis showed SAAG = 1.1, total protein [...]

Case Presentation: A 37-year-old female veterinarian with past medical history of migraines was diagnosed with multiple sclerosis (MS) in December 2015. In April 2016, she was admitted with 3weeks of progressive dysphagia and 20lb weight loss. Although MRI of the brain and cervical spine obtained during admission showed no new lesions, her symptoms were initially [...]

Case Presentation: 72-year-old male with history of hypertension, Stage IIIB squamous cell cancer of the right lung status post chemo-radiation presented to the clinic for a routine annual physical. He was found to be bradycardic with heart rates in the 40s and was subsequently transferred to our hospital for further management.He was asymptomatic with a [...]

Case Presentation: We present a case of a 72 year-old independent woman on warfarin for recently-diagnosed pulmonary embolism, who was admitted to a local hospital for altered mental status. Upon presentation, a CT scan of the brain showed multiple areas of hemorrhage. The patient was transferred to our tertiary hospital for further management. An MRI [...]

Case Presentation: The patient was a 57 year old male with IgG lambda MM (Multiple Myeloma) without remission after autologous hematopoietic stem cell transplant. One month after transplantation, he developed erythematous right flank swelling, high fever, fatigue and anorexia. CT scan revealed inflammatory stranding of right medial gluteal musculature and pre sacral space which was [...]

Case Presentation: Teriflunomide is a pyrimidine synthesis inhibitor used in management of Relapsing Remitting Multiple Sclerosis (RRMS). Leflunomide is the active agent which has been used in rheumatoid arthritis. Chronic diarrhea has been associated with both of these. However, there is no evidence in literature to suggest clostridium difficile (C.Diff) diarrhea associated with these agents. [...]

Case Presentation: A 56-year-old female with a history of a deep vein thrombosis (DVT) during pregnancy and dementia presented with dyspnea and acute hypoxemia. Shortly thereafter, she developed persistent fevers and acute encephalopathy. Initial testing, including lumbar puncture, chest x-ray, multiple blood cultures, urine cultures, respiratory cultures, and RPR were all unremarkable. CT head was [...]

Case Presentation: A thirty-four year-old man with a past medical history of hyperlipidemia initially presented with sharp, ten-out-of-ten in intensity, epigastric pain associated with nausea and non-bloody emesis. He had never experienced this pain before which prompted his decision to come to the emergency department. He was not able to tolerate oral intake since the [...]

Case Presentation: 78-year-old female with a past medical history of diabetes, hypertension, and vascular dementia was brought to the hospital by her family for worsening dementia, behavioral disturbances including agitation, insomnia, hallucinations and delusions. Her lab workup showed hemoglobin of 11.5 g/dl, troponin of 0.09 ng/ml, CK of 88 u/l, CK-MB of 2.25 ng/ml. Electrocardiogram [...]

Case Presentation: A 44 year-old Hispanic female with a past medical history of hypothyroidism presented from her endocrinologist with a diffuse, maculopapular rash, including the face, hands, wrists, torso, arms and legs. The rash had been intermittent for the past six years, painful, pruritic, and exacerbated by sunlight. She also complained of joint pain and [...]