Case Presentation: A 69-year-old female with no significant past medical history presented with three weeks of intermittent fevers followed by 24-hours of persistent fever associated with nausea, fatigue, and malaise. She lived in the metro-Boston area and worked part-time as a dog-walker. She reported a tick bite several weeks ago. Vital signs were notable for [...]

Case Presentation: A 46-year-old woman presented with left hemiparesis following elective hip replacement. Past medical history noted essential hypertension currently untreated and bilateral hip dysplasia corrected as a child. She took ibuprofen and hydrocodone-acetaminophen for pain. She was adopted at age two. She smoked a half pack of cigarettes daily. Right total hip arthroplasty was [...]

Case Presentation: A 35 year-old undomiciled male with a history of epilepsy and recurrent aseptic meningitis was brought in to the emergency department after being found unresponsive. Initial vital signs were notable for temperature of 102˚F. He was intubated in the emergency department and a lumbar puncture was done consistent with a bacterial meningitis (WBC [...]

Case Presentation: A 45 yo woman with alcohol use, liver cirrhosis, hepatic encephalopathy and recurrent abdominal ascites, presented to hospital with decreased urine output and abdominal swelling. She was found to have severe acute renal failure and was treated for suspected hepatorenal syndrome with intravenous albumin infusion. She did not recover renal function and required [...]

Case Presentation: A 65 yo male with insulin-dependent diabetes, chronic kidney disease, and bipolar disorder was referred to hospital due to a rising creatinine level and decreased urine output. Home medications included furosemide, insulin, amlodipine, aspirin, quetiapine, lamotrigine and clonazepam. Patient was diagnosed with acute renal failure with serum BUN/creatinine 125 mg/dL / 6.25 mg/dL [...]

Case Presentation: A 57-year-old male patient with a previous history of alcohol use was brought in by his family for progressive myoclonus and confusion. At baseline, this patient performed activities of daily living with ease. He had no history of neurologic disorders, however his mother had been diagnosed with dementia in her 70s. Over the [...]

Case Presentation: A 52 year-old man was hospitalized for hypoxia one month after surgery for ruptured appendicitis. He also reported abdominal pain and steatorrhea along with a 50 pound weight loss in five months. On exam he was anicteric but cachectic. CT pulmonary angiogram on admission revealed peripheral-based pulmonary lesions concerning for septic emboli and [...]

Case Presentation: Insulinoma is a rare tumor that originates in the beta cells of the pancreas with an incidence of 1-4 cases/million persons/year. Less than 10% of insulinomas are malignant and represent a treatment challenge despite the development of new therapeutic approaches in the last decade. A 28 year old female with no past medical [...]

Case Presentation: There is a trend for increasing frequency of primary and secondary syphilis in developed countries, especially in men who have sex with men. Ocular manifestations of syphilis are rare, occurring in less than one in 1 million persons. Distinctive patterns of syphilitic uveitis include white, focal preretinal opacities, and acute posterior placoid uveitis. [...]

Case Presentation: A 21-year old man presented with one day of scrotal swelling and pain. He developed sharp, throbbing pain after unprotected sex with a male partner a day prior. The pain had worsened over the last few hours. He was afebrile, normotensive and tachycardic. His scrotum was enlarged (> 25 centimeters) with well-demarcated erythema [...]