Case Presentation: This is the case of a 57-year-old lady with rapidly progressive stage IV pulmonary adenocarcinoma who presented two months after diagnosis with findings of significant hyponatremia. Upon admission, she was afebrile, hypotensive and tachycardic. Sodium was 119 mEq/L, potassium 2.4 mEq/L, chloride 67 mEq/L, serum osmolality 246 mosm/kg, urine osmolality 684 mosm/kg and [...]

Case Presentation: A 65-year-old female with a history of sphenoid sinusitis status post recent fiberoptic endoscopic sinus surgery presented with one week of neck stiffness and two days of fever, headache, photosensitivity, and diplopia. Vital signs were: temperature 102.6, heart rate 82, respiratory rate 20, blood pressure 122/45 and 95% room air O2 saturation. Physical [...]

Case Presentation: A 77 year old female with history of prolapsed bladder and back pain was admitted with epidural abscess. Antibiotic therapy with vancomycin and piperacillin/tazobactam was started. She underwent decompression/evacuation of the T12-L4 vertebrae. Cultures of the blood and epidural space grew methicillin-sensitive Staphylococcus aureus. Antibiotics were narrowed to nafcillin. Post-operative course was complicated [...]

Case Presentation: A 19 year old male with no significant medical history presented to the emergency department with one week of fatigue and 2 days of jaundice. He noted new nosebleeds, new shortness of breath particularly when lying flat, abdominal distension, discomfort and constipation. He had no fever, no sore throat, no headache or dizziness, [...]

Case Presentation: A 60-year-old man presented with progressive fatigue, 30-pound weight loss, and arthralgias over six months. He also noted more recent onset of left upper quadrant abdominal discomfort and nonproductive cough. Past medical history was notable for idiopathic thrombocytopenic purpura (ITP) and nephrolithiasis requiring lithotripsy. He had never smoked cigarettes. Examination revealed tender splenomegaly [...]

Case Presentation: A 37-year-old Hispanic female with no medical history presented to the hospital with bilateral lower extremity edema of 3-week duration. Concurrently, she also experienced dysphagia to solids associated with 30-lb weight loss and low-grade fever. Initial examination was significant for bilateral erythematous rash of lower extremities with 3+ pitting edema that extended from [...]

Case Presentation: 68 year-old female presented with three days of progressively worsening myalgias, headaches, fevers after a cruise through Antica, Saint Martin, and Puerto Rico (PR). She also was confused and unable to walk. She had no neck stiffness or photophobia. On exam, she was alert and oriented to name only, with temperature 103 Fahrenheit. [...]

Case Presentation: Urinary retention affects 4.5% and 0.07% of hospitalized men and women, respectively (Verhamme et al, 2008). The causes vary widely; however, it may occur as a result of opioid use. Opioid-induced urinary retention is under-reported in literature. When opioid induced urinary retention occurs, there is the dilemma of achieving resolution, without reversing pain [...]

Case Presentation: A 55-year old man with a history of hypertension presented to the hospital with pleuritic left chest pain for 1 day and enlarging bilateral breasts for 2 months. Initial vital signs were notable for elevated blood pressure of 180/90 mmHg. Physical exam was remarkable for bilateral gynecomastia, areolar tenderness and testicular hypotrophy. Admission [...]

Case Presentation: A 23-year-old woman presented with left lower abdominal pain with mildly elevated creatinine that was identified on routine blood draw at her urology appointment. She had no urinary symptoms; UA and pregnancy test were negative. CT abdomen showed hydronephrosis in the left kidney as well as bilateral ureteral thickening. One month prior, she [...]